Long-term functional outcomes in immunoglobulin-treated multifocal motor neuropathy evaluated through the MMN-Rasch-built Overall Disability Scale

Yusuf Rajabally; Roshan  Iqbal; Chinar Osman; Ahmad Alareed; Joumana Freiha

doi:10.1111/jns.70079

Long-term functional outcomes in immunoglobulin-treated multifocal motor neuropathy evaluated through the MMN-Rasch-built Overall Disability Scale

Yusuf Rajabally^*, Roshan Iqbal , Chinar Osman, Ahmad Alareed, Joumana Freiha

^*Corresponding author for this work

College of Health and Life Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background

Long-term functional outcomes are uncertain in immunoglobulin-treated multifocal motor neuropathy (MMN).
Methods

We retrospectively studied consecutive subjects with MMN from two neuromuscular centres in Southampton and Birmingham, UK. Initial and latest MMN-Rasch-built Overall Disability Scale (MMN-RODS) scores and latest immunoglobulin doses were collected. Latest dose alterations and resulting MMN-RODS changes were ascertained.
Results

We included 32 subjects with MMN (14 females and 18 males). Mean age was 60.0 years (SD: 11.7). Over a mean of 6.2 years, MMN-RODS scores improved in 29 out of 32 (90.6%) subjects and worsened in 3 out of 32 (9.4%) subjects. Mean latest centile MMN-RODS was improved compared to mean initial centile MMN-RODS (81.53 [SD: 14.14] vs. 63.47 [SD: 13.82]; p < 0.001). Mean latest immunoglobulin dose was 26.3 g/week (range: 4–70). There were no associations of the latest immunoglobulin dose with age/disease duration/weight/gender/comorbidities/initial disability/latest disability. There were no inter-centre differences in age/disease duration/weight/gender/comorbidities/initial disability/latest disability. The latest mean immunoglobulin dose was higher in Birmingham than in Southampton (33.9 g/week [SD: 17.1] vs. 18.8 g/week [SD: 8.0]; p = 0.004). Immunoglobulin dose dependency was observed in 16 out of 17 subjects whose last dose alteration was incremental, and in only 3 out of 15 subjects whose last dose alteration was decremental. Dose dependency was demonstrated in a greater proportion of subjects from Birmingham compared to Southampton (13/16 vs. 6/16; p = 0.03).
Conclusions

Function as ascertained by the MMN-RODS shows sustained improvement over > 6 years with individualised immunoglobulin dosing in most subjects with MMN. The large inter-centre/inter-individual dosing and dose dependency variations observed may suggest implications of patient- and physician-related factors, which require further study.

Original language	English
Article number	e70079
Number of pages	7
Journal	Journal of the Peripheral Nervous System
Volume	30
Issue number	4
Early online date	17 Nov 2025
DOIs	https://doi.org/10.1111/jns.70079
Publication status	E-pub ahead of print - 17 Nov 2025

Bibliographical note

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society

Keywords

MMN-RODS
dose
immunoglobulin
minimal clinically important difference
multifocal motor neuropathy
outcomes

Access to Document

10.1111/jns.70079Licence: CC BY 4.0

J Peripheral Nervous Sys - 2025 - Noushad - Long‐Term Functional Outcomes in Immunoglobulin‐Treated Multifocal Motor
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society
Final published version, 193 KBLicence: CC BY 4.0

Cite this

@article{4eb296de5f1d4307ba98427e8fd77331,

title = "Long-term functional outcomes in immunoglobulin-treated multifocal motor neuropathy evaluated through the MMN-Rasch-built Overall Disability Scale",

abstract = "BackgroundLong-term functional outcomes are uncertain in immunoglobulin-treated multifocal motor neuropathy (MMN).MethodsWe retrospectively studied consecutive subjects with MMN from two neuromuscular centres in Southampton and Birmingham, UK. Initial and latest MMN-Rasch-built Overall Disability Scale (MMN-RODS) scores and latest immunoglobulin doses were collected. Latest dose alterations and resulting MMN-RODS changes were ascertained.ResultsWe included 32 subjects with MMN (14 females and 18 males). Mean age was 60.0 years (SD: 11.7). Over a mean of 6.2 years, MMN-RODS scores improved in 29 out of 32 (90.6%) subjects and worsened in 3 out of 32 (9.4%) subjects. Mean latest centile MMN-RODS was improved compared to mean initial centile MMN-RODS (81.53 [SD: 14.14] vs. 63.47 [SD: 13.82]; p < 0.001). Mean latest immunoglobulin dose was 26.3 g/week (range: 4–70). There were no associations of the latest immunoglobulin dose with age/disease duration/weight/gender/comorbidities/initial disability/latest disability. There were no inter-centre differences in age/disease duration/weight/gender/comorbidities/initial disability/latest disability. The latest mean immunoglobulin dose was higher in Birmingham than in Southampton (33.9 g/week [SD: 17.1] vs. 18.8 g/week [SD: 8.0]; p = 0.004). Immunoglobulin dose dependency was observed in 16 out of 17 subjects whose last dose alteration was incremental, and in only 3 out of 15 subjects whose last dose alteration was decremental. Dose dependency was demonstrated in a greater proportion of subjects from Birmingham compared to Southampton (13/16 vs. 6/16; p = 0.03).ConclusionsFunction as ascertained by the MMN-RODS shows sustained improvement over > 6 years with individualised immunoglobulin dosing in most subjects with MMN. The large inter-centre/inter-individual dosing and dose dependency variations observed may suggest implications of patient- and physician-related factors, which require further study.",

keywords = "MMN-RODS, dose, immunoglobulin, minimal clinically important difference, multifocal motor neuropathy, outcomes",

author = "Yusuf Rajabally and Roshan Iqbal and Chinar Osman and Ahmad Alareed and Joumana Freiha",

note = "This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. {\textcopyright} 2025 The Author(s). Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society",

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language = "English",

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TY - JOUR

T1 - Long-term functional outcomes in immunoglobulin-treated multifocal motor neuropathy evaluated through the MMN-Rasch-built Overall Disability Scale

AU - Rajabally, Yusuf

AU - Iqbal , Roshan

AU - Osman, Chinar

AU - Alareed, Ahmad

AU - Freiha, Joumana

N1 - This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2025 The Author(s). Journal of the Peripheral Nervous System published by Wiley Periodicals LLC on behalf of Peripheral Nerve Society

PY - 2025/11/17

Y1 - 2025/11/17

N2 - BackgroundLong-term functional outcomes are uncertain in immunoglobulin-treated multifocal motor neuropathy (MMN).MethodsWe retrospectively studied consecutive subjects with MMN from two neuromuscular centres in Southampton and Birmingham, UK. Initial and latest MMN-Rasch-built Overall Disability Scale (MMN-RODS) scores and latest immunoglobulin doses were collected. Latest dose alterations and resulting MMN-RODS changes were ascertained.ResultsWe included 32 subjects with MMN (14 females and 18 males). Mean age was 60.0 years (SD: 11.7). Over a mean of 6.2 years, MMN-RODS scores improved in 29 out of 32 (90.6%) subjects and worsened in 3 out of 32 (9.4%) subjects. Mean latest centile MMN-RODS was improved compared to mean initial centile MMN-RODS (81.53 [SD: 14.14] vs. 63.47 [SD: 13.82]; p < 0.001). Mean latest immunoglobulin dose was 26.3 g/week (range: 4–70). There were no associations of the latest immunoglobulin dose with age/disease duration/weight/gender/comorbidities/initial disability/latest disability. There were no inter-centre differences in age/disease duration/weight/gender/comorbidities/initial disability/latest disability. The latest mean immunoglobulin dose was higher in Birmingham than in Southampton (33.9 g/week [SD: 17.1] vs. 18.8 g/week [SD: 8.0]; p = 0.004). Immunoglobulin dose dependency was observed in 16 out of 17 subjects whose last dose alteration was incremental, and in only 3 out of 15 subjects whose last dose alteration was decremental. Dose dependency was demonstrated in a greater proportion of subjects from Birmingham compared to Southampton (13/16 vs. 6/16; p = 0.03).ConclusionsFunction as ascertained by the MMN-RODS shows sustained improvement over > 6 years with individualised immunoglobulin dosing in most subjects with MMN. The large inter-centre/inter-individual dosing and dose dependency variations observed may suggest implications of patient- and physician-related factors, which require further study.

AB - BackgroundLong-term functional outcomes are uncertain in immunoglobulin-treated multifocal motor neuropathy (MMN).MethodsWe retrospectively studied consecutive subjects with MMN from two neuromuscular centres in Southampton and Birmingham, UK. Initial and latest MMN-Rasch-built Overall Disability Scale (MMN-RODS) scores and latest immunoglobulin doses were collected. Latest dose alterations and resulting MMN-RODS changes were ascertained.ResultsWe included 32 subjects with MMN (14 females and 18 males). Mean age was 60.0 years (SD: 11.7). Over a mean of 6.2 years, MMN-RODS scores improved in 29 out of 32 (90.6%) subjects and worsened in 3 out of 32 (9.4%) subjects. Mean latest centile MMN-RODS was improved compared to mean initial centile MMN-RODS (81.53 [SD: 14.14] vs. 63.47 [SD: 13.82]; p < 0.001). Mean latest immunoglobulin dose was 26.3 g/week (range: 4–70). There were no associations of the latest immunoglobulin dose with age/disease duration/weight/gender/comorbidities/initial disability/latest disability. There were no inter-centre differences in age/disease duration/weight/gender/comorbidities/initial disability/latest disability. The latest mean immunoglobulin dose was higher in Birmingham than in Southampton (33.9 g/week [SD: 17.1] vs. 18.8 g/week [SD: 8.0]; p = 0.004). Immunoglobulin dose dependency was observed in 16 out of 17 subjects whose last dose alteration was incremental, and in only 3 out of 15 subjects whose last dose alteration was decremental. Dose dependency was demonstrated in a greater proportion of subjects from Birmingham compared to Southampton (13/16 vs. 6/16; p = 0.03).ConclusionsFunction as ascertained by the MMN-RODS shows sustained improvement over > 6 years with individualised immunoglobulin dosing in most subjects with MMN. The large inter-centre/inter-individual dosing and dose dependency variations observed may suggest implications of patient- and physician-related factors, which require further study.

KW - MMN-RODS

KW - dose

KW - immunoglobulin

KW - minimal clinically important difference

KW - multifocal motor neuropathy

KW - outcomes

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U2 - 10.1111/jns.70079

DO - 10.1111/jns.70079

M3 - Article

SN - 1085-9489

VL - 30

JO - Journal of the Peripheral Nervous System

JF - Journal of the Peripheral Nervous System

IS - 4

M1 - e70079

ER -

Long-term functional outcomes in immunoglobulin-treated multifocal motor neuropathy evaluated through the MMN-Rasch-built Overall Disability Scale

Abstract

Bibliographical note

Keywords

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