摘要：Abstract Background The purpose of this study was to investigate with neurophysiological and neuropsychological methods such as pupillometry, cognitive test and Hamilton Depression Rating Scale (HAM-D) the hypothesis of Central Nervous System (CNS) cholinergic involvement in patients with Myasthenia Gravis (MG). Methods Thirty-two patients (32) with {MG} and a mean age of 51.1 ± 17.2 volunteered to participate in this investigation, while thirty-three (33) healthy subjects with a mean age of 50.2 ± 14.8 served as controls. All subjects underwent pupillometric measurements and performed the Wechsler Memory Scale (WMS) and HAM-D. The pupillometric indices studied were: 1) latency for the onset of constriction (T1), 2) maximum constriction velocity (VCmax) and 3) maximum constriction acceleration (ACmax). Results {T1} was found significantly increased by 21.7% (p < 0.05) in {MG} patients as compared to healthy subjects. Conversely, {VCmax} and {ACmax} were significantly decreased in {MG} patients by 33.3% (p < 0.05) and 43.5% (p < 0.05) respectively, as opposed to healthy subjects. Additionally, {MG} patients showed significantly decreased score in {WMS} by 41.6% (p < 0.05) as compared to healthy controls. No significant difference was found for HAM-D between the two groups. Conclusions {VCmax} and {ACmax} are governed mainly by the action of the Parasympathetic Nervous System, through acetylcholine. The results of this study demonstrate that the {CNS} may be affected in {MG} and support the hypothesis that {MG} has central cholinergic effects manifested by cognitive dysfunction.
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