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McCallion J, Borsi A, Noel W, Lee J, Karmous W, Sattler S, Boggia GM, Hardy EJ, Mitchell CR, Mitchell SA, Gilhus NE. Systematic review of the patient burden of generalised myasthenia gravis in Europe, the Middle East, and Africa. BMC Neurol 2024; 24:61. [PMID: 38336636 PMCID: PMC10858594 DOI: 10.1186/s12883-024-03553-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Myasthenia gravis (MG) is a rare autoimmune disease characterised by muscle weakness, and progression from ocular (oMG) to generalised (gMG) symptoms results in a substantial negative impact on quality of life (QoL). This systematic review aimed to provide an overview of the patient burden experienced by people living with gMG. METHODS Electronic database searches (conducted March 2022), supplemented by interrogation of grey literature, were conducted to identify studies reporting patient burden outcomes in patients with gMG in Europe, the Middle East and Africa. Results were synthesised narratively due to the heterogeneity across trials. RESULTS In total, 39 patient burden publications (representing 38 unique studies) were identified as relevant for inclusion in the systematic review, consisting of 37 publications reporting formal patient-reported outcome measures (PROMs), and two publications describing alternative qualitative assessments of patient experience. The studies included a variety of measures including generic and disease-specific PROMs, as well as symptom-specific PROMs focusing on key comorbidities including depression, anxiety, fatigue and sleep disturbance. The findings showed some variation across studies and PROMs; however, in general there was evidence for worse QoL in patients with gMG than in healthy controls or in patients with oMG, and a trend for worsening QoL with increasing MG severity. CONCLUSIONS This review highlights the importance of considering patient QoL when developing and assessing treatment and management plans for patients with gMG. However, the heterogeneity identified across studies illustrates the need for further representative and well-powered studies in large cohorts administering consistent, validated questionnaires. TRIAL REGISTRATION The protocol for this systematic review was registered in PROSPERO: CRD42022328444.
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Affiliation(s)
| | - A Borsi
- Janssen EMEA, Beerse, Belgium
| | - W Noel
- Janssen EMEA, Beerse, Belgium
| | - J Lee
- Janssen EMEA, Beerse, Belgium
| | | | | | | | - E J Hardy
- Mtech Access, Bicester, Oxfordshire, UK
| | | | | | - Nils Erik Gilhus
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.
- Department of Neurology, Haukeland University Hospital, Bergen, Norway.
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Zhou X, Cao S, Hou J, Gui T, Zhu F, Xue Q. Association between myasthenia gravis and cognitive disorders: a PRISMA-compliant meta-analysis. Int J Neurosci 2023; 133:987-998. [PMID: 35285401 DOI: 10.1080/00207454.2022.2031183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/28/2021] [Accepted: 01/06/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This meta-analysis assessed the association between myasthenia gravis (MG) and cognitive disorders. METHODS The PubMed, Web of Science, OVID, EMBASE, CNKI and Wanfang electronic databases were comprehensively searched from inception to October 2020 for relevant studies. The primary outcomes were scores of the cognitive function battery. A random effects model was used to evaluate the cognitive function of patients with MG. RESULTS Eight cross-sectional studies containing 381 patients and 220 healthy controls were included in this meta-analysis. In relation to global cognitive function, patients with MG performed significantly worse than healthy individuals (SMD = -0.4, 95% CI = -0.63 to -0.16, p < 0.001, I2 = 10%). Specifically, the impaired cognitive domains included language, visuospatial function, information processing, verbal immediate and delayed recall memory, visual immediate recall memory, and response fluency, while attention, executive function, and visual delayed recall memory were unimpaired. The patients with early-onset (SMD= -0.527, 95% CI = -0.855 to -0.199, p = 0.002) and generalized MG (SMD= -0.577, 95% CI = -1.047 to -0.107, p = 0.016) had poorer global cognitive performance than the healthy population. CONCLUSIONS Patients with MG may have cognitive disorders, including those associated with the domains of language, visuospatial function, information processing, verbal immediate and delayed recall memory, visual immediate recall memory and response fluency. Furthermore, the age of onset and disease severity may be associated with cognitive disorders in patients with MG.
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Affiliation(s)
- Xiaoling Zhou
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shugang Cao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Jinyi Hou
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Acupuncture and Moxibustion, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou, China
| | - Tiantian Gui
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Feng Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qun Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Stojanov A, Stojanov J, Milosevic V, Malobabic M, Stanojevic G, Stevic M, Djordjevic G. The Impact of the Coronavirus Disease-2019 Pandemic on the Psychological Status and Quality of Life of Myasthenia Gravis Patients. Ann Indian Acad Neurol 2020; 23:510-514. [PMID: 33223669 PMCID: PMC7657293 DOI: 10.4103/aian.aian_551_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives: The coronavirus disease 2019 (COVID-19) is the largest pandemic of our times. We wanted to investigate the impact of COVID-19 pandemic on the psychological status, quality of life (QoL) and quality of sleep (QoS) of myasthenia gravis (MG) patients. Methods: Data on the epidemiological and clinical characteristics of MG were collected. We used a self-designed questionnaire (consisting of 12 questions), a revised 15-item Myasthenia Gravis Quality of Life Questionnaire (MGQOL15r), a 36-item health survey of the Medical Outcomes Study Short Form (SF36), Pittsburgh sleep quality index (PSQI), Hamilton scales for the assessment of anxiety (HAM-A), and depression (HAMD) were used. We reassessed patients who were tested three years ago using the same questionnaires. Results: The study included 64 MG patients. We noticed a statistically significant difference between the results obtained three years ago and the results from April 2020 in PSQI scores (P < 0.01). MGQOL15r, SF36, and PSQI scores correlate with severe clinical manifestation, high scores on HAM-A and HAM-D (P < 0.01). Higher scores on HAM-D and fear that MG symptoms will be worse if the patient gets an upper respiratory infection were independent predictors of the lower SF36 scores. Regarding MGQOL15r-independent predictors of the higher score were higher scores on HAM-D. Conclusions: There is a significant impact of the COVID-19 epidemic on the psychological status and especially on the quality of sleep of MG patients. Healthcare organizations need to provide professional therapeutic advice and psychosocial support for this population of patients during the pandemic.
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Affiliation(s)
| | | | - Vuk Milosevic
- Clinic of Neurology, Clinical Center Nis, Nis, Serbia
| | | | | | | | - Gordana Djordjevic
- Clinic of Neurology, Clinical Center Nis, Nis, Serbia.,Medical faculty, University of Nis, Nis, Serbia
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Stojanov J, Stojanov A, Binić I, Antonijević J, Popević M. QUALITY OF SLEEP IN PATIENTS WITH MYASTHENIA GRAVIS. ACTA MEDICA MEDIANAE 2019. [DOI: 10.5633/amm.2019.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Quality of Life of Myasthenia Gravis Patients in Regard to Epidemiological and Clinical Characteristics of the Disease. Neurologist 2019; 24:115-120. [DOI: 10.1097/nrl.0000000000000238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tascilar NF, Saracli O, Kurcer MA, Ankarali H, Emre U. Is there any relationship between quality of life and polysomnographically detected sleep parameters/disorders in stable myasthenia gravis? Acta Neurol Belg 2018; 118:29-37. [PMID: 28456888 DOI: 10.1007/s13760-017-0787-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
It is known that quality of life in myasthenia gravis is positively correlated with subjective sleep quality, still no data is available regarding the relationship between QOL and polysomnographically detected sleep parameters and disorders. In this study, we tried to highlighten this relationship, by performing polysomnography. Sleep-related complaints were evaluated in face-to-face interviews with 19 clinically stable MG patients and 26 healthy controls. During the interviews questionnaires assessing sleep quality, excessive daytime sleepiness, fatigue, depression, anxiety, and Turkish version of the MG-QOL 15-item scale [(MG-QOL15(T)] were administered and then an overnight polysomnography was performed. Sleep disorders, especially obstructive sleep apnea and fatigue were higher, whereas subjective sleep duration was significantly lower, in patients than controls. Excessive daytime sleepiness and poor sleep quality were not different between patients and controls. Other than percentage of sleep stage III, which was negatively correlated with MG-QOL15(T) scores, neither other sleep parameters nor sleep disorders were correlated with MG-QOL15(T) scores. MG composite, subjective sleep duration, fatigue severity and Hamilton depression rating scale scores were found to be positively correlated with MG-QOL15(T) scores. It was shown that decreasing disease severity and enhancing psychological well-being will improve patients' quality of life. We recommend that our findings should be repeated in a large prospective cohort of MG patients.
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Wu MN, Lai CL, Liu CK, Liou LM, Yen CW, Chen SCJ, Hsieh CF, Hsieh SW, Lin FC, Hsu CY. More severe hypoxemia is associated with better subjective sleep quality in obstructive sleep apnea. BMC Pulm Med 2015; 15:117. [PMID: 26459357 PMCID: PMC4604104 DOI: 10.1186/s12890-015-0112-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 09/28/2015] [Indexed: 11/12/2022] Open
Abstract
Background Perceived sleep quality may play an important role in diagnosis and therapy for obstructive sleep apnea (OSA). However, few studies have assessed factors that are associated with perceived sleep quality in OSA patients. Hypoxemia depresses the central nervous system and attenuates the perceived respiratory load in asthmatic patients. This study aimed to investigate the factors related to perceived sleep quality, focusing on the role of hypoxemia. Methods Polysomnography studies of 156 OSA patients were reviewed. Traditional polysomnographic parameters, including parameters of oxy-hemoglobin saturation (SpO2), were calculated, and the sleep questionnaire and scales were used. Considering the possible pitfalls of absolute values of SpO2 and individualized responses to hypoxemia, the amplitude of desaturation was further computed as “median SpO2 minus lowest 5 % SpO2 “and “highest 5 % SpO2 minus median 5 % SpO2”. Correlations between these parameters and perceived sleep quality, represented as the Pittsburgh sleep quality index (PSQI), were performed. Multiple linear regression analysis was also conducted to investigate the factors associated with the PSQI. Results Although the PSQI was not correlated with the apnea-hypopnea index (r = −0.113, p = 0.162) and oxygen desaturation index (r = −0.085, p = 0.291), the PSQI was negatively correlated with “median SpO2 minus lowest 5 % SpO2” (r = −0.161, p = 0.045). After adjusting for age, total sleep time, the periodic limb movements index, tendency of depression, and the lowest 5 % SpO2, the “median SpO2 minus lowest SpO2” was still a significant predictor for a lower PSQI (β = −0.357, p = 0.015). Conclusions More severe hypoxemia is associated with better perceived sleep quality among OSA patients. This paradox may be associated with hypoxemia-related impairment of perception. The effect of hypoxemia did not appear to be significant in relatively mild hypoxemia but become significant in severe hypoxemia.” Median SpO2 minus lowest 5 % SpO2” may also be a better predictor of perceived sleep quality than the apnea-hypopnea index because of the disproportionate effects of hypoxemia. Additionally, further studies are necessary to confirm the role of hypoxemia on perceived sleep quality and identify the possible threshold of hypoxemia in OSA patients.
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Affiliation(s)
- Meng-Ni Wu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Chiou-Lian Lai
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Ching-Kuan Liu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Li-Min Liou
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan. .,Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, No. 482 Shanming Rd., Siaogang Dist., Kaohsiung City, 812, Taiwan.
| | - Chen-Wen Yen
- Department of Mechanical and Electro-mechanical Engineering, National Sun Yat-Sen University, No. 70 Lienhai Rd., Kaohsiung, 80424, Taiwan.
| | - Sharon Chia-Ju Chen
- Department of Medical Imaging and Radiation Sciences, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Cheng-Fang Hsieh
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Division of Geriatrics and Gerontology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Sun-Wung Hsieh
- Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan. .,Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, No. 482 Shanming Rd., Siaogang Dist., Kaohsiung City, 812, Taiwan.
| | - Feng-Cheng Lin
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Health, Pingtung Hospital, No. 270, Ziyou Rd., Pingtung City, Pingtung County, 900, Taiwan.
| | - Chung-Yao Hsu
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
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Yeh JH, Lin CM, Chiu HC, Bai CH. Home sleep study for patients with myasthenia gravis. Acta Neurol Scand 2015; 132:191-5. [PMID: 25691116 DOI: 10.1111/ane.12382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of the study was to examine predictors for sleep-disordered breathing (SDB) in patients with myasthenia gravis (MG) using Watch-PAT. MATERIALS AND METHODS We prospectively studied 58 consecutive patients with MG without respiratory symptoms for a full-night Watch-PAT with concomitant recording of the MG score and acetylcholine receptor antibody concentration and analyzed potential risk factors of SDB. RESULTS Twenty-four patients (41%) had definitive SDB, which was mild in 12 patients, moderate in six, and severe in six. Assessing risk factors with multivariate models, we found four significant predictors (BMI, age, male gender, and use of azathioprine); BMI was the most powerful predictor. The severity and prevalence of sleep-disordered breathing had no significant association with MG score, myasthenia stage, or seropositivity of acetylcholine receptor antibody. CONCLUSIONS The prevalence of SDB in myasthenic patients with mild and moderate weakness was high when using the Watch-PAT. Both myasthenia-specific factors (use of azathioprine) and general predictors in terms of BMI, age, and male gender predisposed the development of SDB in patients with myasthenia gravis. Careful screening of patients with myasthenia gravis at risk of SDB using Watch-PAT might improve the quality of sleep and cardiovascular health through proper treatment of underlying SDB.
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Affiliation(s)
- J.-H. Yeh
- Department of Neurology; Shin Kong Wu Ho-Su Memorial Hospital; Taipei Taiwan
- College of Medicine; Fu-Jen Catholic University; New Taipei Taiwan
| | - C.-M. Lin
- College of Medicine; Fu-Jen Catholic University; New Taipei Taiwan
- Sleep Center; Shin Kong Wu Ho-Su Memorial Hospital; Taipei Taiwan
| | - H.-C. Chiu
- Department of Neurology; Shin Kong Wu Ho-Su Memorial Hospital; Taipei Taiwan
- College of Medicine; Fu-Jen Catholic University; New Taipei Taiwan
| | - C.-H. Bai
- Department of Public Health; School of Public Health; Taipei Medical University; Taipei Taiwan
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Fernandes Oliveira E, Nacif SR, Alves Pereira N, Fonseca NT, Urbano JJ, Perez EA, Cavalcante V, Santos Oliveira C, Insalaco G, Oliveira ASB, Oliveira LVF. Sleep disorders in patients with myasthenia gravis: a systematic review. J Phys Ther Sci 2015; 27:2013-8. [PMID: 26180370 PMCID: PMC4500033 DOI: 10.1589/jpts.27.2013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/14/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This systematic review evaluated the presence of sleep-disordered breathing in
patients with myasthenia gravis and clarified the role of physiotherapy. [Subjects and
Methods] We followed the PRISMA declaration criteria. The evaluation was performed in
accordance with the STROBE statement for observational and cross-sectional studies and the
CONSORT checklist for clinical trials. Searches were followed by hand on MEDLINE, EMBASE,
SciELO, PubMed Central, and the Cochrane Central Register of Controlled Trials. [Results]
Our searches yielded a total of 36 studies published between 1970 and 2014. The number of
patients involved ranged from 9–490. Of the 36 studies, 19 articles were excluded because
they did not meet the inclusion criteria. Therefore, 17 observational, cross-sectional, or
clinical studies assessing the quality of sleep and prevalence of sleep disorders in
patients with myasthenia gravis were eligible for our review. [Conclusion] Some studies of
patients with MG show that patients with MG are associated with poor sleep quality,
excessive daytime sleepiness, presence of restless syndrome, and a higher incidence of
SDB, while other studies do not report such associations. Therefore, given the current
inconclusive evidence and limited literature, further study of sleep disturbances in
patients with MG is needed.
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Affiliation(s)
| | - Sergio R Nacif
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, Brazil
| | - Nixon Alves Pereira
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, Brazil
| | - Nina Teixeira Fonseca
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, Brazil
| | - Jéssica Julioti Urbano
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, Brazil
| | - Eduardo Araújo Perez
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, Brazil
| | - Valéria Cavalcante
- Division of Neuromuscular Disorders, Department of Neurology and Neurosurgery, Federal University of Sao Paulo (UNIFESP), Brazil
| | - Claudia Santos Oliveira
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, Brazil
| | - Giuseppe Insalaco
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology "A. Monroy", Italy
| | - Acary Sousa Bulle Oliveira
- Division of Neuromuscular Disorders, Department of Neurology and Neurosurgery, Federal University of Sao Paulo (UNIFESP), Brazil
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Raggi A, Schiavolin S, Leonardi M, Antozzi C, Baggi F, Maggi L, Mantegazza R. Development of the MG-DIS: an ICF-based disability assessment instrument for myasthenia gravis. Disabil Rehabil 2013; 36:546-55. [PMID: 23781909 DOI: 10.3109/09638288.2013.804591] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To develop a preliminary version of a disease-specific, patient-reported disability assessment instrument for myasthenia gravis (MG) based on the International Classification of Functioning, Disability and Health (ICF): the MG-DIS. METHODS Five consecutive steps were taken: literature review and selection of outcome measures; linking of measures' concepts to ICF categories and selection of those reported by 30% of the instruments; comparison of linking results with a previous selection of MG-relevant ICF categories; patient interview; development of questions based on retained ICF categories. RESULTS Thirty-one papers containing 21 different outcome measures were found: 13 ICF categories were linked to them. Fifty-five items were retained after the comparison with the list of MG-specific categories, and were used for patient interview. Thirteen interviews were conducted before saturation of data was reached and the final list was composed of 42 categories: based upon them, 44 questions were developed. CONCLUSIONS The preliminary version of the MG-DIS contains more information than each single MG-specific tool, in particular, for the component of environmental factors. Further research is needed to test its psychometric properties. IMPLICATIONS FOR REHABILITATION It is important that patient-reported outcome is incorporated in MG patient's assessment. MG features can be evaluated with ICF-based methods. An MG-specific patient-reported disability assessment instrument can be used to monitor changes of functioning in patients on MG-specific treatments, and can be used in clinical trials as outcome measure.
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Martínez-Lapiscina EH, Martínez De Lapiscina EH, Erro ME, Erro Aguirre ME, Ayuso T, Ayuso Blanco T, Jericó I, Jericó Pascual I. Myasthenia gravis: sleep quality, quality of life, and disease severity. Muscle Nerve 2012; 46:174-80. [PMID: 22806365 DOI: 10.1002/mus.23296] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION There is much research on quality of life in myasthenia gravis (MG), and its relationship to disease severity is well-established. However, evidence regarding sleep disturbance in MG is inconclusive. METHODS To evaluate sleep and quality of life among clinically stable MG patients, 54 subjects were investigated by means of the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and 15-Item-Quality-Of-Life Instrument for MG (MG-QOL15). RESULTS A pathological PSQI score, which was observed in 59% of patients, was increased in subjects with active disease compared with patients in clinical remission [odds ratio = 4.3; confidence interval 95% (1.0-17.6); P = 0.04]. We found a relationship between PSQI and MG-QOL15 scores in patients with clinically active disease (r = 0.62; P < 0.001). CONCLUSIONS Our study highlights the high prevalence of sleep disturbance among MG patients. Disease severity may be considered to be a MG-specific risk factor for patient-reported sleep disturbance. The MG-QOL15 and PSQI should be used to estimate the impact of the disease on sleep and quality of life.
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Sieminski M, Bilinska M, Nyka WM. Increased Frequency of Restless Legs Syndrome in Myasthenia Gravis. Eur Neurol 2012; 68:166-70. [DOI: 10.1159/000339485] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 05/13/2012] [Indexed: 11/19/2022]
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Yeh JH, Chen WH, Chiu HC, Lee CT, Hsu CY. Plasmapheresis Does Not Affect Polysomnographic Parameters in Patients With Myasthenia Gravis: A Case Series Study. Artif Organs 2010; 34:E200-3. [DOI: 10.1111/j.1525-1594.2009.00975.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Concordance between severity of disease, disability and health-related quality of life in Myasthenia gravis. Neurol Sci 2009; 31:41-5. [DOI: 10.1007/s10072-009-0167-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 09/29/2009] [Indexed: 01/06/2023]
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