Vestibular Dysfunction and Disease Activity in Rheumatoid Arthritis: A Controlled cVEMP Study

This study aimed to evaluate vestibular function and the relationship between vestibular dysfunction, if present, and disease activity in rheumatoid arthritis (RA) patients without vestibular symptoms, using the cervical vestibular evoked myogenic potentials (cVEMP) test. This prospective study was conducted with 44 RA patients without vestibular symptoms and 26 healthy volunteers. All participants underwent a detailed ENT examination and the cVEMP test. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were recorded on the date of the test, and disease activity score (DAS)28-CRP values were calculated. cVEMP recordings were then compared with ESR, CRP, and DAS28-CRP values. A cVEMP response was observed in 29.6% of the RA group, a unilateral cVEMP loss being determined in 22.7% and bilateral loss in 47.7%. All members of the control group achieved a response. This difference was statistically significant ( p < 0.001). When disease activity was compared with cVEMP response status, no statistically significant differences were observed in terms of remission, or of low and moderate activity rates ( p > 0.05). This study showed that vestibular dysfunction is widespread among RA patients, but no statistically significant relationship was determined between cVEMP findings and DAS28-CRP, ESR, or CRP values reflecting disease activity. These findings suggest that vestibular system involvement in RA may be independent of acute disease activity and more related to chronic inflammatory and immune-mediated processes.