Correlations of Clinical and Audio-Vestibulometric Findings with Coexisting Anxiety and Depression in Ménière's Disease Patients. 2023

Bugra Subasi, and Nadir Yildirim, and Zeynep Yildiz Akbey, and Nesibe Esra Karaman, and Ozlem Arik
Department of Otorhinolaryngology, Kutahya Health Sciences University Medical Faculty, Kutahya, Turkey.

Ménière's disease (MD) is an inner ear disorder, characterized by vertiginous attacks, fluctuating sensorineural hearing loss, tinnitus, and a feeling of ear fullness. Endolymphatic hydrops has been proven as the underlying pathology. Frequently, psychopathologies accompany the disease. The aim of this study was to investigate the correlation of anxiety and depression with demographic, clinical, and audio-vestibular findings in MD patients. The study included 40 consecutive unilateral MD patients. Demographic data (age, sex, education, employment, and marital status), clinical variables of drop attacks, the duration, frequency and severity of vertigo attacks, and tinnitus disturbance levels were recorded. Hearing threshold levels were graded between 1 and 4. Vestibulometric variables were taken as the presence of saccades and vestibulo-ocular reflex (VOR) gain deficits in the video head impulse tests (vHIT) and canal paresis in bithermal caloric tests. Becks's depression and anxiety scales were used for psychometric evaluations and graded by 4 and 5 from normal to severe and normal to very severe, respectively. The median age of the patients was 48.94 years, and the numbers of both sexes were almost equal (male/female = 19/21). All patients reported at least one vertigo attacks within the last year. The duration of attacks was most commonly (62.5%) 1-3 h, ranging from <1 h to 17 h. Most attacks were graded as mild (67.5%), and the frequency was 2-3 episodes per year in 22 (55%) patients. The number of attacks within the last year was 1-12. Three patients reported having drop attacks. Hearing loss in the affected ear was moderate/moderately severe in 20 (50%) patients. Thirty-seven (92.5%) patients had complaints of tinnitus. In vHIT, saccades and VOR gain deficits were found in 33 (82.5%) and 11 (27.5%) patients, respectively. Canal paresis was present in 18 (45%) patients. The depression and anxiety rates were 35% and 90%, respectively. Depression scores were correlated with education, marital status, and the presence of saccades. Anxiety was correlated only with tinnitus severity and VOR gain deficits. Depression and anxiety were also correlated. Vertigo appears to be more intrusive than the other MD symptoms, and a higher correlation with anxiety than depression was demonstrated in this cohort. However, depression was seen less among married and educated patients, suggesting the role of coping capability, and had more pronounced clinical/vestibulometric correlates. Overall, these results indicated that it is mainly the severity of organic/physiological pathology which determines the degree of depression and anxiety in MD rather than vice versa.

UI MeSH Term Description Entries
D008297 Male Males
D008575 Meniere Disease A disease of the inner ear (LABYRINTH) that is characterized by fluctuating SENSORINEURAL HEARING LOSS; TINNITUS; episodic VERTIGO; and aural fullness. It is the most common form of endolymphatic hydrops. Meniere's Disease,Meniere's Syndrome,Vertigo, Aural,Auditory Vertigo,Aural Vertigo,Ménière Disease,Ménière's Disease,Ménière's Vertigo,Otogenic Vertigo,Auditory Vertigos,Disease, Meniere,Disease, Meniere's,Disease, Ménière,Disease, Ménière's,Diseases, Ménière,Diseases, Ménière's,Meniere Syndrome,Menieres Disease,Menieres Syndrome,Ménière Diseases,Ménière Vertigo,Ménière's Diseases,Ménière's Vertigos,Ménières Disease,Ménières Vertigo,Otogenic Vertigos,Syndrome, Meniere's,Vertigo, Auditory,Vertigo, Ménière's,Vertigo, Otogenic,Vertigos, Auditory,Vertigos, Ménière's,Vertigos, Otogenic
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001007 Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS. Angst,Anxiousness,Hypervigilance,Nervousness,Social Anxiety,Anxieties, Social,Anxiety, Social,Social Anxieties
D013575 Syncope A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9) Drop Attack,Fainting,Presyncope,Syncope, Postural,Syncopal Episode,Syncopal Vertigo,Syncope, Cardiogenic,Syncope, Carotid Sinus,Syncope, Convulsive,Syncope, Deglutitional,Syncope, Effort,Syncope, Hyperventilation,Syncope, Micturition,Syncope, Situational,Syncope, Stokes-Adams,Syncope, Tussive,Attack, Drop,Cardiogenic Syncope,Cardiogenic Syncopes,Carotid Sinus Syncope,Carotid Sinus Syncopes,Convulsive Syncope,Convulsive Syncopes,Deglutitional Syncope,Deglutitional Syncopes,Drop Attacks,Effort Syncope,Effort Syncopes,Episode, Syncopal,Hyperventilation Syncope,Hyperventilation Syncopes,Micturition Syncope,Micturition Syncopes,Postural Syncope,Postural Syncopes,Presyncopes,Situational Syncope,Situational Syncopes,Stokes-Adams Syncope,Stokes-Adams Syncopes,Syncopal Episodes,Syncope, Stokes Adams,Syncopes,Syncopes, Cardiogenic,Syncopes, Carotid Sinus,Syncopes, Convulsive,Syncopes, Deglutitional,Syncopes, Effort,Syncopes, Hyperventilation,Syncopes, Micturition,Syncopes, Postural,Syncopes, Situational,Syncopes, Stokes-Adams,Syncopes, Tussive,Tussive Syncope,Tussive Syncopes,Vertigo, Syncopal,Vertigos, Syncopal
D014012 Tinnitus A nonspecific symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, and other noises in the ear. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of COCHLEAR DISEASES; VESTIBULOCOCHLEAR NERVE DISEASES; INTRACRANIAL HYPERTENSION; CRANIOCEREBRAL TRAUMA; and other conditions. Pulsatile Tinnitus,Ringing-Buzzing-Tinnitus,Spontaneous Oto-Acoustic Emission Tinnitus,Tensor Palatini Induced Tinnitus,Tensor Tympani Induced Tinnitus,Tinnitus of Vascular Origin,Tinnitus, Clicking,Tinnitus, Leudet,Tinnitus, Leudet's,Tinnitus, Noise Induced,Tinnitus, Objective,Tinnitus, Spontaneous Oto-Acoustic Emission,Tinnitus, Subjective,Tinnitus, Tensor Palatini Induced,Tinnitus, Tensor Tympani Induced,Vascular Origin Tinnitus,Clicking Tinnitus,Induced Tinnitus, Noise,Leudet Tinnitus,Leudet's Tinnitus,Noise Induced Tinnitus,Objective Tinnitus,Ringing Buzzing Tinnitus,Spontaneous Oto Acoustic Emission Tinnitus,Subjective Tinnitus,Tinnitus, Leudets,Tinnitus, Pulsatile,Tinnitus, Spontaneous Oto Acoustic Emission,Tinnitus, Vascular Origin
D014717 Vertigo An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1) CNS Origin Vertigo,Central Nervous System Origin Vertigo,Positional Vertigo,Spinning Sensation,Vertigo, Brain Stem,Vertigo, Brainstem,Vertigo, Central Nervous System Origin,Vertigo, Central Origin,Vertigo, Constant,Vertigo, Essential,Vertigo, Intermittant,Vertigo, Paroxysmal,Vertigo, Peripheral,Vertigo, Subjective,Brain Stem Vertigo,Brain Stem Vertigos,Brainstem Vertigo,Brainstem Vertigos,CNS Origin Vertigos,Central Origin Vertigo,Central Origin Vertigos,Constant Vertigo,Constant Vertigos,Essential Vertigo,Essential Vertigos,Intermittant Vertigo,Intermittant Vertigos,Origin Vertigo, CNS,Origin Vertigo, Central,Origin Vertigos, CNS,Origin Vertigos, Central,Paroxysmal Vertigo,Paroxysmal Vertigos,Peripheral Vertigo,Peripheral Vertigos,Sensation, Spinning,Sensations, Spinning,Spinning Sensations,Subjective Vertigo,Subjective Vertigos,Vertigo, CNS Origin,Vertigo, Positional,Vertigos,Vertigos, Brain Stem,Vertigos, Brainstem,Vertigos, CNS Origin,Vertigos, Central Origin,Vertigos, Constant,Vertigos, Essential,Vertigos, Intermittant,Vertigos, Paroxysmal,Vertigos, Peripheral,Vertigos, Subjective

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