Mild cognitive impairment and its predictors in patients with Myasthenia Gravis.

Abstract Background Myasthenia gravis (MG) is an autoimmune disorder characterized mainly by muscle weakness with physical exertion. There is conflicting data about the presence of cognitive dysfunction in MG , hence we conducted this study to assess the cognitive functions in patients with MG, and find possible predictors for cognitive impairment in MG patients. Results A cross-sectional study, where 50 MG patients were recruited consecutively. Patients were diagnosed with MG based on clinical, neurophysiological and laboratorial basis. Their cognitive functions were evaluated via The Arabic Version Montreal Cognitive Assessment (MOCA) and the Arabic Version of Addenbrooke’s Cognitive Examination-III. Moreover, we evaluated patient's Quality of life, Insomnia, and depression via The Arabic version of Myasthenia Gravis Activity Day living (MG-ADL), Insomnia Severity Index (ISI), and the Beck Depression Inventory (BDI) respectively. MG patients had a mean age of 35 ± 12.7 years, majority of patients suffered ocular symptoms (88%). positive ACHR antibody was detected in 80% of patients. MCI was found in 42% of patients, where the visuospatial/executive domains were the most affected. Cognitive impairment correlated with fewer education years, disease duration, severity, elevated AChR antibody titers, and prolonged steroid use. Significant predictors for MCI included bulbar symptoms, MG-ADL score. Conclusion MCI could be common in patients with MG. Bulbar symptoms, the length of steroid use, the level of ACHR antibodies, disease severity, prolonged duration, insomnia, and depression could contribute to an elevated risk.