Vertiginous attacks in Ménière's disease can be anticipated by nonlinear analysis of posturography

Abstract

A characteristic feature of Ménière's disease is the spontaneous occurrence of vertigo attacks, most often without warning. The unpredictability of vertiginous spells is a major threat for uncontrolled or cluster type patients. Nevertheless, it is difficult to predict spells in spite of advances in vestibular research because vestibular tests are not sensitive enough to detect the fine vestibular abnormalities associated with Ménière's disease. In this paper, we show that nonlinear analysis of stabilometry signals can detect a pre-ictal phase preceding the vertiginous spell by means of the dynamical similarity between a reference state and pre-ictal state. Our results confirmed that nonlinear changes in the multi-link network of the postural control system allowed the prediction of 12 out of 17 spells within 3 days (sensitivity: 70.6%). In contrast, the conventional measure showed a lower sensitivity and specificity. Our results are very encouraging to gain a new insight into the mechanism responsible for pre-ictal to ictal transition in inner ear pathophysiology and the corresponding therapeutic implications.