Functioning and quality of life in patients with neuropathy associated with anti-MAG antibodies

Abstract

Although anti-myelin-associated glycoprotein (MAG) antibody neuropathy is reported as a slowly progressive disease, it can lead to significant disability and impairment of health-related quality of life (HR-QoL) and social participation. The aim of this cross-sectional study was to evaluate the functioning and HR-QoL determinants in 67 patients with anti-MAG neuropathy in terms of the International Classification of Functioning, Disability, and Health (ICF). Evaluations included: Medical Research Council (MRC) sum score, Sensory Modality Sum score (SMS), Berg balance scale (BBS), Fatigue Severity Scale (FSS), Visual Analogue Scale (VAS) for pain, 9-Hole Peg Test (9-HPT), 6-min Walk Distance (6MWD), Impact on Participation and Autonomy (IPA) and the physical component score (PCS) and mental component score (MCS) of the short-form-36 health status scale (SF-36) HR-QoL measure. In the regression models, 6MWD was the most reliable predictor of PCS, explaining the 52% of its variance, while the strongest determinants of 6MWD were BBS and FSS, explaining the 41% of its variance. Consistently, VAS and BBS were good predictor of PCS, explaining together 54% of its variance. FSS was the most reliable determinant of MCS, explaining 25% of its variance. SMS and MRC were not QoL determinants. The results of our study suggest that 6MWD and FSS might be considered as potential meaningful outcome measures in future clinical trials. Furthermore, neurorehabilitation interventions aimed at improving balance and walking performance, fatigue management, and specific pain relief therapy should be considered to ameliorate participation in social life and HR-QoL in anti-MAG neuropathy patients.Electronic supplementary materialThe online version of this article (10.1007/s00415-018-9081-7) contains supplementary material, which is available to authorized users.

Limitations in daily activities and general perception of quality of life: Long term follow‐up in patients with anti‐myelin‐glycoprotein antibody polyneuropathy

“…6 To date, several scales and measures have been suggested as general functionality parameters in anti-MAG antibody neuropathy, such as the ability to walk 7 or quantitative gait analysis, 8 Recently, a correlation between the objective evaluation of muscular strength with the vigorimeter and the patient's reported scale Inflammatory-RODS (I-RODS) has been observed in immunemediated neuropathies including anti-MAG antibody neuropathies. 9 These findings have been confirmed by another recent study, 10 In a recently published multicenter cross-sectional study 12 we evaluated the functioning and HRQoL determinants in 67 patients with anti-MAG antibody neuropathy in compliance of the terms defined by the ICF. In our cohort we observed that walking ability and fatigue were the most reliable predictors of physical and mental aspects of QoL, respectively.…”

“…In a recently published multicenter cross‐sectional study we evaluated the functioning and HRQoL determinants in 67 patients with anti‐MAG antibody neuropathy in compliance of the terms defined by the ICF. In our cohort we observed that walking ability and fatigue were the most reliable predictors of physical and mental aspects of QoL, respectively.…”

Wearable Health Technology to Quantify the Functional Impact of Peripheral Neuropathy on Mobility in Parkinson’s Disease: A Systematic Review

“…For the examination of balance performances in PNP, the Berg Balance Scale (BBS) was the most used clinical scale [ 73 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ]. BBS is a standard clinical measure to assess static balance impairments and a robust method to study postural control [ 100 ].…”

Antibody testing in neuropathy associated with anti-Myelin-Associated Glycoprotein antibodies: where we are after 40 years

“…MAG neuropathy can present with mild clinical deficit, and remain stable or only slowly progressive for many years, but can then enter a more rapidly progressive course that can lead to disability, probably resulting from cumulative nerve damage [14,15 ▪ ,16]. There is no correlation between antibody titers and severity of the neuropathy, although increasing antibody titers are probably indicative of expansion of the monoclonal gammopathy.…”

“…An increasing number of laboratories use the Buhlmann MAG ELISA kits, in which sera are tested at a single dilution of 1:1000, and the binding quantified by comparison to a standard titration curve generated with serial dilutions of pooled reactive sera [16]. This system allows for quantitative comparisons of antibody binding between different patients, or between serial samples of the same patient.…”