J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Original Article

Volume 2, Number 5, October 2012, pages 189-197

Attenuated Laser Evoked Potentials in Sarcoidosis Patients in Clinical Remission

Figure 1. Example of a Laser Evoked Potential (LEP) recordings in one representative healthy control (a), and below an example of an attenuated LEP in one representative sarcoidosis patient in clinical remission with complaints of burning pain (b). X-axis represents time in ms; Y-axis represents amplitude in µV. LEP was recorded at electrode Cz. Arrows indicate N2-latency and P2-latency in ms; horizontal lines indicate N2P2-amplitude (µV) over time (ms).

**Table 1.** In- and Exclusion Criteria
Inclusion criteria:
Serum parameters (sIL-2R, ACE, Ca²⁺, CRP)	normal
X-ray	normal or 2 years or more stable
Lung function	normal or 2 years or more stable, i.e.:
VC or FEV₁	< 10% change
DLco	< 15% change
Previously involved organs	no clinical signs of disease activity
sIL-2R: serum soluble interleukine-2 receptor, ACE: angiotensin converting enzyme, CRP: C-reactive protein, VC: vital capacity, FEV₁: forced expired volume in the first second of expiration, DLco: diffusion capacity of the lung for carbon monoxide.
Lofgren’s syndrome	at onset of sarcoidosis
Use of corticosteroids or other immunosuppressive drugs	over the last 6 months
Use of analgesic medication	over the last 3 months
Antidepressive medication	over the last 3 months
Sleep apnea, narcolepsy or restless legs syndrome (by history)
Hb, thrombocytes, leucocytes, Na²⁺, K⁺, creatinine, GGT, AF, ASAT, ALAT, LDH, gluc, protein electrophoresis, TSH, ferritine, routine urine analysis	abnormal
Age	> 65 years

Table 1. In- and Exclusion Criteria

Inclusion criteria:

Serum parameters (sIL-2R, ACE, Ca²⁺, CRP)

normal

X-ray

normal or 2 years or more stable

Lung function

normal or 2 years or more stable, i.e.:

VC or FEV₁

< 10% change

DLco

< 15% change

Previously involved organs

no clinical signs of disease activity

Exclusion criteria:

sIL-2R: serum soluble interleukine-2 receptor, ACE: angiotensin converting enzyme, CRP: C-reactive protein, VC: vital capacity, FEV₁: forced expired volume in the first second of expiration, DLco: diffusion capacity of the lung for carbon monoxide.

Lofgren’s syndrome

at onset of sarcoidosis

Use of corticosteroids or other immunosuppressive drugs

over the last 6 months

Use of analgesic medication

over the last 3 months

Antidepressive medication

over the last 3 months

Sleep apnea, narcolepsy or restless legs syndrome (by history)

Hb, thrombocytes, leucocytes, Na²⁺, K⁺, creatinine, GGT, AF, ASAT, ALAT, LDH, gluc, protein electrophoresis, TSH, ferritine, routine urine analysis

abnormal

Age

> 65 years

**Table 2.** Characteristics of Healthy Controls, Sarcoidosis Patients in Clinical Remission Split in a Group With Complaints of Burning Pain and a Group With no Complaints of Burning Pain
	Healthy controls	Sarcoidosis in clinical remission	P
Significant differences in bold. * Significant difference between healthy controls and patients with burning pain; and between healthy controls and patients without burning pain; # Sensory sum score was measured as follows: touch and pinprick sensation: 4: normal, 3: abnormal distal to wrist/ankle, 2: abnormal distal to half forearm/leg, 1: abnormal distal to knee/elbow, 0: abnormal distal to groin/axilla. Vibration sense: 128 Hz tuning fork perception on: 4: middle finger/hallux, 3: ulnar styloid/medial malleolus, 2: elbow/knee, 1: clavicle/iliac crest, 0: absent. Joint position sensation of middle finger/hallux: 2: normal, 1: diminished, 0: absent.
n	28	17	45
Report on pain in:	0		0
hands		7 (2 males)
feet		5 (2 males)
hands and feet		5 (2 males)
Gender				0.341
male	13	6	19
female	15	11	26
Age in years (mean ± sd)	34 ± 8	46 ± 9	47 ± 7	< 0.001*
Time since diagnosis in years (median (IQR))		7 (5 - 10)	11 (6 - 18)	0.002
Total number of affected organs (median (IQR))		2 (1 - 3)	2 (1 - 2)	0.787
Former use of corticosteroids
Yes		6	17	0.769
months of use (median (IQR))		16 (0.5 - 30)	16 (11 - 22)	0.254
Sensory sum score #
Total		54.23 ± 3.4	55.33 ± 1.8	0.184
touch and pinprick sensation
Arm		28.00 ± 0	27.95 ± 0.3	0.539
Leg		26.00 ± 3.9	26.98 ± 2.5	0.243
vibration sense		18.94 ± 2.1	19.64 ± 1.1	0.082
Joint position sensation		7.17 ± 1.4	7.73 ± 0.8	0.073
Atrophy Extensor Digitorum Brevis				0.467
Absent		16	44
Present		1	1
Achilles Reflex				0.527
Normal		11	35
Reduced		3	6
Absent		3	4

Table 2. Characteristics of Healthy Controls, Sarcoidosis Patients in Clinical Remission Split in a Group With Complaints of Burning Pain and a Group With no Complaints of Burning Pain

Healthy controls

Sarcoidosis in clinical remission

with burning pain

no burning pain

Significant differences in bold. * Significant difference between healthy controls and patients with burning pain; and between healthy controls and patients without burning pain; # Sensory sum score was measured as follows: touch and pinprick sensation: 4: normal, 3: abnormal distal to wrist/ankle, 2: abnormal distal to half forearm/leg, 1: abnormal distal to knee/elbow, 0: abnormal distal to groin/axilla. Vibration sense: 128 Hz tuning fork perception on: 4: middle finger/hallux, 3: ulnar styloid/medial malleolus, 2: elbow/knee, 1: clavicle/iliac crest, 0: absent. Joint position sensation of middle finger/hallux: 2: normal, 1: diminished, 0: absent.

Report on pain in:

hands

7 (2 males)

feet

5 (2 males)

hands and feet

5 (2 males)

Gender

0.341

male

female

Age in years (mean ± sd)

34 ± 8

46 ± 9

47 ± 7

< 0.001*

Time since diagnosis in years
(median (IQR))

7 (5 - 10)

11 (6 - 18)

0.002

Total number of affected organs (median (IQR))

2 (1 - 3)

2 (1 - 2)

0.787

Former use of corticosteroids

Yes

0.769

months of use (median (IQR))

16 (0.5 - 30)

16 (11 - 22)

0.254

Sensory sum score #

Total

54.23 ± 3.4

55.33 ± 1.8

0.184

touch and pinprick sensation

Arm

28.00 ± 0

27.95 ± 0.3

0.539

Leg

26.00 ± 3.9

26.98 ± 2.5

0.243

vibration sense

18.94 ± 2.1

19.64 ± 1.1

0.082

Joint position sensation

7.17 ± 1.4

7.73 ± 0.8

0.073

Atrophy Extensor Digitorum Brevis

0.467

Absent

Present

Achilles Reflex

0.527

Normal

Reduced

Absent