Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, California.
Otol Neurotol. 2021 Mar 1;42(3):e323-e331. doi: 10.1097/MAO.0000000000002958.
Characterize the relationship between cognitive dysfunction and the dizziness severity in Meniére's disease (MD) patients.
Retrospective review.
University-based tertiary medical center.
Three hundred patients were evaluated for MD from 2015 to 2019. Excluding comorbid or alternative vestibular disorders, 29 patients with definite MD and available pre- and postintervention data were included for analysis.
A progressive protocol of salt restriction, diuretics, steroid and/or gentamycin injection, and endolymphatic sac decompression for those refractory to medical therapy.
Quality of life measured with the Dizziness Handicap Inventory (DHI) and cognitive function measured with the Cognitive Failures Questionnaire (CFQ). Pre- and posttreatment DHI and DHI subscale scores and change in these scores were correlated with pre- and posttreatment CFQ scores and change in CFQ with therapy.
Analysis showed a number of limited associations between improvement in DHI and improvement in CFQ. Total DHI scores failed to correlate scores or variation in scores with change in CFQ (p = 0.091 and p = 0.085, respectively). Improvement in the CFQ false-triggering domain was significantly associated with improvement in the DHI physical subscale (r = 0.491, p = 0.007) and was nonsignificantly associated with improvement in total DHI and DHI emotional subscale scores (r = 0.422, p = 0.016 and r = 0.399, p = 0.032).
The DHI correlates with several pre- and posttreatment measures of cognitive dysfunction (CFQ) in MD patients. However, change in DHI and CFQ with therapy correlate poorly. Overall, the commonly used DHI may fail to adequately assess cognitive dysfunction in MD patients possibly due to factors not directly implicated by measures of vestibular dysfunction, such as central nervous system or cognitive dysfunction; however, the specific physical and emotional subscales may offer helpful insight into cognitive dysfunction change/improvement with treatment.
描述梅尼埃病（MD）患者认知功能障碍与头晕严重程度之间的关系。
回顾性研究。
以大学为基础的三级医疗中心。
2015 年至 2019 年期间，对 300 名 MD 患者进行了评估。排除合并症或其他前庭疾病后，对 29 名具有明确 MD 且有干预前后数据的患者进行了分析。
对那些对药物治疗有反应的患者，采用渐进性盐限制、利尿剂、类固醇和/或庆大霉素注射以及内淋巴囊减压治疗。
使用头晕残障量表（DHI）测量生活质量，使用认知失败问卷（CFQ）测量认知功能。治疗前后 DHI 和 DHI 子量表评分以及这些评分的变化与治疗前后 CFQ 评分以及 CFQ 变化与治疗的关系。
分析显示 DHI 改善与 CFQ 改善之间存在一些有限的关联。总 DHI 评分与 CFQ 评分或评分变化均无相关性（p=0.091 和 p=0.085）。CFQ 错误触发域的改善与 DHI 身体子量表的改善显著相关（r=0.491，p=0.007），与总 DHI 和 DHI 情绪子量表评分的改善无显著相关性（r=0.422，p=0.016 和 r=0.399，p=0.032）。
DHI 与 MD 患者的几项治疗前后认知功能障碍（CFQ）测量值相关。然而，DHI 和 CFQ 的变化与治疗的相关性较差。总体而言，常用的 DHI 可能无法充分评估 MD 患者的认知功能障碍，可能是由于与前庭功能障碍因素直接无关的因素，如中枢神经系统或认知功能障碍；然而，特定的身体和情绪子量表可能有助于深入了解认知功能障碍随治疗的变化/改善。
