Epidemiological and clinical differences in Meniere disease across European and East Asian populations

This narrative review focuses on the epidemiologic, clinical, and molecular aspects of Meniere disease, comparing studies from European and East Asian populations. Meniere disease is a complex, heterogeneous, chronic disorder of the human inner ear characterized by recurrent episodes of spontaneous vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness.The overall prevalence of Meniere disease is generally between 0.05% and 0.2% among adults worldwide. In Europe and North America, the reported point prevalence is generally higher than in East Asia, at ∼50-200 per 100,000 adults, with a female-to-male ratio of around 1.5-2:1. This contrasts with a slightly higher Meniere disease female-to-male ratio in East Asian populations, based on Korean data (∼2.17:1). Epidemiological data and genetic studies from China and other East Asian countries remain limited, with a reportedly lower incidence of Meniere disease in Japan (∼17 per 100,000/year based on national hospital surveys). In terms of clinical aspects of Meniere disease, the core symptom spectrum does not differ substantially between European and East Asian patients. Interestingly, comorbidity patterns appear to differ, whereby European studies in Meniere disease report an association with migraine and autoimmunity, whereas in East Asian data, this association is less frequently observed. Conversely, allergies and systemic inflammatory responses mediated by Th2 or autoinflammation have been reported in both European and East Asian studies. Familial Meniere disease is more commonly observed in European than East Asian populations, suggesting that the genetic structure may contribute to its susceptibility. We summarize the commonalities and differences with respect to the clinical manifestations and treatment of Meniere disease. We propose that multinational research on the molecular diagnosis and treatment of Meniere disease will facilitate a better understanding of the condition and provide impetus for future research.