#AANAM – Fatigue Common in MG, Even for People With Milder Forms

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Many people with myasthenia gravis (MG) experience unusual fatigue, including those with pure ocular disease or with milder forms of generalized MG who might also be in remission, and regardless of the severity of muscle weakness, an analysis indicates.

Data also associated fatigue in MG patients with greater motor impairments and worse overall quality of life.

These findings were presented in a poster at the recent American Academy of Neurology (AAN) annual meeting by a team of researchers with Marmara University Hospital in Turkey. It was titled, “Assessment of the Prevalence of Physical and Mental Fatigue in Myasthenia Gravis and Its Correlation with Other Motor and Nonmotor Symptoms.”

Muscle weakness, along with easy fatigability, are two hallmarks of MG. However, the potential effects of fatigue on patients’ quality of life, irrespective of motor difficulties, have not been explored.

Researchers reported the findings of a study that assessed the frequency and effects of fatigue on the quality of life of MG patients, and investigated its possible association with other nonmotor symptoms, such as depression.

Investigators analyzed data from 53 people with either ocular MG or mild generalized MG — in remission or with “minimal” symptoms — as well as 53 healthy volunteers who served as controls. All participants were asked to complete a battery of validated questionnaires assessing the severity of fatigue, depression, and sleep disruptions. MG patients also completed standardized questionnaires on MG severity and life quality.

Analyses of questionnaire scores found patients reported significantly more severe fatigue compared with the control group. Depression scores were also significantly worse among MG patients.

MG patients who experienced more severe fatigue also tended to report greater depression and daytime sleepiness. Researchers also found that depression and sleepiness during the day tended to be more severe among women than men with MG.

People with generalized MG also tended to report more severe fatigue than did those with ocular MG, a disease form in which only the muscles that control eye and eyelid movement are affected.

Fatigue severity in MG patients correlated with the severity of motor signs, the analyses showed, meaning that individuals with more pronounced motor symptoms were also more likely to have substantial fatigue.

The researchers noted that patients reporting substantial fatigue tended to rate their quality of life more poorly than did those with less fatigue.

These findings help to highlight how people with MG can be impacted by unusual fatigue, in ways not always be recognized by clinicians, the team concluded.

“Increased awareness of fatigue and its relationship with other nonmotor symptoms in clinical practice will guide management and positively affect the quality of life of MG patients,” the researchers wrote.