Preliminary report: Neural firing patterns specific for Meniere's disease

Journal of Otolaryngology - Head & Neck Surgery - Tập 43 Số 1 - 2014
Brian W. Blakley1, Zeinab Dastgheib2, Brian Lithgow3, Zahra Moussavi4
1Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, GB421 - 820 Sherbrook Street, Winnipeg, R3A 1R9, Manitoba, Canada
2University of Manitoba, Room E3-512 Eng. Bldg., Biomedical Engineering, 75A Chancellor's Circle, R3T 5 V6, Winnipeg, MB, Canada
3Monash Alfred Psychiatry Research Centre, University of Manitoba, and Research Affiliate of Riverview Health Center, EVestG Research Lab, Riverview Health Centre, Room PE446, 1 Morley Avenue, Winnipeg, R3L2P4, MB, Canada
4Biomedical Engineering, University of Manitoba, and Research Affiliate of Riverview Health Center, Room E3-513 Eng. Bldg., Biomedical Engineering, 75A Chancellor's Circle, R3T 5V6, Winnipeg, MB, Canada

Tóm tắt

Objective To describe the application of a new, objective diagnostic test for Meniere's disease. Introduction Electrovestibulography (EVestG) is a complex, newly-developed test paradigm that searches for neural firing patterns that may be diagnostic for particular neural disorders. EVestG system was previously “trained” to distinguish Meniere's disease from other patients on a set of training data. In this paper we illustrate its diagnostic application in a new group of unknown subjects. Setting Collaborative Academic Bioengineering Research Centre. Study design Prospective, blinded human Clinical Trial. Methods In an attempt to understand the specific neural firing patterns that may objectively characterize latent Meniere's disease, two hundred fifty-six consecutive patients who presented for electronystagmography testing were asked to undergo EVestG testing. Ten subjects actually completed testing but data were too noisy to permit analysis for one patient. Complete data were available for nine patients with either a clinical diagnosis of either Meniere's disease (4 patients) or some other vestibular disorder (2 vestibular neuritis, 2 benign positional vertigo and 1 non-specific dizziness). None of the patients were experiencing attacks of vertigo within a week of EVestG testing. Ten normal control subjects with no history or symptoms of ear disease were also tested. EVestG was performed in a separate engineering research facility by investigators who were unaware of their clinical diagnosis. If EVestG suggested that the probability of Meniere's disease was 0.5 or greater Meniere's disease was considered present by the objective testing. The objective and clinical diagnoses were compared. Results EVestG testing correctly identified three of four Meniere's disease patients and rejected the diagnosis in 9 of the 10 controls. Two of the 5 dizzy, non-Meniere's patients were incorrectly identified as Meniere's disease. The sensitivity and specificity of EvestG testing were 75% and 80%, respectively. EVestG results were statistically significantly different for Meniere's patients versus the other dizzy patients and controls (Univariate ANOVA difference contrasts p = 0.0340) even in this small sample. Conclusion The EVestG protocol appeared to show promise as an objective, diagnostic test for Meniere's disease, but our sample size is too small to generalize widely. Level of evidence N.A. Prospective Human clinical trial.

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Tài liệu tham khảo

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Journal of Otolaryngology - Head & Neck Surgery

Tập 43 Số 1

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