{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:59:24Z","timestamp":1793239164066,"version":"4.5.0"},"reference-count":53,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T00:00:00Z","timestamp":1694131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and healthy controls (HCs). Two reviewers searched four electronic databases, namely PubMed, Web of Science, EMBASE, and SCOPUS, from database inception to 7 July 2023 for studies investigating cardiovascular autonomic parameters in MG vs. HCs. A random-effects meta-analysis was performed to compute Hedges\u2019 g \u00b1 95% confidence intervals (CI). Out of a total of 2200 records, 8 observational studies with a sample size of 301 patients with MG and 454 HCs were included in the systematic review. Meta-analysis revealed lower values of expiration\/inspiration ratio (g = \u22120.45, I2 = 74.7), baroreflex sensitivity (g = \u22120.56, 95%CI \u22120.80, \u22120.33; I2 = 0.3), percentage of adjacent NN intervals differing by more than 50 ms (g = \u22121.2, I2 = 82.8), square root of the mean of squared differences between successive beat intervals (g = \u22121.94, I2 = 95.1), mean of the standard deviations of all NN intervals (g = \u22120.83, 95%CI \u22121.37, \u22120.28; I2 = 55.5), and high frequency of HRV during tilt (g = \u22120.75, 95%CI \u22120.11, \u22120.39; I2 = 0). MG patients vs. HCs had higher systolic blood pressure (g = 0.39; I2 = 56.1), sympathovagal balance at rest\/during tilt (LF\/HF-RRIsupine, g = 0.44; I2 = 0; LF\/HF-RRItilt, g = 0.86; I2 = 0; LF\/HFtilt, g = 0.40; I2 = 0). As a group, MG patients have altered cardiac autonomic function, including decreased parasympathetic function, lower baroreflex sensitivity, and higher sympathovagal balance at rest and during orthostatic challenges.<\/jats:p>","DOI":"10.3390\/neurolint15030071","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T10:42:49Z","timestamp":1694428969000},"page":"1140-1154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Altered Cardiac Autonomic Regulation in Individuals with Myasthenia Gravis\u2014A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3861-7113","authenticated-orcid":false,"given":"Monika","family":"Zawadka-Kunikowska","sequence":"first","affiliation":[{"name":"Department of Human Physiology, Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum in Bydgoszcz, Kar\u0142owicza 24, 85-092 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2995-6148","authenticated-orcid":false,"given":"\u0141ukasz","family":"Rzepi\u0144ski","sequence":"additional","affiliation":[{"name":"Sanitas\u2014Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland"},{"name":"Department of Neurology, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Tafil-Klawe","sequence":"additional","affiliation":[{"name":"Department of Human Physiology, Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum in Bydgoszcz, Kar\u0142owicza 24, 85-092 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-289X","authenticated-orcid":false,"given":"Nicola","family":"Veronese","sequence":"additional","affiliation":[{"name":"Geriatrics Section, Department of Internal Medicine, University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-6530","authenticated-orcid":false,"given":"Mario","family":"Barbagallo","sequence":"additional","affiliation":[{"name":"Geriatrics Section, Department of Internal Medicine, University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Habek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils E.","family":"Gilhus","sequence":"additional","affiliation":[{"name":"Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway"},{"name":"Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis: Executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/s41572-019-0079-y","article-title":"Myasthenia gravis","volume":"5","author":"Gilhus","year":"2019","journal-title":"Nat. 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