scholarly journals Diagnosis of sleepiness, fatigue and depression in patients with myasthenia gravis

2020 ◽  
Vol 10 (4) ◽  
pp. 27-37
Author(s):  
O. A. Kreis ◽  
T. M. Alekseeva ◽  
Yu. V. Gavrilov ◽  
P. O. Valko ◽  
Yu. Valko

Introduction. Examination of excessive daytime sleepiness, fatigue and depression in patients with myasthenia gravis is important for differential diagnosis of other disorders, and adds to a comprehensive clinical assessment.Objective. The aim is a comprehensive assessment of sleepiness, fatigue and depression and evaluation of the impact of autoimmune comorbidity on these symptoms in myasthenia gravis patients, using newly validated Russian versions of international questionnaires. The present article aims at familiarizing a wider Russian-speaking audience of specialists in the field of neuromuscular disease and sleep medicine with the main findings of our previously published work.Materials and methods. The study included 73 patients with MG and 230 control subjects. For sleepiness, fatigue and depression evaluation were used: Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS) (cognitive / physical / psychosocial subscales), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI) (cognitive-affective and somatic domains), Spielberger–Khanin State Trait Anxiety Inventory (STAI).Results. The Fatigue Severity Scale and Fatigue Impact Scale showed good psychometric properties and can be used to identify distinct aspects of fatigue in patients with myasthenia gravis. The studied patient cohort revealed clinically significant fatigue (69.9 %), excessive daytime sleepiness (15.1 %), moderate to severe depression (20.5 %), a high level of personal (64.4 %) and situational anxiety (27.4 %). Among 13 patients with myasthenia gravis and additional autoimmune comorbidity, there were no significant differences in the severity of sleepiness, fatigue and depression compared with the main group.Conclusion. The use of self-reported scale of sleepiness, fatigue and depression combined with careful clinical-neurological characterization adds to a more comprehensive view of the patient. The identification of sleepiness, fatigue and depression can guide therapeutic decisions and contributes to a better patient care. The presence of concomitant autoimmune pathology in patients with myasthenia gravis does not seem to increase the severity of sleepiness, fatigue and depression.

2013 ◽  
Vol 331 (1-2) ◽  
pp. 102-107 ◽  
Author(s):  
Y.C. Learmonth ◽  
D. Dlugonski ◽  
L.A. Pilutti ◽  
B.M. Sandroff ◽  
R. Klaren ◽  
...  

2008 ◽  
Vol 14 (4) ◽  
pp. 500-505 ◽  
Author(s):  
C. Sauter ◽  
K. Zebenholzer ◽  
J. Hisakawa ◽  
J. Zeitlhofer ◽  
K. Vass

Objective Fatigue management and energy conservation are effective strategies to minimize fatigue in multiple sclerosis (MS). Sustained results have not yet been reported. Methods A fatigue management course was provided for 32 MS patients. They were tested prior to, directly after participation in the course and in a 7—9 month follow-up with the Fatigue Severity Scale, the MS-specific Fatigue Scale, the Modified Fatigue Impact Scale (MFIS), the Pittsburgh Sleep Quality Index and a self-rating scale for depression. The Expanded Disability Status Score (EDSS) and the MS functional composite (MSFC) were evaluated before and after participation in the course. Results The total score and the Cognitive and Physical subscores of the MFIS showed significant improvements on both points of time. Scores in the Fatigue Severity Scale, MS-specific Fatigue Scale and Psychosocial Fatigue Impact Scale did not improve significantly. MS functional composite and EDSS remained unchanged after six weeks of course participation. Subjective sleep quality improved directly after participation in the course and after 7—9 months. The depression score decreased significantly to a normal level at the end of training and in the 7—9 month follow-up. Conclusion Fatigue management enables MS patients to cope with their fatigue and energy more effectively. Follow-up evaluations showed stable results after 7—9 months. Multiple Sclerosis 2008; 14: 500—505. http://msj.sagepub.com


2018 ◽  
Vol 138 (5) ◽  
pp. 408-416 ◽  
Author(s):  
Yury V. Gavrilov ◽  
Galina G. Shkilnyuk ◽  
Philipp O. Valko ◽  
Igor D. Stolyarov ◽  
Elena V. Ivashkova ◽  
...  

2021 ◽  
Vol 38 (2) ◽  
pp. 37-44
Author(s):  
T. V. Baidina ◽  
T. I. Kolesova ◽  
Yu. V. Malinina ◽  
T. N. Trushnikova ◽  
M. A. Danilova

Objective. The aim of the work was to study the fatigue syndrome in various organic brain diseases. Materials and methods. Patients in the recovery period of hemispheric stroke, with Parkinson's disease and multiple sclerosis were examined. Along with the clinical one, there was conducted a study using the asthenia questionnaire MFI-20, FIS (Fatigue Impact Scale), FSS (Fatigue Severity Scale). Results. It has been established that patients with various diseases of the central nervous system have a syndrome of fatigue, which is a nosogenic one, that is, a consequence of organic brain damage.


2006 ◽  
Vol 12 (4) ◽  
pp. 481-486 ◽  
Author(s):  
B R Stanton ◽  
F Barnes ◽  
E Silber

Fatigue is common in multiple sclerosis (MS) and is an important cause of disability. However, the cause of fatigue is poorly understood. This study aimed to describe the frequency and pattern of sleep disturbance in a group of outpatients with MS, and to investigate the relationship between sleep disturbance and fatigue. Sixty outpatients with MS completed the Fatigue Severity Scale (FSS) and the Epworth Sleepiness Scale and kept a sleep diary for seven days. Fatigue and excessive daytime sleepiness were common in this group of patients (64 and 32%). Sleep problems on at least two nights per week occurred frequently, including initial insomnia in 42%, middle insomnia in 53% and terminal insomnia in 58%. The reasons cited for different types of insomnia varied, with anxiety and pain/discomfort being the commonest causes of initial insomnia and nocturia the commonest cause of middle insomnia. Middle insomnia was significantly correlated with daytime fatigue, a relationship that remained after controlling for disability. Sleep disturbance is common in MS and is associated with treatable symptoms, including pain and nocturia. Sleep disturbance may be an important factor contributing to fatigue in patients with MS.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Christian Veauthier ◽  
Gunnar Gaede ◽  
Helena Radbruch ◽  
Klaus-Dieter Wernecke ◽  
Friedemann Paul

Objectives. Pittsburgh Sleep Quality Index (PSQI) values correlate with depression, but studies investigating the relationship between PSQI values and polysomnographic (PSG) data showed inconsistent findings.Methods. Sixty-five consecutive patients with multiple sclerosis (MS) were retrospectively classified as “good sleepers” (GS) (PSQI ≤ 5) and “poor sleepers” (PS) (PSQI > 5). The PSG data and the values of the Visual Analog Scale (VAS) of fatigue, Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and the Beck Depression Inventory (BDI) were compared.Results. No significant differences were found either for PSG data or for ESS, MFIS, and FSS values; but PS showed significantly increased BDI and VAS values.Conclusions. Poor sleep is associated with increased depression and fatigue scale values.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mauro Catalan ◽  
Alessandra De Michiel ◽  
Alessio Bratina ◽  
Susanna Mezzarobba ◽  
Lorella Pellegrini ◽  
...  

The objective of the study was to treat fatigue in patients with multiple sclerosis (MS) by a neurocognitive rehabilitation program aimed at improving motor planning by using motor imagery (MI). Twenty patients with clinically definite MS complaining of fatigue were treated for five weeks with exercises of neurocognitive rehabilitation twice a week. Patients were evaluated by Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), MSQoL54, Expanded Disability Status Scale (EDSS), and MS Functional Composite (MSFC). After treatment, a decrease in fatigue was detected with both FSS () and MFIS (). MSFC () and MSQoL54 () scores improved compared to baseline. At six-month followup, the improvement was confirmed for fatigue (FSS, ; MFIS ) and for the physical subscale of MSQoL54 (). No differences in disability scales were found. These results show that neurocognitive rehabilitation, based on MI, could be a strategy to treat fatigue in MS patients.


2018 ◽  
Vol 5 (2) ◽  
pp. 205510291880976 ◽  
Author(s):  
Laura Angioletti ◽  
Maurizio Bossola ◽  
Daniela De Filippis ◽  
Michela Balconi

Fatigue is an incapacitating symptom for patients on chronic hemodialysis treatment. This study explored the relationship between hemodialysis patients’ subjective experience and motivation. The investigation of patients’ narratives and fatigue-related factors was performed by holding semi-structured interviews with 31 hemodialysis patients. Fatigue Severity Scale and Behavioral Inhibition/Activation System questionnaire were used to assess fatigue severity and motivational mechanisms. Results showed significant differences in the use of specific topics and words (such as “family,” “to manage,” “dialysis,” “psychological issues”) depending on high, medium, and low Behavioral Inhibition System, Behavioral Activation System, and Fatigue Severity Scale scores, indicating that hemodialysis patients’ narratives contain keywords related to the motivational sphere.


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