{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T23:25:04Z","timestamp":1791761104492,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,15]],"date-time":"2024-12-15T00:00:00Z","timestamp":1734220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate alterations in the expression of circadian clock and Toll\u2010like receptor (TLR) genes in peripheral blood (PB) leukocytes of patients with Meniere's disease (MD) and vestibular migraine (VM), and determine whether these gene expressions can differentiate MD from VM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Observational prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PB leukocytes were collected from patients diagnosed with MD and VM during recent vertigo attacks, as well as from healthy controls. The expression levels of 9 circadian clock genes and 6 TLR genes were analyzed using real\u2010time quantitative reverse transcriptase\u2010polymerase chain reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010nine participants were enrolled, including 28 patients with MD, 14 patients with VM, and 27 healthy controls. Both MD and VM groups showed lower expression of <jats:italic>PER1<\/jats:italic> compared to the control group (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01). The VM group exhibited significantly lower expression of <jats:italic>PER1<\/jats:italic>, <jats:italic>PER2<\/jats:italic>, <jats:italic>CRY1<\/jats:italic>, <jats:italic>BMAL1<\/jats:italic>, <jats:italic>CLOCK<\/jats:italic>, and <jats:italic>TIM<\/jats:italic> compared to the MD group (all <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The MD group had higher <jats:italic>TLR9<\/jats:italic> expression than the control group, and elevated <jats:italic>TLR4<\/jats:italic>, <jats:italic>TLR8<\/jats:italic>, and <jats:italic>TLR9<\/jats:italic> expression compared to the VM group (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05). In the VM group, patients with severe dizziness handicaps had significantly lower expression of <jats:italic>PER2<\/jats:italic>, <jats:italic>CRY1<\/jats:italic>, <jats:italic>CRY2<\/jats:italic>, and <jats:italic>CK1\u03b5<\/jats:italic> compared to those with mild to moderate handicaps (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study identifies distinct alterations in the circadian clock and TLR gene expression in MD and VM, suggesting potential differences in the pathogenesis of these 2 vertiginous disorders and highlighting the possibility of these gene expressions as biomarkers for differentiation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1085","type":"journal-article","created":{"date-parts":[[2024,12,15]],"date-time":"2024-12-15T14:30:33Z","timestamp":1734273033000},"page":"999-1005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Dissecting the Circadian Clock and Toll\u2010like Receptor Gene Alterations in Meniere's Disease and Vestibular Migraine"],"prefix":"10.1002","volume":"172","author":[{"given":"Ming\u2010Yu","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University Tao\u2010Yuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Nung","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Tsai","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University Tao\u2010Yuan Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010sen University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Hsien","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University Tao\u2010Yuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Feng","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010sen University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4055-1686","authenticated-orcid":false,"given":"Chao\u2010Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010sen University Kaohsiung Taiwan"},{"name":"School of Medicine Chang Gung University College of Medicine Taoyuan 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