Diversity in mental fatigue and social profile of patients with myasthenia gravis in two different Northern European countries

Abstract

Self‐estimated health can be used for comparison of different diseases between countries. It is important to elaborate on whether disparities in self‐estimated health are due to disease‐specific parameters or socioeconomic differences. In this study, we aimed at evaluating clinical and social similarities and differences in myasthenia gravis (MG) patients between comparable regions in two Baltic Sea countries, Estonia and Sweden.MethodsThis cross‐sectional study included southern counties in Sweden and Estonia of comparable size. All patients with a confirmed MG diagnosis were asked to answer two questionnaires including demographic and disease‐specific data, lifestyle issues, and mental fatigue (Fatigue Severity Scale [FSS]). Clinical fatigue was assessed objectively through the Quantitative Myasthenia Gravis Score (QMG).ResultsThirty‐six of 92 identified patients in Estonia and 40 of 70 identified MG patients in Sweden chose to participate in the study. The demographic characteristics and symptoms reported by the patients were similar. QMG score did not differ; however, the Estonian patients scored their current subjective disease severity significantly higher (5.6 ± 2.8) compared to the Swedish patients (3.4 ± 2.3, p = .0005). Estonian patients also had significantly higher FSS scores (5.0 ± 1.7) than Swedish patients (3.5 ± 1.6; p = .001). Swedish patients were more active and performed physical activity more regularly (29.1% in Estonia and 74.2% in Sweden, p = .004).ConclusionsAlthough, the patients had comparable clinical fatigue, Estonian patients evaluated their health state as being more severe and reported more mental fatigue than Swedish patients. These data indicate large regional differences in disease perception of MG, which is important to consider in international studies.

Fatigue in patients with myasthenia gravis. A systematic review of the literature

“…Restriction of physical activity was the best predictor of fatigue severity after controlling for the effect of depression [12] . A cohort comparing 36 Estonian and 40 Swedish MG patients showed lower levels of physical activity and higher fatigue scores in Estonian patients, although QMG scores between the two groups did not differ [25] .…”

“…Secondly, chronically decreased levels of physical activity have a negative effect on muscle mass and strength [31] , [32] , likely causing a vicious circle in patients with neuromuscular disorders. Indeed, restriction of physical activity is a good predictor for fatigue severity [12] , [25] . Physical inactivity may lead to obesity.…”

“…Improvement in fatigue scores correlated significantly with improvement in quality of life in both the treatment and placebo group in the REGAIN study [20] . In a study comparing 2 groups of MG patients from Estonia and Sweden, fatigue correlated strongly with self-perceived health status [25] .…”

Circulating miRNAs as Potential Biomarkers in Myasthenia Gravis: Tools for Personalized Medicine

“…Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder with a prevalence of approximately 40-180 per million (1,2). Antibodies in MG are directed against neuromuscular junction antigens; in the majority of patients, to the nicotinic acetylcholine receptor (AChR) in ∼85% and to muscle-specific tyrosine kinase (MuSK) in ∼7% of patients.…”

Lifestyle factors and disease-specific differences in subgroups of Swedish Myasthenia Gravis

“…Seventy patients (34 women, mean age 66 ± 16 years) with a confirmed MG diagnosis and still living in the region were identified, 40 patients agreed to participate in the questionnaire survey (20 women, 64 ± 16 years, response rate 57%), and 34 of them were clinically evaluated.There were no age or gender differences between responders and nonresponders, and clinical data for all participating MG patients were described previously 8. If absent, antibodies were retested even if the first two criteria were fulfilled.…”