{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T02:29:59Z","timestamp":1791772199758,"version":"4.3.4"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Objectives: The diagnostic criteria for vestibular migraine (VM) and M\u00e9niere\u2019s disease (MD) present an important overlap, which leads to a difficult diagnosis in patients presenting with headache, vertigo, hearing loss, ear fullness, and tinnitus. The objective of our study is to determine whether the area-under-the-curve ratio of the summating potentials (SP) and action potentials (AP) curves on electrocochleography (ECoG) helps differentiate VM from MD with or without the use of the well-established clinical criteria. Method: A retrospective review of patients filling either VM or MD criteria was undertaken between September 2015 and December 2018. All patients underwent ECoG before the introduction of anti-migraine therapy. The prediction of symptom improvement between the clinical criteria and ECoG results was compared by using the Vertigo Symptom Scale. Results: In total, 119 patients were included. An overlap of 36% exists between patients filling VM and MD criteria. Clinical criteria alone did not demonstrate a significant prediction of symptom response to anti-migraine therapy (VM 83%, MD 51%; p = 0.10). However, ECoG results alone did demonstrate adequate prediction (VM 94%, MD 32%; p &lt; 0.001). A negative ECoG result combined with the clinical criteria of VM (100% symptom improvement) was shown to be more predictive of treatment response when compared to clinical criteria alone (83% symptom improvement) (p = 0.017). Finally, when used in patients filling both the VM and MD criteria (VMMD), ECoG was able to predict symptom improvement, thus better differentiating both diseases (normal ECoG: 95%, abnormal ECoG 29%; p &lt; 0.001). Conclusion: Combining VM criteria with normal ECoG using the AUC ratio seems superior in predicting adequate symptom improvement than VM criteria alone.<\/jats:p>","DOI":"10.3390\/audiolres13010002","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T07:33:33Z","timestamp":1672126413000},"page":"12-22","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Vestibular Migraine versus M\u00e9niere\u2019s Disease: Diagnostic Utility of Electrocochleography"],"prefix":"10.3390","volume":"13","author":[{"given":"Paul","family":"Tabet","sequence":"first","affiliation":[{"name":"Division of Otolaryngology Head & Neck Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC H2X 3E4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6118-6185","authenticated-orcid":false,"given":"Ahlem","family":"Elblidi","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Head & Neck Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC H2X 3E4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4475-5988","authenticated-orcid":false,"given":"Issam","family":"Saliba","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Head & Neck Surgery, University of Montreal Hospital Center (CHUM), Montreal, QC H2X 3E4, Canada"},{"name":"University of Montreal Hospital Centre Research Centre (CRCHUM), Montreal, QC H2X 3E4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"733","DOI":"10.14740\/jocmr3126w","article-title":"Meniere\u2019s Disease and Vestibular Migraine: Updates and Review of the Literature","volume":"9","author":"Tabet","year":"2017","journal-title":"J. Clin. Med. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1097\/MAO.0b013e31825d644a","article-title":"Auditory and vestibular symptoms and chronic subjective dizziness in patients with Meniere\u2019s disease, vestibular migraine, and Meniere\u2019s disease with concomitant vestibular migraine","volume":"33","author":"Neff","year":"2012","journal-title":"Otol. Neurotol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/coa.12287","article-title":"Value of clinical data and vestibular testing in a population of 101 patients with recurrent vestibulopathy","volume":"39","author":"Esteban","year":"2014","journal-title":"Clin. Otolaryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1007\/s00415-014-7458-9","article-title":"Endolymphatic space size in patients with vestibular migraine and Meniere\u2019s disease","volume":"261","author":"Nakada","year":"2014","journal-title":"J. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s10162-014-0445-0","article-title":"A Mouse Model Validates the Utility of Electrocochleography in Verifying Endolymphatic Hydrops","volume":"15","author":"Melki","year":"2014","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/MAO.0b013e3181d2779c","article-title":"Clinical utility of electrocochleography in the diagnosis and management of Meniere\u2019s disease: AOS and ANS membership survey data","volume":"31","author":"Nguyen","year":"2010","journal-title":"Otol. Neurotol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1044\/1059-0889(1999\/001)","article-title":"SP\/AP area ratio in the diagnosis of M\u00e9niere\u2019s disease","volume":"8","author":"Ferraro","year":"1999","journal-title":"Am. J. Audiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.joto.2017.04.005","article-title":"Normative data for TM electrocochleography measures","volume":"12","author":"Grasel","year":"2017","journal-title":"J. Otol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3109\/14992020903019338","article-title":"Improved sensitivity of electrocochleography in the diagnosis of Meniere\u2019s disease","volume":"48","author":"Ferraro","year":"2009","journal-title":"Int. J. Audiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"145","DOI":"10.3766\/jaaa.21.3.2","article-title":"Electrocochleography: A Review of Recording Approaches, Clinical Applications, and New Findings in Adults and Children","volume":"21","author":"Ferraro","year":"2010","journal-title":"J. Am. Acad. Audiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/00016480701724888","article-title":"Amplitude and area ratios of summating potential\/action potential (SP\/AP) in Meniere\u2019s disease","volume":"129","author":"Baba","year":"2009","journal-title":"Acta Oto-Laryngol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"257","DOI":"10.3389\/fneur.2014.00257","article-title":"Current treatment options in vestibular migraine","volume":"5","author":"Obermann","year":"2014","journal-title":"Front. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e6989","DOI":"10.1097\/MD.0000000000006989","article-title":"Tricyclic antidepressants for preventing migraine in adults","volume":"96","author":"Xu","year":"2017","journal-title":"Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"139B","DOI":"10.1016\/0002-9149(85)90622-8","article-title":"Calcium-channel blockers in the treatment of migraine","volume":"55","author":"Gelmers","year":"1985","journal-title":"Am. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Jackson, J.L., Kuriyama, A., Kuwatsuka, Y., Nickoloff, S., Storch, D., Jackson, W., Zhang, Z.-J., and Hayashino, Y. (2019). Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0212785"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"167","DOI":"10.3233\/VES-2012-0453","article-title":"Vestibular migraine: Diagnostic criteria","volume":"22","author":"Lempert","year":"2012","journal-title":"J. Vestib. Res. Equilib. Orientat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1177\/0194599814555840","article-title":"Endolymphatic duct blockage: A randomized controlled trial of a novel surgical technique for Meniere\u2019s disease treatment","volume":"152","author":"Saliba","year":"2015","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1177\/0194599816628524","article-title":"2015 Equilibrium Committee amendment to the 1995 AAO-HNS guidelines for the definition of Meniere\u2019s disease","volume":"154","author":"Goebel","year":"2016","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/0022-3999(92)90131-K","article-title":"Symptoms, anxiety and handicap in dizzy patients: Development of the Vertigo symptom scale","volume":"36","author":"Yardley","year":"1992","journal-title":"J. Psychosom. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/MAO.0000000000000782","article-title":"MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Meniere\u2019s Disease","volume":"36","author":"Hornibrook","year":"2015","journal-title":"Otol. Neurotol."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/13\/1\/2\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:51:34Z","timestamp":1760147494000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/13\/1\/2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,26]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["audiolres13010002"],"URL":"https:\/\/doi.org\/10.3390\/audiolres13010002","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,26]]}}}