Inclusion Criteria:  Adults ≥ 18 years < 75 years. Physician diagnosed moderate to severe RA. No previous biologic disease modifying antirheumatic drug therapy Eligible for anti-TNF treatment in line with site local requirements and selected to start adalimumab by their usual rheumatology clinical team for active RA in line with the license for adalimumab (originator or biosimilar) and local practice Self-reported sickness behaviour (fatigue, depression, anxiety) with one component > 4 on NRS Right-handed (to reduce neuroimaging heterogeneity). No contraindications to MRI (e.g. metal implants, claustrophobia). No contraindications to Adalimumab. Agree to use of contraception for study duration, where appropriate. Willing to participate and give informed consent. Satisfactory completion of standard pre-biologic safety screening (including but not limited to exclusion of latent TB infection according to local protocol, chest X-ray, negative HIV screen, negative Hepatitis screen antibody, negative Hepatitis B surface antigen [Hep B sAg] and negative Hepatitis B anit-core antibody [Hep B cAb]  Exclusion Criteria:  Inability to provide written informed consent. Severe physical impairment (e.g. blindness, deafness, paraplegia). Pregnant, planning pregnancy or breast feeding. Serious infection including sepsis, tuberculosis and opportunistic infections such as invasive fungal infections. Severe liver or renal disease. Haemoglobin less than 100g/L Major confounding neurological disease including Multiple Sclerosis, Stroke, Traumatic Brain Injury, Parkinson's Disease, Alzheimer's Disease Previous biologic disease modifying antirheumatic drug therapy with adalimumab, etanercept, qolimumab, infliximab, certolizumab, abatacept, tocilizumab, sarilumab, rituximab, tofacitinib or upadacitinib Recent (within 4 weeks) use of intra-muscular or intra-articular steroid injections History of age-related cognitive impairment or dementia, of any severity Any other medicinal product that may, in the Principal Investigator's opinion, influence underlying disease activity through effects on immune and/or inflammatory responses