Utility of the Frequency Tuning Measure of oVEMP in Differentiating Meniere’s Disease from BPPV

2016 ◽  
Vol 27 (09) ◽  
pp. 764-777 ◽  
Author(s):  
Niraj Kumar Singh ◽  
Animesh Barman
Keyword(s):  
Comparison Group ◽  
Frequency Tuning ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Peak Amplitude ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Healthy Individuals ◽  
Menière's Disease ◽  
Ménière's Disease

Background: Utility of frequency tuning of ocular vestibular evoked myogenic potential (oVEMP) for evaluation of utricular function in individuals with Meniere’s disease is a recent development. However, there is dearth of studies regarding its utility in differential diagnosis of Meniere’s disease from other vestibular pathologies. Purpose: The present study aimed at investigating the feasibility of frequency tuning of oVEMP in discriminating Meniere’s disease from benign paroxysmal positional vertigo (BPPV). Research Design: Static group comparison. Study Sample: oVEMPs were acquired from 36 individuals, each with unilateral Meniere’s disease and unilateral BPPV. Thirty-six age- and gender-matched healthy individuals formed comparison group for each of the two clinical groups. Intervention: Contralateral oVEMPs were recorded from both ears of all the participants. Data Collection and Analyses: The responses pertaining to octave and mid-octave frequencies from 250 to 4000 Hz, one frequency presented at a time, were recorded from infra-orbital electrodes (noninverting placed 1 cm below the lower eyelid and inverting 2 cm below the inverting on the cheek) with forehead as ground. Starting intensity was 125 dB peSPL with subsequent reductions in 10-dB steps to arrive at threshold. The stimuli were delivered to the ear at a rate of 5.1 Hz. The frequency corresponding to the largest peak-to-peak amplitude, best threshold, and/or largest peak-to-peak amplitude at thresholds was considered as the tuning frequency. Proportions of ears with frequency tuning at a particular frequency were compared between the groups Results: The frequency tuning at 1000 Hz was found to exist in a significantly higher proportion of affected ears with Meniere’s disease than the comparison group as well as ears with BPPV (p < 0.05). Using a criterion point of frequency tuning at 875 Hz, the sensitivity and specificity for identifying Meniere’s disease was found to be 68% and 100%, respectively. Conclusion: The shift in frequency tuning is an efficient parameter for not only discriminating Meniere’s disease from healthy individuals but also distinguishing it from BPPV. Therefore, frequency tuning is recommended as a test parameter of oVEMP for identification of Meniere’s disease.

scholarly journals Association between Late-Onset Ménière’s Disease and the Risk of Incident All-Cause Dementia

2021 ◽  
Vol 12 (1) ◽  
pp. 19
Author(s):  
Il Hwan Lee ◽  
Hyunjae Yu ◽  
Seung-Su Ha ◽  
Gil Myeong Son ◽  
Ki Joon Park ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Comparison Group ◽  
Late Onset ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease ◽  
Incidence Of Dementia

Studies reported an association between impaired hearing and vestibular function with the risk of dementia. This study investigated the association between Ménière’s disease (MD) and the risk of dementia using a nationwide cohort sample of data obtained from the South Korea National Health Insurance Service. The MD group (n = 496) included patients aged over 55 years and diagnosed between 2003 and 2006. The comparison group was selected using propensity score matching (n = 1984). Cox proportional hazards regression models were used to calculate incidence and hazard ratios for dementia events. The incidence of dementia was 14.3 per 1000 person–years in the MD group. After adjustment for certain variables, the incidence of dementia was higher in the MD group than in the comparison group (adjusted hazard ratio (HR) = 1.57, 95% confidence interval = 1.17–2.12). Subgroup analysis showed a significantly increased adjusted HR for developing Alzheimer’s disease (1.69, 95% confidence interval = 1.20–2.37) and vascular dementia (1.99, 95% confidence interval = 1.10–3.57) in the MD group. Patients with dementia experienced a higher frequency of MD episodes than those without dementia. Our findings suggest that late-onset MD is associated with an increased incidence of all-cause dementia, and it might be used as a basis for an earlier diagnosis of dementia.

Abstract P626: Stress-Induced Natriuresis and Blood Pressure Regulation in Patients with Meniere’s Disease

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Seung Su Lee ◽  
Deborah L Stewart ◽  
Gregory A Harshfield
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Response ◽  
Meniere’S Disease ◽  
Blood Pressure Regulation ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Healthy Individuals ◽  
Menière's Disease ◽  
Ménière's Disease

Objective: Meniere’s disease is an idiopathic disorder characterized by strong attacks of vertigo, nausea, aural fullness, and fluctuating sensorineural hearing loss. Previous studies by our lab have suggested a possible role of stress-induced natriuresis and blood pressure regulation in Meniere’s disease. This study hypothesized patients with Meniere’s disease will excrete less sodium during stress, as compared to healthy individuals, and will have elevated and delayed blood pressure response. Methods: Twenty-seven patients with Meniere’s disease (51.9% male; 61.1±11.5 years; 24 Caucasians, 3 African-American) were recruited for testing. Seventy-eight percent of the patients were taking medications including anti-inflammatory, diuretics, and anti-hypertensive medications. The protocol included 10 minutes rest, 20 minutes stress (competitive video game), and 10 minutes recovery. Urine samples were collected before and after the rest and stress periods. The data was compared to our previous study which has 586 healthy adolescents (49% male; 16.4±1.12 years; 222 Caucasians, 364 African-Americans) undergoing similar stress protocol. Results: During stress, Meniere’s patients showed lower mean change in sodium excretion, as compared to healthy individuals (Mean deltaUNaV: 0.033±0.064 mEq/L vs 3.256±6.259 mEq/L with p=0.035, controlling for medication and age). A trend of elevated and delayed blood pressure response to stress in Meniere’s disease patients was also observed. Mean systolic blood pressure did not significantly change (p=0.798) in Meniere’s patients from stress (132.96±2.88 mmHg) to recovery (132.21±3.03 mmHg) while it changed significantly (p<0.01) from stress (115.83±0.48 mmHg) to recovery (110.02±0.41) in healthy individuals. Conclusion: This study, to our knowledge, is the first to consider the stress-induced natriuresis among Meniere’s disease patients. Decreased sodium excretion with elevated and delayed blood pressure response, despite taking anti-hypertensive medications, suggests that angiotensin, an important stress hormone, may play a role in the impaired natriuresis and blood pressure regulation in patients with Meniere’s disease.

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