Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Biostatistics, Leiden University Medical Center, Leiden, The Netherlands.
Eur J Neurol. 2019 Jun;26(6):947-950. doi: 10.1111/ene.13867. Epub 2018 Dec 17.
Myasthenia gravis activities of daily living (MG-ADL) is a commonly used questionnaire in MG trials. To investigate whether MG-ADL is equally sensitive to oculobulbar and generalized weakness, its correlation with the oculobulbar and generalized domain of the quantitative myasthenia gravis (QMG) score was analyzed (QMGob and QMGgen, respectively). To test whether the sensitivity of MG-ADL for generalized weakness could be improved, the additional value of ACTIVLIM on top of MG-ADL in the prediction QMGgen in was investigated.
MG-ADL, QMG and ACTIVLIM, an ADL questionnaire focusing on generalized weakness, were analyzed in a prospective cohort of 112 MG patients. A generalized linear model was used to calculate the correlation of MG-ADL with QMGob and QMGgen and to assess the additional value of ACTIVLIM on top of MG-ADL for its correlation with QMGgen.
MG-ADL had a higher correlation with QMGob than with QMGgen (B = 0.68, P < 0.001, and B = 0.38, P < 0.001, respectively). A similar trend was found for changes in the scores (B = 0.68, P = 0.132, and B = 0.39, P = 0.492, respectively). ACTIVLIM had a significant additional value on top of MG-ADL in the prediction of QMGgen, both cross-sectionally (B = -0.61, P < 0.001) and for changes within individual patients (B = -0.93, P = 0.041).
MG-ADL has a lower sensitivity for generalized weakness than for oculobulbar weakness. Adding questions on generalized weakness would improve the sensitivity of the MG-ADL for generalized weakness.
重症肌无力日常生活活动（MG-ADL）是重症肌无力试验中常用的问卷。为了研究 MG-ADL 是否同样敏感于眼肌和全身无力，分析了其与定量重症肌无力（QMG）评分的眼肌和全身域（QMGob 和 QMGgen）的相关性（分别为 QMGob 和 QMGgen）。为了测试 MG-ADL 对全身无力的敏感性是否可以提高，研究了在 MG-ADL 基础上增加 ACTIVLIM 对预测 QMGgen 的额外价值。
在 112 例重症肌无力患者的前瞻性队列中分析了 MG-ADL、QMG 和 ACTIVLIM，这是一种侧重于全身无力的 ADL 问卷。使用广义线性模型计算 MG-ADL 与 QMGob 和 QMGgen 的相关性，并评估 ACTIVLIM 在 MG-ADL 基础上对其与 QMGgen 的相关性的额外价值。
MG-ADL 与 QMGob 的相关性高于与 QMGgen 的相关性（B=0.68，P<0.001，B=0.38，P<0.001）。分数的变化也呈现出类似的趋势（B=0.68，P=0.132，B=0.39，P=0.492）。ACTIVLIM 在预测 QMGgen 方面对 MG-ADL 具有显著的额外价值，无论是在横截面（B=-0.61，P<0.001）还是在个体患者的变化（B=-0.93，P=0.041）。
MG-ADL 对全身无力的敏感性低于对眼肌无力的敏感性。增加关于全身无力的问题将提高 MG-ADL 对全身无力的敏感性。
