Evaluation of Stress and Endolymphatic Hydrops in Patients with Unilateral Meniere’s Disease

Abstract

There have been many reports of endolymphatic hydrops (EH) in patients with Meniere’s disease (MD) since the first report by Hallpike and Yamakawa in 1938. Mental/physical stress and subsequent increase in release of the stress hormone arginine vasopressin (AVP) supposedly triggers MD. Recently, many lines of evidence have suggested the possibility that AVP is closely linked to the formation of EH in cases of MD. In the present study, we attempted to investigate the relationship between stress and EH in patients with unilateral Meniere’s disease (uMD). We enrolled 113 definite uMD patients from July 2014 to October 2019. All patients underwent 3-T magnetic resonance imaging (MRI) 4 hours after intravenous gadolinium injection. We adopted the criteria for evaluation of EH proposed by Nakashima et al. Stress was evaluated using the depressive self-rating scale (SDS), the psychological stress response scale (SRS), and the dizziness handicap inventory (DHI) modified by Nishiike et al. These stress scores and the blood AVP levels were compared in patients with EH. There was no significant correlation between EH and the stress scores on the affected side, but the anxiety score showed a significant correlation with EH on the sound side (p = 0.04). There was no significant correlation between the EH and AVP in either the affected side or the sound side. We suppose that the formation of EH involves a complex process of stresses.