Hoffmann Sarah, Siedler Jana, Brandt Alexander U, Piper Sophie K, Kohler Siegfried, Sass Christian, Paul Friedemann, Reilmann Ralf, Meisel Andreas
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
BMC Neurol. 2015 Dec 23;15:265. doi: 10.1186/s12883-015-0517-8.
Muscular weakness in myasthenia gravis (MG) is commonly assessed using Quantitative Myasthenia Gravis Score (QMG). More objective and quantitative measures may complement the use of clinical scales and might detect subclinical affection of muscles. We hypothesized that muscular weakness in patients with MG can be quantified with the non-invasive Quantitative Motor (Q-Motor) test for Grip Force Assessment (QGFA) and Involuntary Movement Assessment (QIMA) and that pathological findings correlate with disease severity as measured by QMG.
This was a cross-sectional pilot study investigating patients with confirmed diagnosis of MG. Data was compared to healthy controls (HC). Subjects were asked to lift a device (250 and 500 g) equipped with electromagnetic sensors that measured grip force (GF) and three-dimensional changes in position and orientation. These were used to calculate the position index (PI) and orientation index (OI) as measures for involuntary movements due to muscular weakness.
Overall, 40 MG patients and 23 HC were included. PI and OI were significantly higher in MG patients for both weights in the dominant and non-dominant hand. Subgroup analysis revealed that patients with clinically ocular myasthenia gravis (OMG) also showed significantly higher values for PI and OI in both hands and for both weights. Disease severity correlates with QIMA performance in the non-dominant hand.
Q-Motor tests and particularly QIMA may be useful objective tools for measuring motor impairment in MG and seem to detect subclinical generalized motor signs in patients with OMG. Q-Motor parameters might serve as sensitive endpoints for clinical trials in MG.
重症肌无力（MG）患者的肌肉无力通常使用重症肌无力定量评分（QMG）进行评估。更客观和定量的测量方法可能会补充临床量表的使用，并可能检测到肌肉的亚临床病变。我们假设，MG患者的肌肉无力可以通过用于握力评估（QGFA）和不自主运动评估（QIMA）的非侵入性定量运动（Q-Motor）测试进行量化，并且病理结果与通过QMG测量的疾病严重程度相关。
这是一项横断面试点研究，调查确诊为MG的患者。将数据与健康对照（HC）进行比较。受试者被要求举起一个配备电磁传感器的装置（250克和500克），该传感器测量握力（GF）以及位置和方向的三维变化。这些用于计算位置指数（PI）和方向指数（OI），作为肌肉无力导致的不自主运动的测量指标。
总体而言，纳入了40例MG患者和23例HC。在优势手和非优势手，MG患者的PI和OI在两种重量下均显著更高。亚组分析显示，临床眼肌型重症肌无力（OMG）患者的双手和两种重量下的PI和OI值也显著更高。疾病严重程度与非优势手的QIMA表现相关。
Q-Motor测试，尤其是QIMA，可能是测量MG运动障碍的有用客观工具，似乎可以检测OMG患者的亚临床全身性运动体征。Q-Motor参数可能作为MG临床试验的敏感终点。
