Prevention of axonal loss after immediate dosage titration of immunoglobulin in multifocal motor neuropathy
Research output: Contribution to journal › Journal article › Research › peer-review
Background: To evaluate whether ongoing axonal loss can be prevented in multifocal motor neuropathy (MMN) treated with immunoglobulin G (IgG), a group of patients with a median disease duration of 15.7 years (range: 8.3–37.8), treated with titrated dosages of immunoglobulins, was studied electrophysiologically at time of diagnosis and at follow-up. Results: At follow-up, the Z-score of the compound motor action potential amplitude of the median, fibular, and tibial nerves and the neurological performances were determined. In seven patients with a treatment-free period of 0.3 years (0.2–0.4), there was no progression of axonal loss (p = 0.2), whereas a trend toward further axonal loss by 1.3 Z-scores (0.9–17.0, p = 0.06) was observed in five patients with a treatment-free period of 4.0 years (0.9–9.0). The axonal loss in the group with a short treatment delay was significantly smaller than in the group with a longer treatment delay (p = 0.02). Also, there was an association between treatment delay and ongoing axonal loss (p = 0.004). The electrophysiological findings at follow-up were associated with the isokinetic strength performance, the neurological impairment score, and the disability, supporting the clinical relevance of the electrophysiological estimate of axonal loss. Conclusion: Swift initiation of an immediately titrated IgG dosage can prevent further axonal loss and disability in continuously treated MMN patients.
Original language | English |
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Journal | European Journal of Neurology |
ISSN | 1351-5101 |
DOIs | |
Publication status | E-pub ahead of print - 2024 |
Bibliographical note
Publisher Copyright:
© 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
- inflammatory neuropathy, multifocal motor neuropathy, neurological disorders, neuromuscular diseases
Research areas
ID: 390590685