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重症肌无力患者非运动症状的评估

Evaluation of nonmotor symptoms in myasthenia gravis patients.

作者信息

Tekeşin Aysel, Şişman Çağla, Toprak Ufuk Emre, Sar Alena, Akalin Burcu, Koşargelir Goncagül, Tütüncü Melih, Yiğit Enes

机构信息

Department of Neurology, İstanbul Training and Research Hospital, Health Sciences University, İstanbul, Turkiye.

Department of Otolaryngology-Head and Neck Surgery, İstanbul Training and Research Hospital, Health Sciences University, İstanbul, Turkiye.

出版信息

Turk J Med Sci. 2024 Oct 19;55(1):127-139. doi: 10.55730/1300-0144.5951. eCollection 2025.

Abstract

BACKGROUND/AIM: Myasthenia gravis (MG) is chronic autoimmune disorder characterized primarily by muscle weakness and fatigue, due to autoantibodies targeting acetylcholine receptor at neuromuscular junction. Herein, it was aimed to evaluate nonmotor symptoms in MG patients and compare them with disease duration, severity, and clinical features.

MATERIALS AND METHODS

This prospective study was conducted with two groups: 35 MG patients and 35 healthy volunteers. The patient group comprised 17 females and 18 males with a mean age of 52.9 ± 13.6 years. The control group comprised 23 females and 12 males with a mean age of 46.9 ± 12.2 years. The Myasthenia Gravis Foundation of America clinical classification and Myasthenia Gravis Composite and Turkish version of the Myasthenia Gravis Quality of Life 15 scales were applied to the patient group. To assess nonmotor functions, questionnaires evaluating the symptoms of headache, pain, depression, anxiety, sleep, physical activity, cognition, smell, and taste were applied to both the patient and control groups.

RESULTS

The results revealed prevalent and diverse nonmotor symptoms in the MG group. The Montreal Cognitive Assessment (MoCA) score and degree of olfactory function in cinnamon was statistically significantly (p < 0.05) lower in the patient group than in the control group. The degree of impairment on the MoCA, headache rate, Beck depression score, depression rate, Beck anxiety score, anxiety rate, Pittsburgh Sleep Quality Index (PSQI) score, and poor sleep quality rate were significantly higher (p < 0.05) in the patient group than in the control group.

CONCLUSION

In conclusion, this study emphasizes the importance of recognizing and managing nonmotor symptoms in MG patients, advocating for a multidisciplinary approach to care that addresses both motor and nonmotor manifestations. By expanding our understanding of the systemic impact of MG and exploring new treatment modalities, we can improve the lives of those living with this complex autoimmune disorder. Further research is needed to elucidate the pathogenic mechanisms underlying these nonmotor manifestations, which will be pivotal in developing more targeted and effective therapeutic strategies.

摘要

背景/目的:重症肌无力(MG)是一种慢性自身免疫性疾病,主要特征为肌肉无力和疲劳,这是由于自身抗体靶向神经肌肉接头处的乙酰胆碱受体所致。本研究旨在评估MG患者的非运动症状,并将其与疾病持续时间、严重程度及临床特征进行比较。

材料与方法

本前瞻性研究分为两组:35例MG患者和35名健康志愿者。患者组包括17名女性和18名男性,平均年龄为52.9±13.6岁。对照组包括23名女性和12名男性,平均年龄为46.9±12.2岁。对患者组应用美国重症肌无力基金会临床分类、重症肌无力综合量表以及土耳其语版重症肌无力生活质量15量表。为评估非运动功能,对患者组和对照组均应用了评估头痛、疼痛、抑郁、焦虑、睡眠、身体活动、认知、嗅觉和味觉症状的问卷。

结果

结果显示MG组存在普遍且多样的非运动症状。患者组的蒙特利尔认知评估(MoCA)得分及肉桂嗅觉功能程度在统计学上显著低于对照组(p<0.05)。患者组的MoCA受损程度、头痛发生率、贝克抑郁评分、抑郁发生率、贝克焦虑评分、焦虑发生率、匹兹堡睡眠质量指数(PSQI)得分及睡眠质量差的发生率均显著高于对照组(p<0.05)。

结论

总之,本研究强调了识别和管理MG患者非运动症状的重要性,提倡采用多学科护理方法来解决运动和非运动表现。通过扩大我们对MG全身影响的理解并探索新的治疗方式,我们可以改善患有这种复杂自身免疫性疾病患者的生活。需要进一步研究以阐明这些非运动表现背后的致病机制,这对于制定更具针对性和有效性的治疗策略至关重要。

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