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. 2016 Oct 24:7:182.
doi: 10.3389/fneur.2016.00182. eCollection 2016.

Clinical Subgroups in Bilateral Meniere Disease

Lidia Frejo  1 , Andres Soto-Varela  2 , Sofía Santos-Perez  2 , Ismael Aran  3 , Angel Batuecas-Caletrio  4 , Vanesa Perez-Guillen  5 , Herminio Perez-Garrigues  5 , Jesus Fraile  6 , Eduardo Martin-Sanz  7 , Maria C Tapia  8 , Gabriel Trinidad  9 , Ana María García-Arumi  10 , Rocío González-Aguado  11 , Juan M Espinosa-Sanchez  12 , Pedro Marques  13 , Paz Perez  14 , Jesus Benitez  15 , Jose A Lopez-Escamez  16
Affiliations

Clinical Subgroups in Bilateral Meniere Disease

Lidia Frejo et al. Front Neurol. .

Abstract

Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD.

Keywords: Meniere’s disease; autoimmune disorders; cluster analysis; hearing loss; inner ear; migraine; tinnitus; vestibular disorders.

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Figures

Figure 1
Figure 1
Age of onset in bilateral Meniere disease. Distribution of frequencies in familial and sporadic cases shows an earlier onset in FMD.
Figure 2
Figure 2
Age of onset in bilateral Meniere disease according to the type of hearing loss observed.
Figure 3
Figure 3
Summary of cluster analysis in bilateral Meniere disease (BMD). (A) Pie chart showing five groups or clinical variants in BMD. (B) Bar chart ranking the importance of predictors to define the groups. (C) Classification of BMD in five clinical variants according to its observed frequency and lead predictor: type 1, metachronic sensorineural hearing loss (SNHL); type 2, synchronic SNHL; type 3, familial Meniere disease (FMD); type 4, migraine; type 5, autoimmune disease.
Figure 4
Figure 4
Schematic diagram of the five subgroups in BMD. Circle areas are proportional to the frequency observed in each group.
See this image and copyright information in PMC

References

    1. Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandala M, et al. Diagnostic criteria for Meniere’s disease. J Vestib Res (2015) 25(1):1–7.10.3233/VES-150549 - DOI - PubMed
    1. Requena T, Espinosa-Sanchez JM, Cabrera S, Trinidad G, Soto-Varela A, Santos-Perez S, et al. Familial clustering and genetic heterogeneity in Meniere’s disease. Clin Genet (2014) 85(3):245–52.10.1111/cge.12150 - DOI - PubMed
    1. Stahle J, Friberg U, Svedberg A. Long-term progression of Meniere’s disease. Am J Otol (1989) 10(3):170–3. - PubMed
    1. Belinchon A, Perez-Garrigues H, Tenias JM. Evolution of symptoms in Meniere’s disease. Audiol Neurootol (2012) 17(2):126–32.10.1159/000331945 - DOI - PubMed
    1. Perez-Garrigues H, Lopez-Escamez JA, Perez P, Sanz R, Orts M, Marco J, et al. Time course of episodes of definitive vertigo in Meniere’s disease. Arch Otolaryngol Head Neck Surg (2008) 134(11):1149–54.10.1001/archotol.134.11.1149 - DOI - PubMed