The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis
Abstract Repetitive nerve stimulation (RNS) is a standard test for the diagnosis of myasthenia gravis (MG), where decrement of compound muscle action potentials (CMAP) corresponds to clinical muscle fatigability. Our aim was to ascertain the diagnostic and prognostic utility of RNS in MG patients. T...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-30154-5 |
| _version_ | 1797864698065977344 |
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| author | Matthias Tomschik Eva Renaud Fiona Jäger Chiara Paternostro Jakob Rath Walter Rinner Gudrun Zulehner Fritz Zimprich Hakan Cetin |
| author_facet | Matthias Tomschik Eva Renaud Fiona Jäger Chiara Paternostro Jakob Rath Walter Rinner Gudrun Zulehner Fritz Zimprich Hakan Cetin |
| author_sort | Matthias Tomschik |
| collection | DOAJ |
| description | Abstract Repetitive nerve stimulation (RNS) is a standard test for the diagnosis of myasthenia gravis (MG), where decrement of compound muscle action potentials (CMAP) corresponds to clinical muscle fatigability. Our aim was to ascertain the diagnostic and prognostic utility of RNS in MG patients. This study included MG patients treated between 01/2000 and 12/2016, with an observational period of at least one year and a minimum of two neurological examinations. Clinical and electrophysiological data were retrospectively gathered from patient records, and CMAP decrement was correlated with autoantibody titers and clinical disease severity at different time points. Ninety-four patients were included, with 88.3% of the cohort testing positive for acetylcholine receptor autoantibodies (AChR-Abs). RNS sensitivity was higher in patients with generalized disease (71.6%) than in purely ocular MG (38.5%). CMAP decrement did not significantly correlate with AChR-Ab titers, nor with clinical symptom severity at the time of testing or last follow up. However, there was a significant correlation between CMAP decrement and the worst recorded clinical status on a group level. RNS testing is more sensitive in generalized disease and AChR-Ab positive patients, but our data do not support RNS as a tool for long-term outcome prediction. Future studies with a prospective study design could help to overcome a number of limiting factors discussed in our study. |
| first_indexed | 2024-04-09T22:56:12Z |
| format | Article |
| id | doaj.art-776e5a00a402476090d1e7f830014146 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T22:56:12Z |
| publishDate | 2023-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-776e5a00a402476090d1e7f8300141462023-03-22T11:13:39ZengNature PortfolioScientific Reports2045-23222023-02-011311710.1038/s41598-023-30154-5The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravisMatthias Tomschik0Eva Renaud1Fiona Jäger2Chiara Paternostro3Jakob Rath4Walter Rinner5Gudrun Zulehner6Fritz Zimprich7Hakan Cetin8Department of Neurosurgery, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaDepartment of Neurology, Medical University of ViennaAbstract Repetitive nerve stimulation (RNS) is a standard test for the diagnosis of myasthenia gravis (MG), where decrement of compound muscle action potentials (CMAP) corresponds to clinical muscle fatigability. Our aim was to ascertain the diagnostic and prognostic utility of RNS in MG patients. This study included MG patients treated between 01/2000 and 12/2016, with an observational period of at least one year and a minimum of two neurological examinations. Clinical and electrophysiological data were retrospectively gathered from patient records, and CMAP decrement was correlated with autoantibody titers and clinical disease severity at different time points. Ninety-four patients were included, with 88.3% of the cohort testing positive for acetylcholine receptor autoantibodies (AChR-Abs). RNS sensitivity was higher in patients with generalized disease (71.6%) than in purely ocular MG (38.5%). CMAP decrement did not significantly correlate with AChR-Ab titers, nor with clinical symptom severity at the time of testing or last follow up. However, there was a significant correlation between CMAP decrement and the worst recorded clinical status on a group level. RNS testing is more sensitive in generalized disease and AChR-Ab positive patients, but our data do not support RNS as a tool for long-term outcome prediction. Future studies with a prospective study design could help to overcome a number of limiting factors discussed in our study.https://doi.org/10.1038/s41598-023-30154-5 |
| spellingShingle | Matthias Tomschik Eva Renaud Fiona Jäger Chiara Paternostro Jakob Rath Walter Rinner Gudrun Zulehner Fritz Zimprich Hakan Cetin The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis Scientific Reports |
| title | The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis |
| title_full | The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis |
| title_fullStr | The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis |
| title_full_unstemmed | The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis |
| title_short | The diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis |
| title_sort | diagnostic and prognostic utility of repetitive nerve stimulation in patients with myasthenia gravis |
| url | https://doi.org/10.1038/s41598-023-30154-5 |
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