Demiroglu Bilim University Medical Faculty, Neurology Department, Istanbul, Turkey.
Memorial Bahcelievler Hospital, Neurology Department, Istanbul, Turkey.
Ideggyogy Sz. 2021 Jan 30;74(1-2):33-40. doi: 10.18071/isz.74.0033.
Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors.
This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment.
The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033).
The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.
重症肌无力（MG）是一种自身免疫性神经肌肉传递障碍。自主神经功能障碍并不是 MG 的常见并发症。我们进行这项研究旨在评估 MG 及亚组的自主功能，并研究乙酰胆碱酯酶抑制剂的作用。
本研究纳入了 30 名自身免疫性 MG 患者和 30 名健康志愿者。进行了自主神经测试，包括交感皮肤反应（SSR）和 R-R 间期变化分析（RRIV）。对于正在服用乙酰胆碱酯酶抑制剂的患者，在当前评估期间进行了两次测试。
RRIV 在过度通气期间的升高更好（p=0.006），对照组的瓦尔萨尔瓦比值较低（p=0.039）。药物摄入后 SSR 振幅降低（p=0.030）。随着药物给药后时间的推移，SSR 潜伏期延长（p=0.043）。乙酰胆碱受体抗体阴性组的瓦尔萨尔瓦比值较低（p=0.033）。
研究结果表明，眼肌型/全身型 MG 患者均存在亚临床副交感神经异常，且在乙酰胆碱受体抗体阴性组更为明显，吡啶斯的明具有外周交感胆碱能非累积效应。
