QUANTIFIED NEUROLOGICAL EXAMINATION WITH EMPHASIS ON MOTOR AND SENSORY FUNCTIONS IN PATIENTS WITH RHEUMATOID-ARTHRITIS AND CONTROLS

A controlled study of quantified clinical neurological examination, in cluding psychophysical assessment of sensory thresholds, in patients w ith rheumatoid arthritis (RA) was carried out. Fifty-five women with s eropositive RE living in North Norway and 83 healthy controls underwen t clinical neurological examination quantified by neurological symptom score (NSS) and neurological deficit score (NDS). Vibration threshold (VT), warm-cold detection threshold (limen) as well as heat pain dete ction threshold (HPDT) were performed to evaluate afferent myelinated and unmyelinated fibre functions. Higher scores on NSS and NDS were se en in RA patients compared with the controls. Higher index finger and big toe VT was demonstrated in the patients, while results from warm-c old limen and HPDT were not significantly different in the two groups. Among the disease-related variables, the most prominent finding was a positive association of index finger VT with disease duration in the patients (P = 0.01). Maximum walking time (15 m) was a significant pre dictor of big toe VT in the patient group (P = 0.0001). This study sug gests impaired peripheral nerve function in afferent myelinated fibres . However, involvement of dorsal column fibres cannot be excluded, alt hough patients with radiological atlantoaxial subluxation were not inc luded in this study.