Clinical Subgroups in Bilateral Meniere Disease

Frejo, Lidia; Soto-Varela, Andrés; Santos-Pérez, Sofía; Arán, Ismael; Batuecas‐Caletrío, Ángel; Pérez-Guillén, Vanesa; Pérez-Garrigues, Herminio; Fraile, J.; Martín-Sanz, Eduardo; Tapia, Maria C.; Trinidad, Gabriel; García-Arumí, Ana María; González-Aguado, Rocío; Espinosa-Sánchez, Juan Manuel; P, Marques; Pérez, Paz; Benítez, Jesús Romero; Lopez-Escamez, José A.

doi:10.3389/fneur.2016.00182

Cited by 104 publications

(106 citation statements)

References 68 publications

(70 reference statements)

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“…Meanwhile, a discrepancy between autoimmunity and bilaterality was found in this study; systemic autoimmune diseases were not found in BMD patients. Furthermore, the frequency of systemic autoimmune disorders in patients with MD (0.94%) appeared to be much lower than that of Caucasian populations (∼11%), which is significantly higher than the general population . However, autoimmune pathology can be confined to the inner ear, which is unlikely to manifest as systemic symptoms.…”

Section: Discussionmentioning

confidence: 82%

“…In bilateral cases, intratympanic steroid injections and endolymphatic sac surgeries were chosen for the second‐line treatment for the second‐involved ear. Patients with simultaneous bilateral involvement with an interval shorter than 1 month between the first‐ and second‐ear involvement were considered to have synchronous BMD, and other bilateral involvements were categorized as metachronous BMD …”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, there are still controversies regarding the differences in the clinical characteristics and prognoses between patients with BMD and those with unilateral MD (UMD). Several studies have suggested associations between BMD and a higher frequency of migraines, a family history of MD, and systemic autoimmune diseases, whereas several studies have reported no significant differences in these conditions between patients with BMD and UMD . Additionally, changes in the frequency or duration of vertigo attacks after treatment are reported inconsistently .…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Bilateral Meniere's Disease in a Single Asian Ethnic Group

et al. 2018

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Objectives/Hypothesis To identify the clinical characteristics of patients with bilateral Meniere's disease (MD) in an Asian population. Study Design Cross‐sectional retrospective study. Methods We compared the clinical features of bilateral MD (BMD) and unilateral MD (UMD) in 320 Asian patients with single ethnicity. Demographic variables; age of onset; inner ear function; the coexistence of related disorders such as vestibular migraine, delayed MD, systemic autoimmune diseases, and familial MD; and prognoses were analyzed and compared. Results The overall prevalence of BMD was 5.6%. The mean age of disease onset was 40.3 ± 14.8 and 47.0 ± 14.1 years for patients with BMD and UMD, respectively (P = .07). Demographic variables were not significantly different between patients with BMD and UMD (P > .05). Inner ear function, evaluated by hearing thresholds, caloric tests, and cervical vestibular evoked myogenic potentials, was significantly more deteriorated in the first involved ear of patients with BMD than in the second involved ear or the affected side of patients with UMD (P < .05). Among the comorbid conditions, only the prevalence of delayed MD was significantly higher in patients with BMD than in patients with UMD. Systemic autoimmune disease was found in only three patients with UMD. There was no significant prognostic difference between patients with UMD and BMD (P > .05). Conclusions A low prevalence of BMD, a higher frequency of delayed MD in BMD patients, and a low frequency of systemic autoimmune diseases in both UMD and BMD patients are significant findings in an Asian population. Level of Evidence 4 Laryngoscope, 129:1191–1196, 2019

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Section: Discussionmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics of Bilateral Meniere's Disease in a Single Asian Ethnic Group

et al. 2018

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“…Recently, an interesting cluster analysis on bilateral Meniere disease was published to define clinical subgroups with potential similar etiologies. In this study, five clinical variants of bilateral Meniere disease were found based on six clinical variables and with a high silhouette measure of 0.8 (9). This study is not only beneficial to improve the selection of patients but also can explain the negative treatment effects of several treatment trials, as results can be biased by a heterogeneous patient group based on etiology (9).…”

Section: Discussionmentioning

confidence: 87%

“…In this study, five clinical variants of bilateral Meniere disease were found based on six clinical variables and with a high silhouette measure of 0.8 (9). This study is not only beneficial to improve the selection of patients but also can explain the negative treatment effects of several treatment trials, as results can be biased by a heterogeneous patient group based on etiology (9). The difficulty in cluster analysis is that it is a type of analysis that is very sensitive to change of variables.…”

Section: Discussionmentioning

confidence: 87%

Cluster Analysis to Identify Possible Subgroups in Tinnitus Patients

et al. 2017

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IntroductionIn tinnitus treatment, there is a tendency to shift from a “one size fits all” to a more individual, patient-tailored approach. Insight in the heterogeneity of the tinnitus spectrum might improve the management of tinnitus patients in terms of choice of treatment and identification of patients with severe mental distress. The goal of this study was to identify subgroups in a large group of tinnitus patients.MethodsData were collected from patients with severe tinnitus complaints visiting our tertiary referral tinnitus care group at the University Medical Center Groningen. Patient-reported and physician-reported variables were collected during their visit to our clinic. Cluster analyses were used to characterize subgroups. For the selection of the right variables to enter in the cluster analysis, two approaches were used: (1) variable reduction with principle component analysis and (2) variable selection based on expert opinion.ResultsVarious variables of 1,783 tinnitus patients were included in the analyses. Cluster analysis (1) included 976 patients and resulted in a four-cluster solution. The effect of external influences was the most discriminative between the groups, or clusters, of patients. The “silhouette measure” of the cluster outcome was low (0.2), indicating a “no substantial” cluster structure. Cluster analysis (2) included 761 patients and resulted in a three-cluster solution, comparable to the first analysis. Again, a “no substantial” cluster structure was found (0.2).ConclusionTwo cluster analyses on a large database of tinnitus patients revealed that clusters of patients are mostly formed by a different response of external influences on their disease. However, both cluster outcomes based on this dataset showed a poor stability, suggesting that our tinnitus population comprises a continuum rather than a number of clearly defined subgroups.

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Cluster Analysis to Identify Clinical Subtypes of Ménière's Disease

Phillips,

Murdin,

Khondoker

et al. 2024

The Laryngoscope

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ObjectiveTo identify distinct clinical subtypes of Ménière's disease by analyzing data acquired from a UK registry of patients who have been diagnosed with Ménière's disease.Study DesignObservational study.MethodsPatients with Ménière's disease were identified at secondary/tertiary care clinics. Cluster analysis was performed by grouping participants sharing similar characteristics and risk factors into groups based on a defined measure of similarity.ResultsA total of 411 participants were recruited into this study. Two main clusters were identified: participants diagnosed with ear infections (OR = 0.30, p < 0.014, 95% CI: 0.11–0.78) were more likely to be allocated in Cluster 1 (C1). Participants reporting tinnitus in both ears (OR = 11.89, p < 0.001, 95% CI: 4.08–34.64), low pitched tinnitus (OR = 21.09, p < 0.001, 95% CI: 7.47–59.54), and those reporting stress as a trigger for vertigo attacks (OR = 14.94, p < 0.001, 95% CI: 4.54–49.10) were significantly more likely to be in Cluster 2 (C2). Also, participants diagnosed with Benign Paroxysmal Positional Vertigo (OR = 13.14, <0.001, 95% CI: 4.35–39.74), autoimmune disease (OR = 5.97, p < 0.007, 95% CI: 1.62–22.03), depression (OR = 4.72, p < 0.056, 95% CI: 0.96–23.24), migraines (OR = 3.13, p < 0.008, 95% CI: 1.34–7.26), drug allergy (OR = 3.25, p < 0.029, 95% CI: 1.13–9.34), and hay fever (OR = 3.12, p < 0.009, 95% CI: 1.33–7.34) were significantly more likely to be clustered in C2.ConclusionsThis study supports the hypothesis that Ménière's disease is a heterogeneous condition with subgroups that may be identifiable by clinical features. Two main clusters were identified with differing putative etiological factors.Level of Evidence3 Laryngoscope, 2024

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Clinical Subgroups in Bilateral Meniere Disease

Cited by 104 publications

References 68 publications

Clinical Characteristics of Bilateral Meniere's Disease in a Single Asian Ethnic Group

Clinical Characteristics of Bilateral Meniere's Disease in a Single Asian Ethnic Group

Cluster Analysis to Identify Possible Subgroups in Tinnitus Patients

Cluster Analysis to Identify Clinical Subtypes of Ménière's Disease

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