title: Effect of stress-related hormones on inner ear fluid homeostasis and function.
abstract: OBJECTIVE
  Induction of suprathreshold levels of stress-related hormone by systemic administration of epinephrine can change inner ear fluid homeostasis and function.
  
  
  BACKGROUND
  Meniere's disease is frequently associated with high levels of anxiety and other forms of psychological disturbance. Most clinicians agree that emotional stress or severe anxiety can precipitate relapse or aggravate the symptoms. In general, it is known that stress-related hormones such as epinephrine, norepinephrine, vasopressin, aldosterone, and cortisol are released into systemic circulation in response to stress. Significantly higher levels of plasma norepinephrine and vasopressin in patients with Meniere's disease have been reported.
  
  
  METHODS
  Concentrations of sodium and potassium in perilymph were measured by a flame photometer after systemic infusion of epinephrine (6.3 microg/min for 3 hours). Control animals were treated with equal volumes of 0.9% physiologic saline. Compound action potentials (CAP) elicited by brief tone bursts were measured before and 3 hours after the infusion of epinephrine. For chronic studies, epinephrine (10 microg/d/kg) was given by osmotic pump implanted subcutaneously for 1, 2, 3, and 4 weeks, respectively. Click- and tone-evoked auditory brain responses (ABRs) were measured at 1, 2, 3, and 4 weeks after epinephrine administration.
  
  
  RESULTS
  Concentrations of sodium and potassium increased significantly in perilymph (p < 0.001 and p < 0.01) after epinephrine infusion over controls. The osmolality increased significantly in serum and perilymph after epinephrine infusion. The CAP threshold was significantly elevated at all frequencies. The shift of the CAP threshold caused by epinephrine tended to be larger at higher frequencies. In chronic studies, epinephrine administration caused a transient 20 to 45 dB threshold shift that increased with time and was relatively constant across frequency.
  
  
  CONCLUSIONS
  There is good evidence to suggest that stress-related hormones such as epinephrine can alter inner ear fluid homeostasis and auditory function. This study confirmed this hypothesis and illuminated the processes of alteration by demonstrating specific changes in perilymph composition and auditory function.
authors.affiliation: Department of Otolaryngology, University of Minnesota, Medical School, Minneapolis, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Juhn
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: J Y
authors.initials: JY
authors.lastname: Kim
authors.forename: E
authors.initials: E
authors.lastname: Javel
authors.forename: S
authors.initials: S
authors.lastname: Levine
authors.forename: R M
authors.initials: RM
authors.lastname: Odland
mesh_terms: D000818:Animals; D002682:Chinchilla; D007758:Ear, Inner / Q000502:physiology*; D004837:Epinephrine / Q000009:adverse effects*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D006706:Homeostasis / Q000502:physiology*; D009997:Osmotic Pressure; D010498:Perilymph / Q000737:chemistry; D011188:Potassium / Q000032:analysis / Q000378:metabolism; D012964:Sodium / Q000032:analysis / Q000378:metabolism; D013315:Stress, Psychological / Q000139:chemically induced*
chemical_list: D012964:Sodium; D011188:Potassium; D004837:Epinephrine