A PROSPECTIVE, ONE-YEAR FOLLOW-UP STUDY OF PATIENTS NEWLY DIAGNOSED WITH NEUROSARCOIDOSIS

Background: Sarcoidosis is a granulomatous inflammation of unknown etiology. Neurosarcoidosis (NS) occurs in 5–10% of patients with sarcoidosis and is a severe manifestation of sarcoidosis. The clinical presentation is heterogeneous and depends on the inflammation within the nervous system. Objectives: This study aimed to describe NS patients and their clinical course of treatment. Our outcomes were changes in 1) enhancing lesions on MRI of the central nervous system (CNS), 2) cerebrospinal fluid (CSF), 3) disability and dependency in daily activities assessed by the modified Rankin Scale (mRS), 4) cognitive function assessed by the Symbol Digit Modality Test (SDMT), 5) quality of life assessed by Short-Form 36 Health Survey (SF-36), 6) fatigue assessed by Fatigue Assessment Scale (FAS), and 7) depression measured by Beck Depression Inventory-II (BDI-II). Methods: In this observational cohort study with a one-year follow-up, we consecutively recruited NS patients (N=20), not including patients with polyneuropathy, from the Departments of neurology and rheumatology at Odense University Hospital between January 2016 and August 2020. Patients were examined clinically, with questionnaires and MRI at baseline (V) and after three months (V3), six months (V6), and 12 months (V12). Cerebrospinal fluid (CSF) was examined at baseline, V6, and V12. Results: The median age was 51.6 years, and the median duration of sarcoidosis symptoms was 8 months before inclusion. At baseline, 60% of NS patients had headache, followed by vertigo (55%) and tinnitus (50%). Objective neurological findings were peripheral sensory signs (50%), peripheral motor signs (40%), and cranial nerve involvement (30%). At V12, there were significant improvements in vertigo (p=0.03), cranial nerve involvement (p=0.03), and joint symptoms (p=0.03). At baseline, 60% of patients had abnormal findings on MRI of CNS. During the study, the number of contrast-enhancing lesions on MRI decreased significantly (p<0.0001). The mRS declined significantly from mean (SD) 3.0 (0.8) at baseline to 1.8 (1.1) at V12 (p<0.0001), and 75% of patients experienced clinically important improvement (mRS≥1). The SDMT score improved significantly from mean (SD) 38 (9) at baseline to 45 (12) at V12 (p<0.0001). The SF-36 Physical (PCS) and Mental Component Summary scores (MCS) improved significantly from baseline: PCS mean (SD) 35 (11) to 41 (12) at V12 (p=0.003) and MCS mean (SD) 41(9) to 48 (10) at V12 (p=0.03). The proportions of patients with substantial fatigue (75%) and high depression score (35%) were unchanged. Conclusion: One year of immunosuppression in NS patients improved several outcomes, and 75% of patients experienced clinically important improvement. Disclosure of Interests: None declared Citation: , volume 81, supplement 1, year 2022, page 1015Session: Other orphan diseases (POSTERS only)