Effect of Late‐Stage Meniere's Disease and Vestibular Functional Impairment on Hippocampal Atrophy

Abstract

ObjectiveWe investigated correlations among clinical features, degree of inner ear endolymphatic hydrops (EH), and hippocampal volume (HV) in different stages of Meniere's disease (MD).MethodsFrom February 2021 to April 2022, clinical data were collected from 99 patients (39 males, 60 females, mean age: 50.4 ± 10.0 [range: 26–69] years) with unilateral MD admitted to the Department of Vertigo Disease of Shandong ENT Hospital. The left and right ears were affected in 64 and 35 patients, respectively. There were 50 and 49 cases in early (Stages 1, 2) and late stages (Stages 3, 4), respectively. Fifty healthy participants were included as controls. Audiovestibular function test results, EH grading using gadolinium‐enhanced magnetic resonance imaging (MRI), and HV determined on MRI were analyzed for patients at different stages of MD.ResultsBetween‐group comparisons of early and late MD revealed significant differences in the disease course, vestibular function (VF), degree of EH, and HV. There were no significant between‐group differences based on age, sex, affected side, subjective degree of dizziness, hospital anxiety, or depression. Mean HV in patients with early‐stage MD was correlated with the canal paresis value of the caloric test and pure tone hearing threshold, HV in late‐stage patients was correlated with vestibular EH.ConclusionPatients with late‐stage MD exhibited severe auditory and VF impairments, increased EH, and atrophy of the HV. More advanced disease was associated with greater vestibular damage and degree of EH.Level of Evidence3 Laryngoscope, 2023

Vestibular dysfunction leads to cognitive impairments: State of knowledge in the field and clinical perspectives (Review)

“…A study revealed that individuals with MD and right-sided hearing loss exhibited more prominent memory and concentration difficulties than those with left-sided hearing loss ( 157 ). Previous research has indicated that individuals with MD display signs of hippocampal atrophy, which could potentially contribute to their cognitive decline ( 158 , 159 ). A recent study found that patients with MD were more likely to have cognitive deficits than benign paroxysmal positional vertigo ( 160 ).…”

Comparison of Halmágyi–Curthoys Head Impulse (Thrust) Test with Romberg’s Test in Detection of Vestibular Hypofunctioning in Vertigo Patients

“…Additionally, the subjective nature of the assessment necessitates trained examiners to interpret subtle changes. Newer versions like the quantified Romberg test, employing force plates or video-based analysis, can provide more objective data [21].…”

Interpreting the meaning of changes in hippocampal volume associated with vestibular loss

“… Van Cruijsen et al (2007) found that MD was associated with an atrophy of the left HPC, as did Seo et al (2016) . On the other hand, Jian et al (2023) reported that unilateral, late stage MD was associated with a bilateral HPC atrophy.…”