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Memory dysfunction in myasthenia gravis

Evidence for central cholinergic effects

Department of Neurology, University of Missouri School of Medicine, and Department of Psychology, University of Missouri-Columbia (Drs. Tucker and Roeltgen)
Department of Neurology, University of Missouri School of Medicine, Columbia, and the Department of Psychology, Missouri Western State College, St. Joseph (Dr. Wann)
Department of Neurology, University of Missouri School of Medicine, Columbia, MO (Dr. Wertheimer).

Two studies are presented that investigate the possible central cholinergic effects of myasthenia gravis as measured by cognitive dysfunction. In the first study, performance on a battery of cognitive tasks by 12 subjects with myasthenia gravis is compared with that of ten healthy control subjects and ten medical control subjects with chronic disease of a nonneurologic nature. The tests used were the Boston Naming Test, Rey Auditory Verbal Learning Test (AVLT), and the Logical Memory and Design Reproduction portions of the Wechsler Memory Scale (WMS). Results indicate that the myasthenic group was significantly impaired relative to both the medical and healthy control groups for performance on the Boston Naming Test, WMS Logical Memory, and WMS Design Reproduction. Both the myasthenic and the medical control groups were impaired relative to the healthy controls on the AVLT. In the second study, a myasthenic patient had plasmapheresis for treatment of her myasthenia on two separate occasions. Her memory was examined prior to as well as following each series of plasma exchanges with a variation of the Peterson-Peterson consonant trigram task. Results showed that this patient had significantly fewer interference effects and less rapid forgetting following plasmapheresis. The results of these two studies support the hypothesis that myasthenia gravis has central cholinergic effects manifested by cognitive dysfunction.

Address correspondence and reprint requests to Dr. Tucker, Department of Neurology, UMCHSC, Columbia, MO 65212.

Received October 15,1987. Accepted for publication in final form December 17, 1987.

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