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.
Highlights
IntroductionAnti-myelin-associated glycoprotein (MAG) neuropathy is usually slowly progressive, it can sometimes lead to persistent disability and reduced autonomy [2, 3, 7, 8]
Anti-myelin-associated glycoprotein (MAG) neuropathy is a distal symmetric, predominantly sensory polyneuropathy [1,2,3] associated with monoclonal immunoglobulin MGenetics, Maternal and Child Health, University of Genova, IRCCS Policlinico San Martino, Genova, Italy 8 Department of Medical, Surgical and Neurological Sciences, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy1 3 Vol.:(0123456789)Journal of Neurology (2018) 265:2927–2933(IgM) reactive towards MAG [2, 4,5,6]
Our population presented with a predominantly sensory neuropathy with balance impairment, Sum score (SMS) score was altered in almost all patients (65/67, 97.0%), and Berg balance scale (BBS) score in 56 patients (83.6%)
Summary
Anti-MAG neuropathy is usually slowly progressive, it can sometimes lead to persistent disability and reduced autonomy [2, 3, 7, 8]. The International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO), has provided researchers with a framework to understand the interacting consequences of any health condition, ranging from impairments (deficits in body structures and functions) to activity limitations, and participation restrictions [10]. The aim of this study was to evaluate patient’s functioning and health-related quality-of-life (HR-QoL) determinants in terms of the ICF classification, to identify meaningful outcome measure to be used in clinical trials and potential targets for tailored interventions in patients with anti-MAG neuropathy
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