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Research Article

The relevance of hypothalamus-pituitary-adrenocortical axis-related hormones to the cochlear symptoms in Ménière's disease

, , , , , & show all
Pages 897-904 | Received 22 Feb 2011, Accepted 11 Jul 2011, Published online: 15 Sep 2011
 

Abstract

Abstract

Objective: To investigate the association of the HPA (hypothalamus-pituitary-adrenocortical) axis-related hormones with the progression of cochlear symptoms in patients with Ménière's disease. Design: Clinical assessments (Tinnitus Handicap Inventory: THI, visual analog scale to rate the degree of the tinnitus: VAS, hearing levels in pure-tone audiometry) were conducted upon entry into the study (baseline) and at 12 weeks follow-up (week 12). Blood sampling to measure HPA axis-related hormones took place between 9:00 and 10:00 a.m. at baseline and at 12 weeks follow-up. Study samples: This study consisted of 20 unilateral Ménière's disease patients and 21 patients with other diseases with unilateral sensorineural hearing loss and tinnitus. Results: A significant deterioration of the hearing level at high frequency range, especially at 2 kHz, was found during the 12 weeks follow-up in the Ménière's disease group (p < 0.05). The average hearing levels significantly correlated with the serum cortisol level at baseline and week 12 in the Ménière's disease group, especially regarding the high frequency levels (p < 0.01). Conclusions: Our results suggest that the cortisol levels influence the endolymphatic homeostasis resulting in a deterioration of hearing at high frequency with upstaging of Ménière's disease.

Sumario

Objetivo: Investigar la asociación de hormonas relacionadas con el eje hipotálamo-pituitario-adrenocortical (HPA), con la progresión de síntomas cocleares en pacientes con enfermedad de Ménière. Diseño: Se llevaron a cabo evaluaciones clínicas (Cuestionario de desventaja por acúfeno, THI; Escala análoga visual para clasificar el grado del acúfeno: VAS; y niveles de audición con audiometría por tonos puros) al iniciarse el estudio (línea basal) y a 12 semanas de seguimiento (semana 12). Se tomó muestra de sangre para medir las hormonas relacionadas con el eje HPA entre las 9:00 y las 10:00 de la mañana en la linea basal y en la semana 12 del seguimiento. Muestras de estudio: Este estudio comprendióa 20 pacientes con enfermedad de Ménière unilateral y 21 pacientes con otras enfermedades con pérdida auditiva neurosensorial unilateral y acufeno. Resultados: Se encontró un deterioro significativo de los niveles auditivos en el rango de las frecuencias altas, especialmente en 2 kHz, durante las 12 semanas de seguimiento en el grupo de enfermos de Ménière (p > 0.05). Los niveles promedio de audición correlacionaron significativamente con el nivel de cortisol sérico en la línea basal y en la semana 12 en el grupo con enfermedad de Ménière, especialmente en relación con los niveles en las frecuencias altas (p > 0.01). Conclusiones: Nuestros resultados sugieren que los niveles de cortisol sérico ejercen influencia en la homeostasis endolinfática, lo que determina un deterioro de la audición en laa frecuencias altas y que hacen eclipsable a la enfermedad de Ménière.

Acknowledgements

A part of this research was supported by Yamada Research Grant, grants-in-aid for scientific research of the Japan Society for the Promotion of Science (No. 20591978) and a grant from the intractable diseases fund (vestibular disorders) of the Ministry of Health and Welfare, Japan.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

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