Affiliations: [a] Harvard University, Massachusetts Institute of Technology Division of Health Sciences and Technology, Cambridge, USA | [b] Harvard Medical School, Department of Otology and Laryngology, Boston, USA | [c] Jenks Vestibular Diagnostic Laboratory of the Massachusetts Eye and Ear Infirmary, Boston, USA
Note: [*] Corresponding author: Conrad Wall III, Ph.D., Jenks Vestibular Diagnostic Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114, USA. Tel.: +1 617 573 4153; Fax: +1 617 573 4154; E-mail: cwall@mit.edu
Abstract: Menière's disease (MD) and migraine associated dizziness (MAD) are two disorders that can have similar symptomatologies, but differ vastly in treatment. Vestibular testing is sometimes used to help differentiate between these disorders, but the inefficiency of a human interpreter analyzing a multitude of variables independently decreases its utility. Our hypothesis was that we could objectively discriminate between patients with MD and those with MAD using select variables from the vestibular test battery. Sinusoidal harmonic acceleration test variables were reduced to three vestibulo-ocular reflex physiologic parameters: gain, time constant, and asymmetry. A combination of these parameters plus a measurement of reduced vestibular response from caloric testing allowed us to achieve a joint classification rate of 91%, independent quadratic classification algorithm. Data from posturography were not useful for this type of differentiation. Overall, our classification function can be used as an unbiased assistant to discriminate between MD and MAD and gave us insight into the pathophysiologic differences between the two disorders.
Keywords: vestibulo-ocular reflex, time constant, decision analysis, Menière's disease, migraine
