Lemmen Doreen L, van Eijk Ruben P A, van Unnik Jordi W J, Allen Jeffrey A, Rajabally Yusuf A, van den Berg Leonard H, van der Pol W Ludo, Goedee H Stephan
Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
J Peripher Nerv Syst. 2025 Mar;30(1):e70005. doi: 10.1111/jns.70005.
Multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) are immune-mediated neuropathies characterized by muscle weakness and/or sensory deficits. Identifying treatment response, relapse, and stability can be challenging in these chronic, sometimes unpredictable, conditions. This study explores the potential of a monitoring app designed to address these challenges.
Patients were monitored weekly or monthly, based on stability and patient preference, using grip strength, modified timed-up-and go (mTUG), and patient-reported outcome measures (PROMs). User experience was evaluated via a questionnaire addressing content and ease of use (scale 0-10). Adherence was measured as the percentage of completed mandatory assessments. We investigated reliability using intra-class correlation coefficients (ICCs) and standard errors of the mean (SEM) of repeated measurements. Longitudinal changes were analyzed using linear mixed-effects models.
We included 38 patients, with a mean follow-up of 11 months (IQR 4.6-19.5). The mean user experience score was 8.35/10 (range 7-10). Adherence was 93% (95% CI: 91.9%-94.1%). Reported remote measurements for grip strength were 1358/1468 (93%), and 1343/1430 (94%) for mTUG. Grip strength and mTUG ICCs were both 0.96 (95% CI: 0.93-0.98 and 0.92-0.99, respectively). The average SEM was 8.46% (95% CI: 6.58-10.28) for grip strength and 8.18% (95% CI: 6.12-10.41) for mTUG. Only grip strength changed significantly, increasing by 3.1 pounds per 6 months (95% CI: 0.61-5.83; p = 0.016).
Our study demonstrates that tele-neuromonitoring is feasible and reliable, showing high adherence, positive user experience and high ICCs. We anticipate tele-neuromonitoring could complement routine follow-up, enabling clinicians to make better-informed treatment decisions.
多灶性运动神经病（MMN）和慢性炎症性脱髓鞘性多发性神经病（CIDP）是免疫介导的神经病，其特征为肌肉无力和/或感觉障碍。在这些慢性、有时不可预测的病症中，确定治疗反应、复发和病情稳定性可能具有挑战性。本研究探讨了一款旨在应对这些挑战的监测应用程序的潜力。
根据病情稳定性和患者偏好，每周或每月对患者进行监测，监测指标包括握力、改良计时起立行走试验（mTUG）以及患者报告的结局指标（PROMs）。通过一份关于内容和易用性的问卷（0 - 10分制）评估用户体验。以完成的强制评估的百分比衡量依从性。我们使用组内相关系数（ICC）和重复测量的均值标准误差（SEM）来研究可靠性。使用线性混合效应模型分析纵向变化。
我们纳入了38例患者，平均随访11个月（四分位间距4.6 - 19.5个月）。平均用户体验评分为8.35/10（范围7 - 10）。依从性为93%（95%置信区间：91.9% - 94.1%）。报告的握力远程测量数据为1358/1468（93%），mTUG为1343/1430（94%）。握力和mTUG的ICC均为0.96（95%置信区间：分别为0.93 - 0.98和0.92 - 0.99）。握力的平均SEM为8.46%（95%置信区间：6.58 - 10.28），mTUG为8.18%（95%置信区间：6.12 - 10.41）。只有握力有显著变化，每6个月增加3.1磅（95%置信区间：0.61 - 5.83；p = 0.016）。
我们的研究表明远程神经监测是可行且可靠的，具有高依从性、良好的用户体验和高ICC值。我们预计远程神经监测可以补充常规随访，使临床医生能够做出更明智的治疗决策。
