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Cerebral Small Vessel Disease in Elderly Patients With Menière's Disease
Fieke K Oussoren1,2, Roeland B van Leeuwen1, Tjard R Schermer1,3
1Apeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, The Netherlands.
Background:
Menière's disease (MD) is an inner ear disease characterized by vertigo attacks, progressive hearing loss, tinnitus, and the sensation of aural fullness. Although the exact pathophysiology of MD is unknown, endolymphatic hydrops is considered to be its histopathological hallmark. It has been suggested that endolymphatic hydrops results from lowered perfusion pressure due to cardiovascular comorbidity. Cardiovascular risk factors can cause cerebral small vessel disease (CSVD), visible on MRI. The presence of CSVD in turn raises the risk of developing a stroke.
Objectives:
This study aimed to compare the presence of CSVD and cardiovascular risk factors in elderly patients with MD to a control cohort.
Methods:
Patients diagnosed with MD, aged 50 years and older, were retrospectively reviewed and compared with a control cohort. The primary outcome was the difference in CSVD on MRI imaging, which was assessed by the number of white matter hyperintensities using the ordinal Fazekas scale. The secondary outcome was the presence of brain infarctions on MRI.
Results:
A total of 111 patients with MD were compared with a control cohort of 111 patients. No difference in the degree of white matter hyperintensities (P = 0.890) was found between the MD and control cohort. Brain infarctions were seen in 8 of 111 patients with MD and 14 of 111 patients from the control cohort (P = 0.261).
Conclusion:
CSVD is not more frequently visible on MRI in elderly patients with MD than in controls. This result does not support hypoperfusion-induced ischemia in the pathophysiology of MD.
Insights
This study found no increased evidence of cerebral small vessel disease (CSVD) on MRI scans in elderly Menière
Area of Science:
- Neurology
- Otolaryngology
- Radiology
Background:
- Menière's disease (MD) is an inner ear disorder characterized by vertigo, hearing loss, tinnitus, and aural fullness.
- Endolymphatic hydrops is the hallmark of MD, potentially linked to cardiovascular comorbidities and reduced perfusion.
- Cardiovascular risk factors can lead to cerebral small vessel disease (CSVD), detectable via MRI, and increase stroke risk.
Purpose of the Study:
- To compare the prevalence of CSVD and cardiovascular risk factors in elderly patients with MD against a control group.
- To investigate the potential role of hypoperfusion-induced ischemia in the pathophysiology of Menière's disease.
Main Methods:
- Retrospective review of 111 elderly MD patients and 111 controls.
- Primary outcome: Comparison of CSVD via white matter hyperintensities (Fazekas scale) on MRI.
- Secondary outcome: Assessment of brain infarctions on MRI.
Main Results:
- No significant difference in white matter hyperintensities (Fazekas scale) between MD and control groups (P = 0.890).
- Brain infarctions were observed in 7.2% of MD patients and 12.6% of controls (P = 0.261).
Conclusions:
- Cerebral small vessel disease is not more prevalent in elderly MD patients compared to controls.
- These findings do not support the hypothesis that hypoperfusion-induced ischemia contributes to the pathophysiology of Menière's disease.
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