Evaluate NIH Toolbox motor battery (NIHTB-M), a multidimensional set of measures used to track motor impairment, for use in people with neurosarcoidosis (PwNS).

Despite its profound impact on quality of life, there are no validated measures of neurologic impairment in NS to track disability progression or treatment response.

Cross-sectional study of adults with NS recruited from a tertiary referral center for sarcoidosis. All participants were adults meeting NS Consortium diagnostic criteria for NS. NIHTB-M measures were compared to age-, education-, sex-, and race/ethnicity-matched peers using neurologically healthy individuals from the NIHTB norming project. NIHTB-M measures were compared to patient-reported assessments of mobility and fine motor control using Quality of Life in Neurological Disorders (Neuro-QoL) and clinician-assessed functional impairment using Barthel Index (BI).

41 PwNS were enrolled, 62% female, 29% African American, 71% Caucasian, 86% with biopsy-proven sarcoidosis. 7% had severe, 27% moderate, 7% slight, and 56% no functional dependence by BI. Compared to propensity-matched healthy controls, impairment (≥ 1 standard deviation worse than normative mean) was more common in PwNS on 9-Hole Peg Test (9-HPT) (81% vs. 14%, OR: 19.53, 95%CI [6.51, 67.56]) and 4-Meter Walk Test (4-MWT) (77% vs. 15%, OR: 18.89, 95% CI [6.41, 64.41]). There were moderate correlations between 9-HPT and Neuro-QoL fine motor scores (r = 0.39, 95% CI [0.03, 0.66]) and strong correlations between 4-MWT and 2-Minute Walk Test (2-MWT) and Neuro-QoL mobility scores (r = -0.69, 95% CI [-0.84, -0.44]; 0.66, 95% CI [0.44, 0.78], respectively). Scores on 9-HPT (P=0.008), 4-MWT (P=0.007), 2-MWT (P=0.032), and select measures of Standing Balance Test (SBT) (P < 0.001) were significantly different between subjects who were functionally dependent versus independent by BI.