{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:39:24Z","timestamp":1790278764067,"version":"4.1.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Multifocal motor neuropathy (MMN) is a chronic immune-mediated disorder associated with long-term disability and reduced quality of life (QoL). Longitudinal real-world data on QoL in MMN are scarce, particularly during the COVID-19 era. This study aimed to evaluate long-term changes in QoL and disease outcomes in MMN patients over a 6-year follow-up and to assess the multidimensional impact of the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twelve MMN patients were re-evaluated 6 years after baseline assessment. Functional disability was assessed using the INCAT disability score and I-RODS scale. QoL was measured using the SF-36 questionnaire, while depressive symptoms and fatigue were evaluated using the Beck Depression Inventory (BDI) and Fatigue Severity Scale (FSS). Pandemic-related impact was assessed using a specifically designed questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Functional disability remained overall stable during follow-up (INCAT total score 3.4\u202f\u00b1\u202f2.2 vs. 3.3\u202f\u00b1\u202f1.9). However, fatigue and depressive symptoms increased significantly, with the prevalence of fatigue rising from 17 to 58% and depression from 8 to 25% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Mean FSS scores increased from 20.1\u202f\u00b1\u202f13.3 to 35.3\u202f\u00b1\u202f15.0, and BDI scores from 3.3\u202f\u00b1\u202f7.8 to 9.2\u202f\u00b1\u202f15.4. Physical QoL domains declined over time, particularly Physical Functioning (76.7\u202f\u00b1\u202f29.9 to 57.5\u202f\u00b1\u202f31.6) and Bodily Pain (82.8\u202f\u00b1\u202f28.9 to 71.7\u202f\u00b1\u202f28.5), while mental domains remained relatively preserved (MCS 69.1\u202f\u00b1\u202f19.5 vs. 69.4\u202f\u00b1\u202f21.3). During the COVID-19 pandemic, 33% of patients developed SARS-CoV-2 infection, 17% experienced treatment interruption, and one patient died from severe COVID-19.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Long-term immunotherapy in MMN appears to stabilize motor disability but does not prevent the progressive increase of fatigue and depressive symptoms, which emerge as major contributors to long-term disease burden. The COVID-19 pandemic further affected healthcare access and psychosocial wellbeing. These findings support routine screening for fatigue and mental health symptoms and highlight the need for a multidisciplinary approach to MMN management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnhum.2026.1824742","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:56:17Z","timestamp":1778219777000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term motor stability but increasing non-motor burden in multifocal motor neuropathy: a 6-year real-world follow-up study during the COVID-19 era"],"prefix":"10.3389","volume":"20","author":[{"given":"Ivana","family":"Basta","sequence":"first","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]},{"name":"University of Belgrade-Faculty of Medicine","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Jeremic","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksa","family":"Palibrk","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Momcilovic","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vukan","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mladen","family":"Jankovic","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nenad","family":"Jovanovic","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Bulatovic","sequence":"additional","affiliation":[{"name":"Neurology Clinic, University Clinical Center of Montenegro","place":["Podgorica, Montenegro"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stojan","family":"Peric","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]},{"name":"University of Belgrade-Faculty of Medicine","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Bozovic","sequence":"additional","affiliation":[{"name":"University Clinical Center of Serbia-Neurology Clinic","place":["Belgrade, Serbia"]},{"name":"University of Belgrade-Faculty of Medicine","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/0272-7358(88)90050-5","article-title":"Psychometric properties of the Beck depression inventory","volume":"8","author":"Beck","year":"1988","journal-title":"Clin. 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