Authors: David Cioncoloni Stefania Casali Federica Ginanneschi Marisa Carone Boni Veronica Alessandro Rossi Fabio Giannini
Publish Date: 2016/04/01
Volume: 37, Issue: 5, Pages: 717-723
Abstract
Myasthenia gravis MG is an autoimmune neuromuscular disorder in which disabling muscle weakness may affect healthrelated quality of life HRQoL The aim of this study was to investigate which common motorfunctional deficits and corresponding severity are most determinant of poor HRQoL in these patients In 41 patients the dichotomized first item of the Italian Myasthenia Gravis Questionnaire IMGQ categorizing patients who report “good” and “poor” HRQoL was chosen as dependentoutcome variable All items composing the myasthenia gravisspecific scale MGADL ie talking chewing swallowing breathing impairment of ability to brush teeth or comb hair impairment of ability to rise from chair double vision and eyelid droop were acquired as independent variables and dichotomized Stepwise backward LR multivariable logistic regression analysis was performed In addition the main characteristics of patients were compared MGADL items “chewing” ≥1 ie “fatigue chewing solid food” and “breathing” ≥2 ie “shortness of breath at rest” proved to be significant determinants Higher dose of corticosteroid therapy was significantly p = 0027 r s = −035 correlated with poor HRQoL At diagnosis a decremental response to repetitive nerve stimulation RNS from the abductor pollicis brevis was significantly more frequent in patients with poor HRQoL In conclusion impaired “chewing” and “breathing” functions indicate the need for careful planning of rehabilitation reeducation and patient management Moreover decremental response to RNS at diagnosis may identify patients at risk for poor HRQoLThis manuscript has not been published before and is not being considered for publication elsewhere I exclude any financial or other relationships that might lead to a conflict of interest The authors and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subjects of this article
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