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Impact of neurologic signs and symptoms on functional status in peripheral neuropathies

From the Departments of Neurology (Drs. Molenaar, Vermeulen, and de Visser) and Clinical Epidemiology and Biostatistics (Dr. de Haan), Academic Medical Center, University of Amsterdam, the Netherlands.

Address correspondence and reprint requests to Dr. D.S.M. Molenaar, Department of Neurology (H2-214), Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, the Netherlands.

OBJECTIVE: To determine whether the Neurologic Disability Score (NDS), the Neuropathic Symptom Score (NSS), and the Medical Research Council (MRC) "sumscore" are reliable, and to determine whether they provide information regarding the functional status of patients with peripheral neuropathies.

METHODS: The authors analyzed homogeneity of the frequently used outcome measures in 97 patients using Cronbach’s alpha coefficient and corrected item–total correlations. Their association with functional status (sickness impact profile and modified Rankin score) was analyzed univariately with Pearson’s and Spearman’s correlation coefficients, and multivariately with linear regression analysis.

RESULTS: The NDS and MRC scales were homogeneous (range of Cronbach’s alpha, 0.81 to 0.97) compared with the NSS scales (range, 0.20 to 0.63). The correlation patterns between neurologic signs and symptoms and functional status ranged from 0.13 to 0.65. Multivariate linear regression analyses showed that 40% or less of patients’ functional status could be explained by the three tested outcome measures.

CONCLUSION: The NDS and MRC are reliable measures, but these measures do not correlate with measures of functional status.

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