Evaluation of personal anxiety in patients with myasthenia gravis

Kalbus O.I.

Summary. Aim — to study the level of personal anxiety (PA) in patients with myasthenia gravis. Materials and methods. 182 patients with mya­sthenia gravis were examined (147 (80.8%) — with generalized, 35 (19.2%) — with an ocular form). Clinical and neurological examination were performed, the class of myasthenia was determined according to the MGFA, the degree of manifestations of myasthenia was quantitated with the QMG scale. PA was assessed with the Spielberg — Khanin anxiety scale. The levels of antibodies to acetylcholine receptors (AchR-AB) and muscle-specific tyrosine kinase (MuSK-AB) were determined by immunoassay, the detection of antibodies to titin and SOX1 was performed by indirect immunofluorescence. Results. The mean PA level in patients with ocular myasthenia was 44.0 (40.0–47.0) points and corresponded to the moderate level of PA. The mean PA level in patients with generalized myasthenia was significantly higher — 55.0 (48.0–60.0) points (p<0.001) and corresponded to the high PA level. Most patients with ocular myasthenia (60%) had moderate level of PA and most patients with a generalized myasthenia (83.7%) had high level of PA. The increasing in the myasthenia class according to MGFA was significantly accompanied by an increase in PA level (p<0.001). The level of PA correlates with the age of patients (ρ=0.17; p<0.05), with clinical form of myasthenia (ρ=–0.43; p<0.05), with the MGFA class (ρ=–0.2; p<0.05) and the subclass of the disease (ρ=–0.23; p<0.05), with the QMG score (ρ=0.59; p<0.05), with the presence of AchR antibodies and their titre (ρ=0.46; p<0.001 and ρ=0.25; p<0.05 respectively), with antibodies to titin receptors (ρ=0.19; p<0.05). There were no correlation between the level of PA and the presence and titre of antibodies to MuSK (ρ=0.09; p>0.05 and ρ=0.1; p>0.05 respectively), with the presence of antibo­dies to SOX1 (ρ=0.05; p>0.05). Conclusions. An increase in the degree of clinical manifestations during myasthenia significantly increases the level of PA. This fact must be taken into account when planning a therapeutic tactic for each individual patient.