Evaluation of nonmotor symptoms in myasthenia gravis patients

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.

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.

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.

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.