Myasthenia gravis
Conditions
Interventions
None listed
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Recently diagnosed MG patients - Definitive diagnosis of MG defined as the presence of serum autoantibodies (anti-acetylcholine receptor [AChR], anti-muscle specific tyrosine kinase [MuSK]) - Start of symptoms was less than a year ago - No corticosteroid treatment received in the past year - No TSH-receptor auto-antibodies, no laboratory signs of thyroid dysfunction (T4, TSH), Chronic MG patients - Definitive diagnosis of MG, defined as described above - Persisting symptoms of diplopia - Start of symptoms was more than a year ago - No TSH-receptor auto-antibodies, no laboratory signs of thyroid dysfunction (T4, TSH), Seronegative MG patients - Clinical diagnosis of MG with asymmetric, fluctuating and fatigable muscle weakness and at least one abnormal neurophysiological test, indicative of neuromuscular dysfunction (repetitive nerve stimulation or single fiber EMG) - No serum autoantibodies (anti-acetylcholine receptor [AChR], anti-muscle specific tyrosine kinase [MuSK]) - No TSH-receptor auto-antibodies, no laboratory signs of thyroid dysfunction (T4, TSH) Healthy controls - No symptoms of diplopia - No ophthalmopathy - No prior systemic treatment with corticosteroids, Patient controls: Graves* orbitopathy - Definitive diagnosis of Graves* orbitopathy, Patient controls: Other neuromuscular disease - Definitive diagnosis of a neuromuscular disease other than Myasthenia gravis
Exclusion criteria
Exclusion criteria: - Subjects who are not legally capable - Subjects under the age of 18 - Contraindications to MRI scanning, including: o Claustrophobia o Pregnancy o Pacemakers and defibrillators o Nerve stimulators o Intracranial clips o Metallic fragments o Cochlear implants o Ferromagnetic implants o Hydrocephalus pump o Permanent make-up o Tattoos above the shoulders o Piercings (unless they can be removed) o Subjects who cannot keep their head still (eg. Tremor, Parkinson*s disease) o Severe physical restriction (completely wheelchair dependent) * In the case of uncertainty about the MRI-contraindications, the MR-safety commission of the radiology department will decide whether this subject can be included in the study or not.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| (1) QMRI parameters (muscle fat fraction, muscle inflammation, muscle volume) which are hypothesized to differ between MG patients and the healthy/disease controls for diagnostic value. (2) For the second objective comparing recently diagnosed and chronic MG patients for exploring the pathophysiology | — |
Secondary
| Measure | Time frame |
|---|---|
| (3) For the third objective comparing the qMRI parameters in time in the recently diagnosed MG group to measures of severity of disease to assess the predictive value for treatment response. (4) For the fourth objective comparing qMRI parameters to functional measures in all groups for exploring the relationship with the symptoms | — |
Outcome results
None listed