Department of Neurology, Marmara University School of Medicine, Fevzi Cakmak, Muhsin Yazıcıoglu Cd No:10, 34899 Pendik/İstanbul, 34899, Istanbul, Turkey.
Acta Neurol Belg. 2022 Aug;122(4):915-923. doi: 10.1007/s13760-022-01919-y. Epub 2022 Mar 25.
Muscle weakness and easy fatigability are the clinical hallmarks of myasthenia gravis (MG). However, fatigue perception, which can be seen quite often in myasthenic patients, and its effect on the quality of life, irrespective of motor deficit, has not been elucidated yet. The aim is to evaluate the frequency of fatigue in myasthenic patients with nearly full muscle strength and the effect of fatigue on quality of life by assessing its correlation with other symptoms.
Fifty-three patients with ocular or mild generalized MG in remission or minimal manifestations completed the questionnaires measuring the severity of MG and quality of life (MG Composite Scale and MG-Activities of Daily Living Profile). Both patient group and control group (53 healthy volunteers)completed the scales assessing fatigue [Fatigue Assessment Scale (FAS) and Fatigue Impact Scale (FIS)], depression [Beck Depression Inventory (BDI)] and sleep (Epworth Sleepiness Scale). Disease severity was assessed using MG Foundation of America (MGFA) and MGFA Post-Intervention Status classifications.
FAS, FIS physical and BDI scores were significantly higher in patients compared to the control group (p = 0.003, p = 0.001, and p = 0.003, respectively) and fatigue was associated with depression and daytime sleepiness. Inpatient group, depressive symptoms and daytime sleepiness were higher in females (p = 0.019 and p = 0.013). The mean values of FIS total and cognitive scores were higher in patients with generalized MG (p = 0.033 and p = 0.045). Fatigue scores correlated with motor signs.
Fatigue can be seen in MG independently from muscle weakness and is an important symptom worsening the quality of life.
肌无力和易疲劳是重症肌无力（MG）的临床特征。然而，疲劳感在 MG 患者中经常出现，且不论运动缺陷如何，其对生活质量的影响尚未阐明。目的是评估几乎完全肌力的 MG 患者疲劳的频率，以及疲劳通过评估其与其他症状的相关性对生活质量的影响。
53 例缓解期或仅有轻微表现的眼肌或轻度全身性 MG 患者完成了评估 MG 严重程度和生活质量的问卷（MG 综合量表和 MG 日常生活活动量表）。患者组和对照组（53 名健康志愿者）都完成了评估疲劳的量表（疲劳评估量表（FAS）和疲劳影响量表（FIS））、抑郁（贝克抑郁量表（BDI））和睡眠（嗜睡量表）。使用美国重症肌无力基金会（MGFA）和 MGFA 干预后状态分类评估疾病严重程度。
与对照组相比，患者的 FAS、FIS 躯体和 BDI 评分明显升高（p=0.003、p=0.001 和 p=0.003），疲劳与抑郁和日间嗜睡有关。住院组女性的抑郁症状和日间嗜睡更为严重（p=0.019 和 p=0.013）。全身性 MG 患者的 FIS 总分和认知评分较高（p=0.033 和 p=0.045）。疲劳评分与运动体征相关。
MG 患者即使没有肌肉无力也会出现疲劳，这是一种重要的症状，会降低生活质量。
