No, this research paper reports the results of one testing session in each patient. We do not mention testing before and afer medication. I think that your questions may refer to some other paper.
Patients report significant variations in cognition when meds due and one hour after. Might be a further line of thought. Have you seen the work on MG and olfactory deficiency?
This is a very interesting observation. I haven't known about that. However, I no longer work with MG patients, I switched to neurodegenerative research. So I'm not planning further research in the area of MG in the near future. I haven't read the paper on olfaction in MG. I think it would be good to talk to researchers that are currently more involved in MG research.
I have not tested the patients and I have no observation of any effect of mestinon on cognition. In some patients with blood-brain barrier damage you can expect some effect of mestinon on CNS function,particularly in patients with epilepsy, but ther are no data about effect on cognitive function.