{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:29:30Z","timestamp":1793716170244,"version":"4.6.1"},"reference-count":35,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012686","name":"Deutsche Stiftung Neurologie","doi-asserted-by":"publisher","award":["80766145"],"award-info":[{"award-number":["80766145"]}],"id":[{"id":"10.13039\/501100012686","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019776","name":"German Center for Vertigo and Balance Disorders","doi-asserted-by":"crossref","award":["EO 0901"],"award-info":[{"award-number":["EO 0901"]}],"id":[{"id":"10.13039\/501100019776","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003493","name":"Hertie Foundation","doi-asserted-by":"crossref","award":["Not applicable."],"award-info":[{"award-number":["Not applicable."]}],"id":[{"id":"10.13039\/501100003493","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2024,7,29]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Vestibular migraine (VM), the most frequent episodic vertigo, is difficult to distinguish from M\u00e9ni\u00e8re\u2019s disease (MD) because reliable biomarkers are missing. The classical proof of MD was an endolymphatic hydrops (EH). However, a few intravenous gadolinium-enhanced MRI studies of the inner ear (<jats:italic>i<\/jats:italic>MRI) also revealed an EH in VM. The major questions were the frequency and distribution characteristics of EH in VM for diagnostic use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective case-control study of 200 participants, 75 patients with VM (49 females; mean age 46 years) and 75 with MD (36 females; mean age 55 years), according to the B\u00e1r\u00e1ny and International Headache Society, and 50 age-matched participants with normal vestibulocochlear testing (HP), were enrolled. Analyses of<jats:italic>i<\/jats:italic>MRI of the endolymphatic space included volumetric quantification, stepwise regression, correlation with neurotological parameters and support vector machine classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>EH was maximal in MD (80%), less in VM (32%) and minimal in HP (22%). EH was milder in VM (mean grade 0.3) compared with MD (mean grade 1.3). The intralabyrinthine distribution was preferably found in the vestibulum in VM, but mainly in the cochlea in MD. There was no interaural lateralisation of EH in VM but in the affected ear in MD. The grade of EH in the vestibulum was correlated in both conditions with the frequency and duration of the attacks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Three features of the<jats:italic>i<\/jats:italic>MRI evaluation were most supportive for the diagnosis of VM at group and individual levels: (1) the bilateral manifestation, (2) the low-grade EH and (3) the intraaural distribution.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2024-334419","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T17:26:18Z","timestamp":1726248378000},"page":"415-423","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Imaging endolymphatic space of the inner ear in vestibular migraine"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9397-436X","authenticated-orcid":false,"given":"Valerie","family":"Kirsch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Boegle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5053-1462","authenticated-orcid":false,"given":"Johannes","family":"Gerb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5443-4806","authenticated-orcid":false,"given":"Emilie","family":"Kierig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit B","family":"Ertl-Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-3583","authenticated-orcid":false,"given":"Sandra","family":"Becker-Bense","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0454-2371","authenticated-orcid":false,"given":"Thomas","family":"Brandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9903-9594","authenticated-orcid":false,"given":"Marianne","family":"Dieterich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"2025041009251788000_96.5.415.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2017.58"},{"key":"2025041009251788000_96.5.415.2","doi-asserted-by":"publisher","DOI":"10.3233\/VES-2012-0453"},{"key":"2025041009251788000_96.5.415.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-11532-x"},{"key":"2025041009251788000_96.5.415.4","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000001257"},{"key":"2025041009251788000_96.5.415.5","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.674092","article-title":"Recurrent vestibular symptoms not otherwise specified: clinical characteristics compared with vestibular migraine and Meni\u00e8re\u2019s Disease","volume":"12","author":"Dlugaiczyk","year":"2021","journal-title":"Front Neurol"},{"key":"2025041009251788000_96.5.415.6","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00749"},{"key":"2025041009251788000_96.5.415.7","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.594481"},{"key":"2025041009251788000_96.5.415.8","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.28"},{"key":"2025041009251788000_96.5.415.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-09651-8"},{"key":"2025041009251788000_96.5.415.10","doi-asserted-by":"crossref","unstructured":"Connor S , Pai I , Touska P , et al . 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