Definite Meniere's Disease Research Articles

The correlation between symptoms of definite Meniere's disease and endolymphatic hydrops visualized by magnetic resonance imaging.

This study aimed at investigating the correlation between a battery of diagnostic symptoms of definite Meniere's disease (MD) and the degree of endolymphatic hydrops (EH) in the inner ear. Prospective study. Fifty-four patients diagnosed with unilateral definite MD were enrolled in the study. The hearing levels of all patients at the low, middle, and high frequencies were evaluated. Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and three-dimensional real inversion recovery (3D-real IR) magnetic resonance imaging (MRI) were performed 24 hours after bilateral intratympanic injection of gadolinium to assess the presence and grading of EH. Various degrees of EH were observed in the vestibule and/or each turn of the cochlea in the affected ears of all patients. The duration of MD disease and low-tone and middle-tone hearing thresholds were proportional to the extent of EH in the vestibule and cochlear. However, no significant correlation was demonstrated between EH and other aspects of symptoms such as high-tone hearing loss, tinnitus, and aural fullness. Of all subjects, 16.7% exhibited bilateral EH on MRI exam who were diagnosed with unilateral MD based on diagnostic criteria. EH in the inner ear of MD patients exhibits a progressive deteriorative trend over time. Low-tone and middle-tone hearing thresholds can indirectly reflect the severity of EH in the cochlea. EH may not be the primary cause of tinnitus and aural fullness in patients with MD. Patients diagnosed with unilateral MD should maintain long-term regular follow-ups for the possibility of developing bilateral EH. 4.

Abnormal fast fluctuations of electrocochleography and otoacoustic emissions in Menière's disease

The responses of cochlear hair cells to sound stimuli depend on the resting position of their stereocilia bundles, which is sensitive to the chemical and mechanical environment. Cochlear hydrops, a hallmark of Menière's disease (MD), which is likely to come with disruption of this environment, results in hearing symptoms and electrophysiological signs, such as excessive changes in the cochlear summating potential (SP) and in the postural shifts of distortion-product otoacoustic emissions (DPOAEs). Here, SP from the basal part of the cochlea and DPOAEs from the apical part of the cochlea were recorded concomitantly in 73 patients with a definite MD, near an attack (n = 40) or between attacks with no clinical symptoms (n = 33), to compare their sensitivities to posture and evaluate their stability. The phase of the 2f1-f2 DPOAEs was monitored during body tilt, with stimuli f1 = 1 kHz and f2 = 1.2 kHz at 72 dB SPL. Extratympanic electrocochleography was performed in response to 95-dBnHL clicks. The normal limits of the DPOAE phase shift with body tilt, [−18°, +38°], and of the SP to action-potential (AP) ratio, <0.40, were exceeded in 75% and 60% of patients, respectively, near an attack. In these patients, but not in the asymptomatic ones, both tests reveal fluctuating cochlear responses from one data sample to the next. They emphasize how hydrops hinders normal hair-cell operation and may generate fast fluctuations in inner-ear functioning. If these fluctuations also occur on shorter time scales, it might explain the imperfect diagnostic sensitivity of SP and DPOAE tests, as averaging procedures would tend to level out transient fluctuations characteristic of hydrops.

Migraine features in patients with Meniere's disease.

To better understand the features of migraine in Meniere's disease (MD). Retrospective review of prospectively obtained surveys in an outpatient clinic of a tertiary medical center. Detailed questionnaires on headaches and dizziness were given to consecutive patients presenting with dizziness. The responses were verified by the clinician with the patient. The data, in addition to the clinical history and audiogram, were used to diagnose patients with migraine headaches and MD using criteria set by the International Headache Society (IHS) and the American Academy of Otolaryngology-Head and Neck Surgery, respectively. The prevalence of migraine-like symptoms in those patients with MD, who did not fit the diagnostic criteria for migraine, was evaluated. Thirty-seven patients with definite MD were included. There was a predominance of females (female/male:26/11). Mean age of patients was 52 ± 14 years. Nineteen patients (51%) had migraine headaches. Fifteen patients fulfilled the criteria for definite vestibular migraine. Of those who did not fulfill the IHS migraine criteria, a majority had characteristics such as a family history of migraine, visual motion sensitivity, or lifelong motion sickness that were highly suggestive of a migraine disorder. A majority of patients with MD have migraine headaches as defined by the IHS. Sensitivity to visual motion, light and sound, head motion, smells, weather changes, or medication was present in 95% of all patients with definite MD and 82% of non-IHS migraine MD patients. This may suggest that MD may be an atypical variant of migraine.

Head-shaking and Vibration-induced Nystagmus During and Between the Attacks of Unilateral Ménière’s Disease

To aid in defining each phase of Ménière's disease (MD) and underlying vestibular pathophysiology by analyzing the evolving patterns of spontaneous, head-shaking (HSN), and vibration-induced nystagmus (VIN) during and between the attacks of MD. Retrospective case series review. We analyzed the patterns of HSN and VIN during 123 attacks from 87 patients who had definite unilateral MD and underwent recording of eye movements both during and between the attacks using video-oculography. HSN tended to beat toward the lesion side during the irritative phase (80.0%) and toward the healthy side during the paretic phase (82.9%). In contrast, VIN was more commonly induced during the irritative phase (63.7%) and more likely beat toward the healthy side irrespective of the phases evaluated (84.3%). Directional dissociation may occur between HSN and VIN, especially during the irritative phase when HSN mostly beat to the lesion side, but VIN is toward the healthy side. The characteristic patterns of HSN and VIN during each phase of MD would aid in defining the acute phases of MD and understanding the underlying vestibular pathophysiology.

Genetic aspects and clinical characteristics of familial Meniere's disease in a South Korean population.

This study was undertaken to investigate the prevalence, inheritance patterns, and clinical characteristics of familial Meniere's disease (MD) in a South Korean population. Direct interviews, telephone interviews, and reviews of the medical records of definite Meniere's disease patients and their families. Direct and telephone interviews were performed for 286 definite MD patients and their family members who were suspected of having MD. The diagnosis of MD in family members was made by obtaining a detailed history, performing basic neurotological examinations and reviewing hearing test results. The clinical characteristics as well as the prevalence and inheritance patterns of familial MD were analyzed. The prevalence of familial Meniere-like syndrome (at least one family member with definite MD and other members with probable MD) and definite familial MD (two or more family members with definite Meniere's disease) were 9.8% and 6.3%, respectively, and the most common inheritance pattern was autosomal dominant with incomplete penetrance. The significant clinical characteristics of familial cases were an early disease onset and a higher prevalence of migraines. This is the first report describing the genetic aspects of MD in a single large Asian population. The prevalence of definite familial MD was 6.3% with an incomplete autosomal dominant inheritance pattern in most cases. Early-onset age and a high prevalence of migraines were significant clinical features of familial MD in this South Korean population. These data could provide a basis for the analysis of the genetic mechanism of familial MD in Asian populations. 4.

Benign Paroxysmal Positional Vertigo Prevalence in Meniere’s Disease: Is Meniere's Disease a Predisposing Factor?

Article type: Original Article Background: Meniere’s disease (MD) is a chronic illness defined as an idiopathic syndrome of endolymphatic hydrops. Benign paroxysmal positional vertigo (BPPV) is a balance disorder and can be the sequel of diverse inner ear impairments. Objectives: The purpose of this study was to investigate the prevalence of BPPV in MD patients. Materials and Methods: All patients with definite or probable MD participated in this cross-sectional descriptive and analytic study between March 2013 and February 2014. We used the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) criteria plus electrocochleography (ECochG) test results to define the presence of MD and positional tests to determine the presence of BPPV. The frequency was reported. Independent sample t-test was also used in SPSS19. Results: A total of 39 patients (43 ears) with definite or probable MD (26 female, 13 male; mean age: 46.4 ± 9.2 years) were enrolled in this study. Six out of 39 cases (15.4%) had BPPV in the posterior semicircular canal. The mean duration of MD was 28.5 months in BPPV group and 13.2 months in the non-BPPV group. Regardless of the age of the patients, there was a significant difference (p = 0.02) between the duration of MD in the two groups. Conclusions: It seems that MD and BPPV are related and a longer duration of MD may result in a greater risk of developing BPPV.

Episodic Dizziness with Unilateral Hearing Loss: Clinical Characteristics According to Hearing Loss Pattern

Received July 8, 2014 Revised August 12, 2014 Accepted August 26, 2014 Address for correspondence Jae Yun Jung, MD Department of OtolaryngologyHead & Neck Surgery, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea Tel +82-41-550-3973 Fax +82-41-556-1090 E-mail jjkingy2k@gmail.com Background and ObjectivesZZLow frequency hearing loss is known to be the most common hearing loss form in Meniere’s disease (MD) and episodic dizziness with low frequency sensorineural hearing loss is considered a very crucial symptom for the diagnosis of MD. However, flat or high frequency hearing loss is also commonly encountered in the Ear, Nose and Throat clinic. The aim of this study is to investigate the differences in clinical manifestation between episodic dizzy patients with low frequency hearing loss (LFHL) group and non-low frequency hearing loss (non-LFHL) group. Subjects and MethodZZWe reviewed medical records of 78 patients (36 of LFHL group and 42 of non-LFHL group) who had episodic dizziness with unilateral hearing loss and analyzed clinical characteristics according to hearing loss pattern. ResultsZZThe clinical features of LFHL include a predominance of female sufferers, high incidence of tinnitus and short duration of dizziness. There was no significant difference in frequency, nature of dizziness, and results of vestibular function test. Although the proportion of patients diagnosed with definite MD was higher in LFHL group at initial and final diagnosis, there were no statistically significant differences between two groups. ConclusionZZTherefore, when episodic dizziness is accompanied with unilateral hearing loss, not only low frequency but flat or high frequency hearing loss could be considered as a critical sign for possible progression to Meniere’s disease and careful observation should be taken. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(3):173-6

Vestibular evoked myogenic potentials and video head impulse tests in different stages of Meniere′s disease

Introduction Meniere's disease (MD) is characterized by intermittent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural pressure. Histopathologically, endolymphatic hydrops is seen initially in the cochlear duct and the saccule; with the progression of the disease, subsequent affection of the utricle and semicircular canals (SCC) occur. Objectives The aim of this study was to assess the function of the saccule, the utricle, and the three SCCs using cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), and video head impulse test (vHIT), respectively, in Meniere's patients and to correlate the findings with the different stages of MD. Patients and methods Forty patients diagnosed with unilateral definite MD according to the American Academy of Otolaryngology and Head and Neck Surgery's 1995 criteria [AAO-HNS (1995) criteria] were tested. They were divided into four subgroups based on the stage of MD using the average of 500, 1000, 2000, and 3000 Hz pure-tone thresholds of the worst documented audiogram during the 6-month interval before examination. A control group of 40 healthy age-matched adults were equally divided into four corresponding subgroups based on their pure-tone average. In all, 500 and 1000 Hz tone burst air conduction cVEMP and oVEMP tests, bithermal caloric test, and vHIT for all SCCs were recorded for both groups. Results The results of this study showed that the highest prevalence of abnormalities in Meniere's patients were seen in the pure tone average (PTA) (85%), followed by cVEMP (72.5%) and oVEMP (67.5%). Caloric test abnormalities follow with a lower prevalence of 32.5%. The vHIT presented the lowest prevalence of abnormalities, with 20% in the lateral canal, 7.5% in the anterior, and 5% in the posterior canal. This pattern of abnormality is in agreement with the reported pattern of hydrops formation in the vestibular system. Conclusion The findings of the current study suggest that with the advancement in the stage of MD consequent abnormal cVEMP, oVEMP, caloric, and vHIT responses occur following the histopathological evidence of progression of the disease from the saccule up to the SCCs.

The Reliability of 3T MRI in Detecting Endolymphatic Hydrops in the Meniere’s Disease and Sudden Sensorineural Hearing Loss

Aim: The aim of this study was to assess the reliability of 3T MRI in detecting endolymphatic hydrops (EH) in the Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL). Methods: Fifty patients with the unilateral clinical diagnosis of definite MD and twenty with unilateral sudden sensorineural hearing loss were evaluated with inner ear MRI. The MRI detection and imaging measurement was completed 24 hrs after intratympanic administration of gadolinium chelate. The sequence of MRI was three-dimensional fast spin-echo T1-weighted imaging (3D-FSET1WI). Results: For the vestibule, the EH was visualized in 45 of 50 (90%) patients with MD and 4 of 20 (20%) patients with SSHL. For the cochlea, the EH was visualized in 46 of 50 (92%) patients with MD and 4 of 20 (20%) patients with SSHL. Conclusion: For detecting EH in MD and SSHL, the inner ear MRI assessment after intratympanic injection of gadolinium is a useful and confident method for the diagnosis of EH in MD and SSHL. The present work also approved existence of EH in SSHL for the first time in the literature.

Chronic cerebrospinal venous insufficiency in Ménière’s disease: diagnosis and treatment

The purpose of this study was to evaluate by the means of Doppler ultrasound and phlebography the relationship between Meniere’s disease (MD) and chronic cerebrospinal venous insufficiency (CCSVI) and to test whether angioplasty is effective in improving symptoms. Phase 1: 50 patients diagnosed with definite MD (American Academy of Otolaryngology 1995) who had gained no benefit from routine therapy, underwent echoenhanced color Doppler sonography using the Zamboni protocol to check for CCSVI. Onehundred healthy subjects matched for age and gender acted as controls. Phase 2: in 20 of echo-color Doppler positive Meniere’s cases we performed a venogram and the diagnosis of associated CCSVI was confirmed. These patients were simultaneously treated by angioplasty of the internal jugular vein, then re-tested respect the baseline scales of MD. Out of a total of 50 patients with MD, an ultrasound diagnosis was made of CCSVI in 45 patients (90%). In the healthy population CCSVI is found in only 3% of cases (P<0.001). Twenty patients were given venograms that confirmed the CCSVI diagnosis. Finally, percutaneous transluminal angioplasty (PTA) proved to be effective in 90% of patients, with significant improvement of several scales of vestibular function at six months follow-up. There is a significant prevalence of CCSVI in patients with MD and treatment with PTA seems useful because of an improvement in symptoms and vestibular function recorded in the majority of patients.

The first attack of Ménière's disease: a study through SVV perception, clinical and pathogenetic implications.

This is a study of Subjective Visual Vertical (SVV) perception during acute attacks of Ménière's disease (MD) with comparative evaluation of concurrent nystagmus. We studied 21 patients with unilateral MD during the acute phase and 7 days later. Of the nine patients with an initial attack of MD, seven had an alteration of SVV perception and of these, three indicated a match with canal functional signs, while four patients showed an opposite trend of SVV perception relative to the spontaneous nystagmus. Nine of the 12 patients with definite MD had a pathological SVV perception always in correspondence with the same type of canal event. At 1-week control, no patient with an initial MD attack had alteration of SVV perception, whereas 5 patients with definite MD presented a pathological SVV perception toward the affected side. In the course of acute attacks of unilateral MD, clinical manifestations may include otolithic involvement and this may have an opposite trend compared to concomitant canal signs, especially during initial attacks. This behavior allows us to distinguish clinical signs of maculo-canal "correspondence" and "dissociation" with a significant prevalence of the second indication in those subjects with an initial MD attack.

Intratympanic dexamethasone versus high dosage of betahistine in the treatment of intractable unilateral Meniere disease

PurposeThe objective of our randomized, double-blind study was to compare the effectiveness of intratympanic (IT) dexamethasone versus high-dosage of betahistine in the treatment of patients with intractable unilateral Meniere disease (MD). Materials and methodsSixty six patients with definite unilateral MD were randomly divided in two groups: Group A received a combination of IT dexamethasone (DX) and identical-appearing placebo pills while Group B received a combination of high-dosage betahistine and IT saline. Intratympanic injections were repeated for three times with an interlude of 3days. High-dosage of betahistine entailed 144mg/day. Mean outcome measures consisted of vertigo control, pure tone average (PTA), speech discrimination score, Functional Level Score, Dizziness Handicap Inventory and Tinnitus Handicap Inventory. ResultsFifty nine patients completed the study and were available at 12months for analysis. In Group A complete vertigo control (class A) was attained in 14 patients (46.6%) and substantial control (class B) in 7 patients (20%). In Group B, 12 patients (41%) achieved complete vertigo control (class A), 5 patients (17%) substantial control (class B). There is no statistical difference in vertigo control between the two treatment groups. In Group A hearing was unchanged in 14 patients and improved in 4 patients, while in Group B hearing was unchanged in 16 patients and improved in 2 patients. ConclusionsOur preliminary results demonstrate that high-dosage of betahistine achieved similar outcomes as IT dexamethasone in the control of vertigo and hearing preservation.

Intratympanic dexamethasone as a symptomatic treatment for Ménière's disease.

Determine whether intratympanic (IT) dexamethasone, when given on an as needed basis, can successfully control Ménière's disease (MD) symptoms in a large percentage of patients and allow them to avoid ablative therapies. Retrospective chart review. Tertiary medical center. One hundred fifty-nine patients met the American Academy of Otolaryngology-Head and Neck Surgery criteria for unilateral definitive MD. All patients failed dietary and medical therapy and received at least one IT dexamethasone treatment by one of 4 otologists in an academic center. IT dexamethasone. Patients were determined to be treatment failures if they did not achieve satisfactory control of their symptoms with IT dexamethasone and chose another treatment modality. Treatment success was defined as IT dexamethasone providing control of MD symptoms to the degree that they did not require any other further treatment modalities. Successful avoidance of ablative surgery was achieved in 81.1% of patients with greater than 24 months of follow-up. No statistically significant associations were found related to age, sex, laterality, or duration of symptoms. For each IT dexamethasone perfusion sequence, there was a 20.0% increase in likelihood of successful treatment (OR, 1.20; 95% CI, 1.01-1.40; p = 0.01). IT dexamethasone is a successful adjuvant treatment for Ménière's disease in patients on medial therapy and dietary restrictions.

Sex-specific association of RANTES gene -403 variant in Meniere's disease.

Several studies have shown the correlation between RANTES gene and inflammatory disorders; the aim of the present study was to investigate the association between RANTES promoter gene polymorphism and Meniere's disease (MD) in an Iranian population. In this study patients with MD comprising definite MD (N = 56) and probable MD (N = 15) were selected according to diagnostic criteria of AAO-HNS. The control group (N = 101) were healthy normal subjects who did not have a history of ear disease and vertigo. PCR-RFLP for RANTES -403G>A has been performed. We found a protective role for RANTES -403A allele in male group in our population. None of the male patients with MD were carrier of allele A which was significantly different from the presence of allele A in the male control group (AA+GA vs. GG: p = 0.0004, OR 0.05, 95 % CI 0.001-0.39). This difference was not significant in female group. There was no significant association between RANTES gene polymorphism and the level of hearing loss. our results showed a sex-specific association between RANTES gene polymorphism and MD but more studies are necessary to further assess this association.

Cochlear Implantation in Ménière's Disease.

Though the effects of cochlear implantation (CI) on patients with hearing loss has been well described, its effect on the auditory and vestibular symptoms in patients with Ménière's disease (MD) has not been firmly established. To determine whether CI in patients with MD improves hearing performance as measured by standard post-CI audiometric testing and to describe the impact of CI on subjective auditory and vestibular quality-of-life measures. Retrospective review of all patients with MD 18 years or older who met diagnostic criteria for definite MD and underwent CI at Wake Forest University Baptist Medical Center, a tertiary care academic medical center, from 2000 through 2012. Patients were invited to answer questions regarding their current hearing ability, subjective perception of symptoms, and functional status related to their MD before and after CI. Patient records were reviewed for pertinent information. Results were then analyzed for statistical significance. Pre-CI and post-CI sentence testing scores, frequency and severity of MD vestibular and auditory symptoms via the MD Functional Level Scale (FLS), and hearing quality of life via the Hearing Handicap Index were reviewed. Eleven CIs were performed in 10 patients. Mean long-term follow-up was 41 months. The mean age at first implantation was 64 years. The mean sentence testing scores in quiet improved from 22.8% before CI to 77.0% after CI (P < .001) at the most recent follow-up. Mean (SD) pre-CI and post-CI MD-FLS vestibular scores were similar: 3.9 (1.9) and 3.4 (1.9) (P = .52). Patients with MD who undergo CI are capable of achieving substantial receptive communication improvement comparable to the gains experienced by patients without MD. Implantation seems to neither adversely alter the natural history of vestibular function nor notable exacerbate auditory symptoms.

Chronic cerebrospinal venous insufficiency in Ménière disease

The aim of this study was to focus on patients suffering from cochleo-vestibular disorder with and without Ménière disease (MD) in order to verify whether chronic cerebrospinal drainage abnormalities could play a role in the etiopathogenesis of endolymphatic hydrops. Fifty-two volunteers were enrolled and subdivided into two groups: 24 definite MD and 28 not-MD. Both magnetic resonance venography imaging with contrast-enhanced imaging of the venous cerebrospinal system (MRV) and venous echo-color Doppler (ECD) were performed. MRV showed abnormalities in 83% of MD and 57% of not-MD subjects (p < 0.001). Asymmetrical cervical venous flow, assessed by MRV, was confirmed by ECD in 62.5% of MD but in only 21.5% of not-MD subjects (p<0.001). Chronic cerebrospinal venous insufficiency might be the anatomical background, which provides a predisposing factor for the development of endolymphatic hydrops in MD patients.

Chemical labyrinthectomy for the worse ear of adult Nigerians with bilateral Meniere’s disease: preliminary report of treatment outcomes

The objective of this study was to assess the effectiveness of variable titration, low-dose intratympanic gentamycin (ITG) into the worse affected ear of patients with bilateral Meniere's disease (MD). It is a prospective analytic case series conducted in a tertiary care referral hospital in a developing economy and a tertiary care otologic private ENT clinic. Patients with MD who failed or are intolerant to medical treatment were recruited based on the criteria of definite MD and bilateral ear involvement. 0.75 cc of low-dose (40 mg/ml) buffered gentamycin was injected into the worse affected ear and patients followed up every 2 months, and the regime repeated only if subjective vertigo persists. The patient's age, sex, duration of MD symptom, ear first affected, ear selected for ITG, pure tone threshold at each visit, duration of caloric response (in seconds) for the injected ear, status of tinnitus in both ipsilateral (injected) and contralateral ears, total number of injections before last follow-up, and time since last follow-up are entered into the study protocol and analyzed. Nine patients with a mean age of 45 years and mean duration of symptoms of 59 months were treated. The mean total number of injections was 2.8 with a mean follow-up period of 34 months. Three cases showed drop in pure tone average threshold (2.5-7.5 dB) while an increase in threshold was noted in six cases (2.5-5 dB). All cases demonstrated decrease in duration of response to iced water caloric stimulation in ipsilateral ear, and 4/9 of contralateral ear. The variable titration method using low-dose intratympanic gentamycin directed at worse ear of adult Nigerians with bilateral Meniere's disease appears to be highly effective. More studies are needed.

The diagnostic value of vestibular evoked myogenic potentials in patients with Meniere's disease

To estimate the sensitivity and specificity of vestibular evoked myogenic potentials (VEMPs) in comparison with caloric test in diagnosing Meniere's disease (MD) among patients with dizziness. Data were retrospectively collected from 1,170 consecutive patients who underwent vestibular tests. Among them, 114 patients were diagnosed as having unilateral definite MD. VEMPs in response to clicks and short tone burst stimulation as well as caloric tests were performed. The sensitivity and specificity of each test were evaluated. The results of each test were compared with hearing level and staging of MD. The sensitivity and specificity of VEMPs were 50.0% and 48.9%, while those of the caloric test were 37.7% and 51.2%, respectively. There was no significant difference in hearing level between patients appropriately or inappropriately identified by VEMPs, whereas there was a significant difference in those of the caloric test. Combined use of VEMP and caloric test increased the sensitivity to 65.8%. Although the sensitivity and specificity of VEMPs in diagnosing MD were not high, they were comparable to those of caloric test. VEMPs as well as caloric testing may give additional information as part of a diagnostic test battery for detecting vestibular abnormalities in MD.

L’admittancemétrie multifréquentielle dans le diagnostic de la maladie de Menière – étude personnelle et revue de la littérature

Saccades are often observed on video head impulse tests (vHIT) in patients with Meniere's Disease (MD) and Vestibular Migraine (VM). However, their saccadic features are not fully described.This study aims to identify the saccades characteristics of MD and VM.75 VM patients and 103 definite unilateral MD patients were enrolled in this study. First raw saccades were exported and analyzed. The VM patients were divided into left and right based on their ears, while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.The MD patients have more saccades on the affected side (85% vs. 69%), and saccade velocity is more consistent than the contralateral side (shown by the coefficient of variation). The saccades occurrence rates on both sides are similar in VM (77% vs. 76%), as are other saccadic parameters. The MD patients have more significant inter-aural differences than the VM patients, manifested in higher velocity (p-value 0.000), earlier arriving (p-value 0.010), and more time-domain gathered (p-value 0.003) on the affected side.Bilateral saccades are commonly observed in MD and VM. In contrast to MD, saccades on VM are subtle, scattered, and late-arrived. Furthermore, the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.

Genetic Evidence for an Ethnic Diversity in the Susceptibility to Ménière’s Disease

Ménière's disease (MD) is a debilitating disorder of the inner ear characterized by cochlear and vestibular dysfunction. The cause of this disease is still unknown, and epidemiological data for MD are sparse. From the existing literature, women seem to be more susceptible than men, and Caucasians seem to be more susceptible than Asians. In this article, we characterize a large definite MD cohort for sex and age of onset of disease and use molecular genetic methodologies to characterize ethnicity. Medical record review for sex and age of onset. Ancestry analysis compared results from the principal component analysis of whole-genome genotype data from MD patients to self-identified ancestry in control samples. House Clinic in Los Angeles. Definitive MD patients. Our review of medical records for definitive MD patients reveals that women are more susceptible than men. We also find that men and women have nearly identical age of onset for disease. Lastly, interrogation of molecular genetic data with principal component analysis allowed detailed observations about the ethnic ancestry of our patients. Comparison of the ethnicity of MD patients presenting to our tertiary care clinic with the self-recollected ethnicity of all patients visiting the clinic revealed an ethnic bias, with Caucasians presenting at a higher frequency than expected and the remaining major ethnicities populating Los Angeles (Hispanics, Blacks, and Asians) presenting at a lower frequency than expected. To the best of our knowledge, this report is the first ethnic characterization of a large MD cohort from a large metropolitan region using molecular genetic data. Our data suggest that there is a bias in sex and ethnic susceptibility to this disease.