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Preliminary report: neural firing patterns specific for Meniere's disease.

Blakley B, Dastgheib ZA, Lithgow B, Moussavi Z - J Otolaryngol Head Neck Surg (2014)

Bottom Line: Collaborative Academic Bioengineering Research Centre.The objective and clinical diagnoses were compared.The sensitivity and specificity of EvestG testing were 75% and 80%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, GB421 - 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9 Canada.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Flow chart for recruitment of dizzy patients for the study. In addition to the dizzy patients 10 normal controls were tested.
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Fig1: Flow chart for recruitment of dizzy patients for the study. In addition to the dizzy patients 10 normal controls were tested.

Mentions: EVestG data for one of the 10 patients had too much electrical noise to permit analysis; thus, our final dataset consists of 9 patients including 4 with Meniere’s disease and 5 with other vestibular disorders (2 vestibular neuritis, 2 benign positional vertigo and 1 “non-specific” dizziness (see Figure 1) and 10 controls. Patients and controls were asymptomatic at the time of testing. All patients were seen by an experienced, fellowship-trained clinical neurotologist for treatment of dizziness, who assigned a diagnosis of either “Meniere’s disease” using the AAO criteria [2] or “non-Meniere’s.” ENG and audiometric findings and the diagnosis were not communicated to the researchers performing EVestG testing in another facility on another day. The protocols were approved by the Ethics Review Boards of the University of Manitoba and Riverview Heath Centre in Winnipeg.Figure 1


Preliminary report: neural firing patterns specific for Meniere's disease.

Blakley B, Dastgheib ZA, Lithgow B, Moussavi Z - J Otolaryngol Head Neck Surg (2014)

Flow chart for recruitment of dizzy patients for the study. In addition to the dizzy patients 10 normal controls were tested.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4279806&req=5

Fig1: Flow chart for recruitment of dizzy patients for the study. In addition to the dizzy patients 10 normal controls were tested.
Mentions: EVestG data for one of the 10 patients had too much electrical noise to permit analysis; thus, our final dataset consists of 9 patients including 4 with Meniere’s disease and 5 with other vestibular disorders (2 vestibular neuritis, 2 benign positional vertigo and 1 “non-specific” dizziness (see Figure 1) and 10 controls. Patients and controls were asymptomatic at the time of testing. All patients were seen by an experienced, fellowship-trained clinical neurotologist for treatment of dizziness, who assigned a diagnosis of either “Meniere’s disease” using the AAO criteria [2] or “non-Meniere’s.” ENG and audiometric findings and the diagnosis were not communicated to the researchers performing EVestG testing in another facility on another day. The protocols were approved by the Ethics Review Boards of the University of Manitoba and Riverview Heath Centre in Winnipeg.Figure 1

Bottom Line: Collaborative Academic Bioengineering Research Centre.The objective and clinical diagnoses were compared.The sensitivity and specificity of EvestG testing were 75% and 80%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, GB421 - 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9 Canada.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus