Lin Jianwei, Xiao Heng, Lin Chenxin, Huang Gengliang, Guo Xiaojing, Cai Huimin, Ye Shengnan
Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Otorhinolaryngology-Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Front Neurol. 2025 Apr 17;16:1581670. doi: 10.3389/fneur.2025.1581670. eCollection 2025.
To compare the clinical characteristics of patients with early and late-onset Ménière's disease (MD) and to investigate the impact of psychological factors between the two groups.
The patients were divided into two groups based on their age of onset: early-onset (<45 years old) and late-onset (>55 years old). The differences in clinical symptoms, auditory, vestibular examination, gadolinium-enhanced MRI, vertigo, and psychological assessment were compared. To assess the severity of vertigo, the Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) were used. The Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scales were used to assess the patient's psychological status.
Thirty-five patients were included in the early-onset and thirty-seven in the late-onset MD groups. Tinnitus was more common in the early-onset group. The aggravating (fatigue) and alleviating (ambient quiet; acute rest) factors of a vertigo episode were statistically different between the two groups. The severity of vestibular endolymphatic hydrops, abnormal rate of canal paresis (CP) value of the caloric test, total DHI score, and VAS score were all higher in the late-onset group. PHQ-9 and GAD-7 scores were significantly correlated with total DHI score in the early-onset group.
Early-onset patients have a higher incidence of tinnitus and are more prone to experience vertigo bouts brought on by fatigue. In late-onset patients, vestibular endolymphatic hydrops are more severe, and the vertigo symptoms are more pronounced. Psychological factors are more closely related to the symptoms of vertigo in early-onset patients.
比较早发型和晚发型梅尼埃病（MD）患者的临床特征，并研究两组之间心理因素的影响。
根据发病年龄将患者分为两组：早发型（<45岁）和晚发型（>55岁）。比较两组在临床症状、听觉、前庭检查、钆增强磁共振成像、眩晕及心理评估方面的差异。采用头晕残障量表（DHI）和视觉模拟量表（VAS）评估眩晕的严重程度。采用患者健康问卷9项（PHQ-9）和广泛性焦虑障碍7项（GAD-7）量表评估患者的心理状态。
早发型MD组纳入35例患者，晚发型MD组纳入37例患者。耳鸣在早发型组中更常见。两组眩晕发作的加重（疲劳）和缓解（周围安静；急性休息）因素在统计学上存在差异。晚发型组的前庭内淋巴积水严重程度、冷热试验半规管轻瘫（CP）值异常率、DHI总分及VAS评分均更高。早发型组中PHQ-9和GAD-7评分与DHI总分显著相关。
早发型患者耳鸣发生率较高，更容易经历由疲劳引发的眩晕发作。晚发型患者的前庭内淋巴积水更严重，眩晕症状更明显。心理因素与早发型患者的眩晕症状关系更密切。
