Seasonality and Cardio-Cerebrovascular Risk Factors for Benign Paroxysmal Positional Vertigo

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, especially in the elderly. Several studies have revealed a possible seasonality to BPPV. However, whether the seasonality of BPPV also exists in China is unclear. The characteristics of cardio-cerebrovascular risk factors for BPPV in the cold season have not yet been investigated. Objectives: (1) To investigate the seasonality of BPPV; (2) To explore the relationship between cardio-cerebrovascular risk factors and seasonality of BPPV. Methods: A retrospective observational study was performed in Beijing Tiantan Hospital from Jan 2016 to Dec 2018. The study included 1,409 new-onset BPPV patients aged 18-88 years. The demographic data, onset time, and medical history of BPPV were collected. The meteorological data, including temperature, atmospheric pressure, rainfall, and insolation, was obtained from Beijing Meteorological service. The x 2 goodness of fit test was used to evaluate whether BPPV patients' numbers were significantly different among different months of the year. The Spearman correlation was used to detect the correlation between numbers of BPPV patients diagnosed monthly with each climatic parameter. The chi-square test for linear-by-linear association were used to investigate the relationship between cardio-cerebrovascular risk factor and seasonality of BPPV. Results: November to next March is the top 5 months with higher BPPV patient numbers (P < 0.001). The numbers of BPPV diagnosed monthly were conversely correlated with temperature and rainfall (r = −0.736, P = 0.010; r = −0.650, P = 0.022, respectively), positively correlated with atmospheric pressure (r = 0.708, P = 0.010), but no significant correlated with insolation. BPPV in the cold season (including January, February, March, November, and December) had a higher proportion, accounting for 54.2% of all BPPV patients. Among BPPV patients with ≥2, 1, and none cardio-cerebrovascular risk factors, the cold season accounted for 57.0, 56.0, 49.8%, respectively. As the number of cardio-cerebrovascular risk factors increased, the proportion of patients in the cold season of BPPV increased (P = 0.025). Cao et al. Seasonality, Cardio-Cerebrovascular Factors for BPPV Conclusions: BPPV patients are seen more in the months with low temperature, low rainfall, and high atmospheric pressure. Compared with the non-cold season, BPPV patients have more risk factors for cardio-cerebrovascular diseases in the cold season.

Nystagmus Parameters of Supine Roll Test Correlates With Prognosis After Repositioning Maneuver in Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo

“…Our study shows HC-BPPV recurrence is not correlated with age, gender, seasons, and blood pressure status, which is consistent with some previous studies (21)(22)(23), while other studies presented conflicting results, including our previous study on PC-BPPV (16). The results also showed that the recurrence of BPPV was closely associated with the female gender.…”

The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo

“…The inner ear is an organ with strong aerobic metabolism and is sensitive to ischemia [9,23]. In particular, ischemia can cause local microcirculation disturbances to the vestibule, damage the elliptic sac, make otoliths more likely to fall off, and at the same time, affect the absorption of otoliths in the endolymph, which causes BPPV recurrence and occurrence of RD [7][8][9].…”

“…The labyrinthine artery of the inner ear is a tiny terminal artery. Small vessel lesions that directly damage the tiny arteries of the inner ear lead to microcirculation disorders, which can cause damage to the blood Ivyspring International Publisher supply vessels of the inner ear, leading to the shedding of otoliths, which may be involved in BPPV pathogenesis [7][8][9]. Abnormal cerebral small vessels, including arterioles, branch arterioles, capillaries and venules, can directly damage blood supply, leading to microcirculatory disorders [10].…”

Climatic Variations as Indicators of Vitamin D Levels and Benign Paroxysmal Positional Vertigo

“…The median number of BPPV patients, median sunshine hours per month, horizontal solar irradiance, and other climatic variations are described and demonstrate no statistical significance between the month of BPPV onset and months with low serum Vitamin D levels (Figures 2 and 3). Several studies mention the statistically significant difference between the incidence of BPPV in months when Vitamin D levels are lower compared to those months that these levels are higher while others report on specific atmospheric data such as barometric pressure and its possible relationship with BPPV [5][6][7][15][16][17]. On the other hand, recent studies report no seasonality in BPPV patients [8,9].…”

“…Several studies mention the statistically significant difference between the incidence of BPPV in months when Vitamin D levels are lower compared to those months that these levels are higher while others report on specific atmospheric data such as barometric pressure and its possible relationship with BPPV [ 5 - 7 , 15 - 17 ]. On the other hand, recent studies report no seasonality in BPPV patients [ 8 , 9 ].…”