{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T01:38:49Z","timestamp":1788485929460,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007436","name":"Erling-Perssons Stiftelse","doi-asserted-by":"publisher","award":["2022_0030"],"award-info":[{"award-number":["2022_0030"]}],"id":[{"id":"10.13039\/100007436","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Physical activity and sleep influence fatigue in myasthenia gravis (MG), and digital health technologies (DHT) enable objective monitoring of these behaviors in daily life. Using this approach, we evaluated whether a lifestyle intervention targeting physical activity or sleep hygiene could reduce fatigue in MG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this three\u2010arm, randomized controlled trial (DIG\u2010MG; NCT05992025), 72 MG patients completed 6\u2009weeks of baseline monitoring with a DHT ring (OURA), followed by 12\u2009weeks of (i) physical activity guidance, (ii) sleep hygiene education, or (iii) observation, and a 6\u2010week follow\u2010up. The primary outcome was the MG Activities of Daily Living (MG\u2010ADL) score 1 week postintervention. Secondary outcomes included Fatigue Severity Scale (FSS) scores; exploratory outcomes were DHT\u2010derived physical activity and sleep parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline MG\u2010ADL scores were similar (median: 5.0). Postintervention medians were 4.0 (physical activity), 3.5 (sleep hygiene), and 3.0 (control), with no significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.073). Clinically meaningful MG\u2010ADL improvement occurred in six, seven, and six participants, respectively. FSS scores showed no group differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.992), with clinically relevant improvement in eight participants in each intervention group and five controls. Participants were more physically active than expected: 64.7% exceeded 600 MET\u2010min\/week at baseline. DHT adherence was excellent. REM sleep was lower than expected, while deep sleep was preserved. Self\u2010reported data aligned with DHT measurements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Digital lifestyle interventions were feasible and well\u2010accepted but did not improve MG\u2010ADL or FSS in this unusually active population. However, DHT\u2010based monitoring may support individualized follow\u2010up, and reduced REM sleep warrants further investigation as a fatigue\u2010related factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70234","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T06:35:40Z","timestamp":1776494140000},"page":"92-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Digital Phenotyping and Lifestyle Intervention in Patients With Myasthenia Gravis (\n                    <scp>DIG<\/scp>\n                    \u2010\n                    <scp>MG<\/scp>\n                    ): A Randomized Controlled Trial of Feasibility, Adherence, and Effects on Fatigue"],"prefix":"10.1002","volume":"74","author":[{"given":"Maja","family":"Norling","sequence":"first","affiliation":[{"name":"Clinical Neurophysiology, Department of Medical Sciences Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niclas","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Uppsala Clinical Research Center Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Westerberg","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingela","family":"Nygren","sequence":"additional","affiliation":[{"name":"Neurology, Department of Medical Sciences Uppsala University and Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Norman","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, Department of Medical Sciences Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hedberg","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, Department of Medical Sciences Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sui H.","family":"Wong","sequence":"additional","affiliation":[{"name":"King's College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0633-8104","authenticated-orcid":false,"given":"Susanna","family":"Jernel\u00f6v","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernilla","family":"\u00c5senl\u00f6f","sequence":"additional","affiliation":[{"name":"Physiotherapy and Behavioral Medicine, Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rostedt","family":"Punga","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, Department of Medical Sciences Uppsala University  Uppsala Sweden"},{"name":"Clinical Neurophysiology Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10891-1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2021.05.007"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.538","article-title":"Fatigue in Myasthenia Gravis: Risk Factors and Impact on Quality of Life","volume":"6","author":"Hoffmann S.","year":"2016","journal-title":"Brain and Behavior: A Cognitive Neuroscience 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