Physical and mental fatigue in myasthenia gravis and its correlation with other symptoms

Suzan, Aysegul Akkan; Koytak, Pınar Kahraman; Uluç, Kayıhan; Tanridag, Tulin

doi:10.1007/s13760-022-01919-y

Cited by 8 publications

(13 citation statements)

References 25 publications

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“…Eye problems and fatigue were also among the most discussed symptoms, reflecting a pattern of symptoms seen in real-world observational studies 7 . Fatigue is common in MG, particularly among women and those with more severe disease 30 , 37 , 38 , and is an important indicator of worsening quality of life 30 , 39 . While one domain of fatigue relates to the muscular disorder that impacts patients’ functional performance (peripheral fatigue), another is independent of muscle weakness, relating to a lack of energy and feelings of tiredness that interfere with patients’ mental and/or physical activities (central fatigue) 30 , 39 .…”

Section: Discussionmentioning

confidence: 99%

“…Fatigue is common in MG, particularly among women and those with more severe disease 30 , 37 , 38 , and is an important indicator of worsening quality of life 30 , 39 . While one domain of fatigue relates to the muscular disorder that impacts patients’ functional performance (peripheral fatigue), another is independent of muscle weakness, relating to a lack of energy and feelings of tiredness that interfere with patients’ mental and/or physical activities (central fatigue) 30 , 39 . In our study, physical and functional impacts of fatigue were discussed more commonly than the mental impact; however, women talked about the mental impact of fatigue more frequently than men (19% vs 8% of conversations).…”

Section: Discussionmentioning

confidence: 99%

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Patient perceptions of disease burden and treatment of myasthenia gravis based on sentiment analysis of digital conversations

Anderson,

Pesa,

Choudhry

et al. 2024

Sci Rep

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Myasthenia gravis (MG) is a rare, autoimmune, antibody-mediated, neuromuscular disease. This study analyzed digital conversations about MG to explore unprovoked perspectives. Advanced search, data extraction, and artificial intelligence-powered algorithms were used to harvest, mine, and structure public domain digital conversations about MG from US Internet Protocol addresses (August 2021 to August 2022). Thematic analyses examined topics, mindsets, and sentiments/key drivers via natural language processing and text analytics. Findings were described by sex/gender and treatment experience with steroids or intravenous immunoglobulin (IVIg). The 13,234 conversations were extracted from message boards (51%), social media networks (22%), topical sites (21%), and blogs (6%). Sex/gender was confirmed as female in 5703 and male in 2781 conversations, and treatment experience was with steroids in 3255 and IVIg in 2106 conversations. Topics focused on diagnosis (29%), living with MG (28%), symptoms (24%), and treatment (19%). Within 3176 conversations about symptoms, eye problems (21%), facial muscle problems (18%), and fatigue (18%) were most commonly described. Negative sentiments about MG were expressed in 59% of conversations, with only 2% considered positive. Negative conversations were dominated by themes of impact on life (29%), misdiagnosis problems (27%), treatment issues (24%), and symptom severity (20%). Impact on life was a key driver of negativity in conversations by both men (27%) and women (34%), and treatment issues was a dominant theme in conversations by steroid-treated (29%) and IVIg-treated (31%) patients. Of 1382 conversations discussing treatment barriers, 36% focused on side effects, 33% on lack of efficacy, 21% on misdiagnosis, and 10% on cost/insurance. Side effects formed the main barrier in conversations by both steroid-treated and IVIg-treated patients. Capturing the patient voice via digital conversations reveals a high degree of concern related to burden of disease, misdiagnosis, and common MG treatments among those with MG, pointing to a need for treatment options that can improve quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient perceptions of disease burden and treatment of myasthenia gravis based on sentiment analysis of digital conversations

Anderson,

Pesa,

Choudhry

et al. 2024

Sci Rep

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“…Inventory (MDI) and the SF-36 [32,[35][36][37][38]. Few studies report using depression and anxiety scales that patients can use on their own, such as the Centre for Epidemiologic Studies Depression Scale, Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Patient Health Questionnaire (PHQ ) [39,40].…”

Section: Anxiety and Depression Scale (Hads) Multiscale Depressionmentioning

confidence: 99%

“…Depression is often associated with fatigue, which can be attributed to an overlap in symptomatology, such as physical fatigue; the HADS excludes physical symptoms and could therefore be useful to overcome this overlap [41]. Both depression/anxiety and fatigue assessments are frequently accompanied by MG-specific assessments (e.g., MG-ADL) to assess disease severity, with positive correlations being demonstrated between fatigue assessments and the MG-ADL [37,41,42].…”

Section: Anxiety and Depression Scale (Hads) Multiscale Depressionmentioning

confidence: 99%

Expert consensus recommendations for improving and standardising the assessment of patients with generalised myasthenia gravis

Meisel,

Saccà,

Spillane

et al. 2024

Euro J of Neurology

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BackgroundRegular and consistent disease assessment could provide a clearer picture of burden in generalised myasthenia gravis (gMG) and improve patient care; however, the use of assessment tools in practice lacks standardisation. This modified Delphi approach was taken to review current evidence on assessment tool use in gMG and develop expert‐derived consensus recommendations for good practice.MethodsA European expert panel of 15 experienced gMG neurologists contributed to development of this consensus, four of whom formed a lead Sub‐committee. The PICO (Population, Intervention, Control, Outcomes) framework was used to define six clinical questions on gMG assessment tools, a systematic literature review was conducted, and evidence‐based statements were developed. According to a modified Delphi voting process, consensus was reached when ≥70% of the experts rated agreement with a statement as ≥8 on a scale of 1–10.ResultsEighteen expert‐ and evidence‐based consensus statements based on six themes were developed. Key recommendations include: consistent use of the Myasthenia Gravis Activities of Daily Living score (MG‐ADL) across clinical settings, followed by a simple question (e.g., Patient Acceptable Symptom State [PASS]) or scale to determine patient satisfaction in clinical practice; use of a Quantitative Myasthenia Gravis [QMG] or quality of life [QoL] assessment when the MG‐ADL indicates disease worsening; and consideration of symptom state to determine the timing and frequency of recommended assessments. Expert panel consensus was reached on all 18 statements after two voting rounds.ConclusionsThis process provided evidence‐ and expert consensus‐based recommendations for the use of objective and subjective assessment tools across gMG research and care to improve management and outcomes for patients.

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“…The 50% concordance in idiopathic chronic fatigue in monozygotic twins suggests that both genetic and environmental factors are important in the pathogenesis 6 . Fatigue is common, with a rate of approximately 20% in the general population 7 . Researchers have investigated the relationship between fatigue and many diseases and revealed that this rate increases up to 50% in cancer, chronic infections, autoimmune, and neurological diseases in which the immune system is affected 8 .…”

Section: Introductionmentioning

confidence: 99%

Fatigue and primary sarcopenia in geriatric patients

Suzan

Kanat

Yavuzer

2022

Rev. Assoc. Med. Bras.

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OBJECTIVE: This study aimed to investigate the frequency of fatigue in geriatric patients with primary sarcopenia and to evaluate the relationship between fatigue and symptoms such as depression and sleepiness. METHODS: This case-control study was conducted between December 2020 and August 2021 in the geriatrics outpatient clinic of Istanbul University-Cerrahpasa. The European Working Group on Sarcopenia in Older People 2 criteria were considered for the diagnosis of sarcopenia. Demographic data, accompanying chronic diseases, comprehensive geriatric assessments, and laboratory values of the patients were noted. Scales used to assess fatigue in all participants include Fatigue Assessment Scale, Fatigue Severity Scale, and Fatigue Impact Scale and associated symptoms include Geriatric Depression Scale and Epworth Sleepiness Scale. RESULTS: The mean (standard deviation) age was 75.3 (7.1) for 51 primary sarcopenia (38 female) patients and 73.5 (5.8) for 51 control (37 female) patients. There was no significant difference between the two groups in terms of gender and age (p=0.822, p=0.171). The prevalence of hypertension was higher, and the level of education was lower in the sarcopenic group than in the nonsarcopenic group (p=0.017, p=0.013). Fatigue Assessment Scale, Fatigue Severity Scale, Fatigue Impact Scale total, Fatigue Impact Scale cognitive, Fatigue Impact Scale physical, and Fatigue Impact Scale social questionnaire scores were significantly higher in the sarcopenic group (all p<0.001). The Geriatric Depression Scale score was statistically higher in the sarcopenic group; however, there was no significant difference in the Epworth Sleepiness Scale score between the two groups (p=0.014, p=0.072). Multivariate analysis was performed on education level, hypertension, fatigue questionnaires, and Geriatric Depression Scale, which were found to be significant in the univariate logistic regression analysis. In the multivariate logistic regression analysis, only the Fatigue Impact Scale total was determined to be associated with sarcopenia [odds ratio 1.161, 95% confidence interval (1.084-1.242)]. CONCLUSION: In primary sarcopenia, there is mental and social fatigue as well as physical fatigue. Therefore, the prevention and treatment of sarcopenia in geriatric patients is important.

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Physical and mental fatigue in myasthenia gravis and its correlation with other symptoms

Cited by 8 publications

References 25 publications

Patient perceptions of disease burden and treatment of myasthenia gravis based on sentiment analysis of digital conversations

Patient perceptions of disease burden and treatment of myasthenia gravis based on sentiment analysis of digital conversations

Expert consensus recommendations for improving and standardising the assessment of patients with generalised myasthenia gravis

Fatigue and primary sarcopenia in geriatric patients

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