Elevated red cell distribution width predicts residual dizziness in patients with benign paroxysmal positional vertigo

Abstract

ObjectiveThe present study aimed to determine whether residual dizziness (RD) after successful repositioning treatment in benign paroxysmal positional vertigo (BPPV) patients could be predicted by red blood cell distribution width (RDW).Materials and methodsIn this study, a total of 303 BBPV patients hospitalized at the neurology department were investigated. The enrolled patients were divided into two groups after successful repositioning treatment: non-RD group included patients who were completely cured, and RD group included patients with RD. We collected data on all subjects, including general information, blood routine examination, blood biochemical examination, and magnetic resonance imaging tests.ResultsThe mean RDW values of patients in the RD group were significantly higher than that in the non-RD group (13.63 ± 1.8 vs. 12.5 ± 0.8; p < 0.001). In subsequent multivariate analysis, elevated RDW levels were a statistically significant risk factor associated with the occurrence of RD [odds ratio = 2.62, 95% confidence interval (CI) 1.88–3.64, p < 0.001]. The area under the ROC curve was 0.723 in terms of its predictive ability to distinguish patients with RD. A cut-off point of 12.95% of RDW predicted RD with a sensitivity of 75.6% and a specificity of 69.5%. Moreover, the AUC for the ability of the RDW to predict recurrence were 0.692 (95% CI = 0.561–0.831; p < 0.014).ConclusionsElevated RDW level was related to increased risk of RD among BPPV patients, requiring further efforts to clarify the actual underlying pathophysiology.

Residual dizziness after BPPV management: exploring pathophysiology and treatment beyond canalith repositioning maneuvers

“…There is evidence that BPPV patients have higher levels of oxidative stress than healthy groups. Oxidative stress is a critical factor in microcirculation disturbances through the induction of erythrocyte adhesion to the vascular endothelium and the reduction of erythrocyte deformability (20). It has also been suggested that oxidative stress might play a role in the development of BPPV through its relationship with calcium metabolism and the direct toxic effects of free oxygen radicals, including the triggering of apoptosis (21).…”

“…Otolin-1 is considered an inner ear-specific glycoprotein that can pass the blood-labyrinth barrier and be detected in peripheral blood (124). Elevated RDW is a potential rapid, inexpensive, and readily available laboratory biomarker of RD (20). Elevated RDW promotes platelet activation and aggregation and is a marker of the procoagulant status of red blood cells.…”

“…Elevated RDW promotes platelet activation and aggregation and is a marker of the procoagulant status of red blood cells. It may impair the microcirculation of the labyrinthine artery and increase oxidative stress (20), thus making it a possible indicator of RD. Of note, another assessment-the modified Clinical Test of Sensory Integration and Balance-has been proposed as an objective evaluation of both RD and postural imbalance after a successful CRM for BPPV (125), but it is not specific for RD in BPPV patients.…”