Symptom network structure and its association with quality of life in myasthenia gravis: a cross-sectional study

Objective Myasthenia gravis (MG) is characterized by heterogeneous symptoms that often co-occur and may collectively impair quality of life (QOL). This study aimed to characterize symptom burden and symptom interrelationships in patients with MG and to examine the associations between symptom clusters and QOL. Methods In this cross-sectional study, 220 patients with MG recruited from a tertiary hospital in China between March 2025 and February 2026 completed the Myasthenia Gravis Symptom Cluster Scale and the 15-item Myasthenia Gravis Quality of Life Scale. Network analysis was used to estimate symptom interrelationships, identify central and bridge symptoms, and assess node predictability. Hierarchical linear regression was performed to examine symptom clusters independently associated with QOL. Results The most prevalent symptoms were ptosis, upper limb weakness, diplopia, anxiety, and lower limb weakness. Dysphagia had the highest estimated strength and expected influence. Anxiety had the highest bridge strength, and the psychological symptom cluster showed the highest centrality in the symptom-cluster network. Greater generalized and psychological symptom-cluster burden was independently associated with poorer QOL. Conclusion Dysphagia and anxiety may warrant priority assessment in patients with MG. The observed associations of psychological and generalized symptom clusters with QOL warrant further examination in longitudinal and intervention studies.