Extended phenotype and clinical subgroups in unilateral Meniere disease: A cross-sectional study with cluster analysis.
OBJECTIVE
To define clinical subgroups by cluster analysis in patients with unilateral Meniere disease (MD) and to compare them with the clinical subgroups found in bilateral MD.


METHODS
A cross-sectional study with a two-step cluster analysis.


METHODS
A tertiary referral multicenter study.


METHODS
Nine hundred and eighty-eight adult patients with unilateral MD.


METHODS
best predictors to define clinical subgroups with potential different aetiologies.


RESULTS
We established five clusters in unilateral MD. Group 1 is the most frequently found, includes 53% of patients, and it is defined as the sporadic, classic MD without migraine and without autoimmune disorder (AD). Group 2 is found in 8% of patients, and it is defined by hearing loss, which antedates the vertigo episodes by months or years (delayed MD), without migraine or AD in most of cases. Group 3 involves 13% of patients, and it is considered familial MD, while group 4, which includes 15% of patients, is linked to the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by a comorbid AD. We found significant differences in the distribution of AD in clusters 3, 4 and 5 between patients with uni- and bilateral MD.


CONCLUSIONS
Cluster analysis defines clinical subgroups in MD, and it extends the phenotype beyond audiovestibular symptoms. This classification will help to improve the phenotyping in MD and facilitate the selection of patients for randomised clinical trials.
Otology & Neurotology Group CTS495, Department of Genomic Medicine- Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain.
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http://orcid.org/0000-0002-6104-0941
L
Frejo
Department of Otolaryngology, Hospital Universitario de Getafe, Getafe, Spain.
E
http://orcid.org/0000-0003-1175-3844
E
Martin-Sanz
Department of Otolaryngology, San Raffaelle Scientific Institute, Milan, Italy.
R
R
Teggi
Division of Otoneurology, Department of Otorhinolaryngology, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain.
G
G
Trinidad
Division of Otoneurology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.
A
A
Soto-Varela
Division of Otoneurology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.
S
S
Santos-Perez
Department of Otolaryngology, Clinica Universidad de Navarra, Pamplona, Spain.
R
R
Manrique
Department of Otolaryngology, Clinica Universidad de Navarra, Pamplona, Spain.
N
N
Perez
Department of Otolaryngology, Complexo Hospitalario de Pontevedra, Pontevedra, Spain.
I
I
Aran
Department of Otolaryngology, Hospital de Poniente, El Ejido, Almería, Spain.
M S
MS
Almeida-Branco
Department of Otolaryngology, Hospital Universitario Salamanca, Salamanca, Spain.
A
A
Batuecas-Caletrio
Department of Otolaryngology, Hospital Miguel Servet, Zaragoza, Spain.
J
J
Fraile
Otology & Neurotology Group CTS495, Department of Genomic Medicine- Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain.|Department of Otorhinolaryngology, Hospital San Agustin, Linares, Jaen, Spain.
J M
JM
Espinosa-Sanchez
Department of Otorhinolaryngology, Hospital Universitario La Fe, Valencia, Spain.
V
V
Perez-Guillen
Department of Otorhinolaryngology, Hospital Universitario La Fe, Valencia, Spain.
H
H
Perez-Garrigues
Department of Otorhinolaryngology, Hospital Costa del Sol, Marbella, Malaga, Spain.
M
M
Oliva-Dominguez
Department of Otolaryngology, Hospital General Universitario de Alicante, Alicante, Spain.
O
O
Aleman
Department of Otolaryngology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain.
J
J
Benitez
Department of Otorhinolaryngology, Hospital Universitario de Cabueñes, Gijon, Spain.
P
P
Perez
Otology & Neurotology Group CTS495, Department of Genomic Medicine- Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain.|Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universidad de Granada (CHUGRA), Granada, Spain.
J A
JA
Lopez-Escamez
D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000145:classification* / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D010641:Phenotype; D012189:Retrospective Studies; D013997:Time Factors