Clinical subgroups in bilateral meniere disease

Lidia Frejo, Andres Soto-Varela, Sofía Santos-Perez, Ismael Aran, Angel Batuecas-Caletrio, Vanesa Perez-Guillen, Herminio Perez-Garrigues, Jesus Fraile, Eduardo Martin-Sanz, Maria C. Tapia, Gabriel Trinidad, Ana María García-Arumi, Rocío González-Aguado, Juan M. Espinosa-Sanchez, Pedro Marques, Paz Perez, Jesus Benitez, Jose A. Lopez-Escamez, Juan Carlos Amor-Dorado, Raquel Manrique HuarteNicolas Perez-Fernandez, Ricardo Sanz, Manuel Oliva Dominguez, Roberto Teggi, On Behalf of the Meniere's Disease Consortium (MeDiC)

Research output: Contribution to journalArticlepeer-review


Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD.

Original languageEnglish
Article number182
JournalFrontiers in Neurology
Issue numberOCT
Publication statusPublished - Oct 24 2016
Externally publishedYes


  • Autoimmune disorders
  • Cluster analysis
  • Hearing loss
  • Inner ear
  • Meniere's disease
  • Migraine
  • Tinnitus
  • Vestibular disorders

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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