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重症肌无力患者的昼夜认知功能:以昼夜节律类型和抑郁为研究对象的一项初步研究

Diurnal cognitive functioning in patients with myasthenia gravis with the role of chronotype and depression: a pilot study.

作者信息

Wiłkość-Dębczyńska Monika, Liberacka-Dwojak Magdalena, Rzepiński Łukasz, Gilhus Nils E

机构信息

Faculty of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland.

Sanitas - Outpatient Neurology Clinic, Bydgoszcz, Poland.

出版信息

Postep Psychiatr Neurol. 2024 Jun;33(2):49-53. doi: 10.5114/ppn.2024.141051. Epub 2024 Jul 11.

Abstract

PURPOSE

Myasthenia gravis (MG) is an autoimmune disease manifested by fatigue and weakness of the skeletal muscles. Recent research has indicated that MG patients perform significantly worse than healthy controls in cognitive domains such as attention, verbal fluency, visual learning, and memory. This study aimed to investigate the diurnal fluctuations in cognitive performance in patients with myasthenia gravis in relation to selected clinical and socioeconomic parameters of the disease course, along with the role of chronotype and depression.

METHODS

The participants were recruited from a neurology outpatient clinic. Patients' cognitive functions were assessed twice: in the morning and the evening of the same day. Neuropsychological diagnosis included attention, memory, executive, verbal, and visuospatial abilities. Mood was measured with the Beck Depression Inventory-II and Positive and Negative Affect Schedule. The Morningness-Eveningness Questionnaire was used to examine chronotype.

RESULTS

The analyses performed showed no significant differences between subjects and within subjects, apart from semantic fluency. Patients receiving antidepressant treatment obtained better results on attention and working memory tasks.

CONCLUSIONS

The data obtained show that diurnal neuropsychological performance in MG patients is associated with depression. Routine assessment and treatment of mood disorders could significantly improve cognitive functioning in myasthenia gravis patients.

摘要

目的

重症肌无力(MG)是一种自身免疫性疾病,表现为骨骼肌疲劳和无力。最近的研究表明,重症肌无力患者在注意力、语言流畅性、视觉学习和记忆等认知领域的表现明显比健康对照者差。本研究旨在调查重症肌无力患者认知表现的昼夜波动情况,及其与疾病进程中选定的临床和社会经济参数的关系,同时探讨昼夜节律类型和抑郁的作用。

方法

参与者从神经内科门诊招募。在同一天的上午和晚上对患者的认知功能进行两次评估。神经心理学诊断包括注意力、记忆力、执行能力、语言能力和视觉空间能力。使用贝克抑郁量表第二版和正负性情绪量表测量情绪。使用晨型-夜型问卷来检查昼夜节律类型。

结果

除语义流畅性外,所进行的分析显示受试者之间和受试者内部均无显著差异。接受抗抑郁治疗的患者在注意力和工作记忆任务上取得了更好的成绩。

结论

所获得的数据表明,重症肌无力患者的昼夜神经心理学表现与抑郁有关。对情绪障碍进行常规评估和治疗可显著改善重症肌无力患者的认知功能。

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本文引用的文献

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Myasthenia Gravis and Congenital Myasthenic Syndromes.重症肌无力与先天性肌无力综合征
Continuum (Minneap Minn). 2019 Dec;25(6):1767-1784. doi: 10.1212/CON.0000000000000800.
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Myasthenia gravis.重症肌无力。
Nat Rev Dis Primers. 2019 May 2;5(1):30. doi: 10.1038/s41572-019-0079-y.

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