Frejo, LidiaSoto-Varela, AndresSantos-Perez, SofíaAran, IsmaelBatuecas-Caletrio, AngelPerez-Guillen, VanesaPerez-Garrigues, HerminioFraile, JesusMartin-Sanz, EduardoTapia, Maria CTrinidad, GabrielGarcía-Arumi, Ana MaríaGonzález-Aguado, RocíoEspinosa-Sanchez, Juan MMarques, PedroPerez, PazBenitez, JesusLopez-Escamez, Jose A2016-11-112016-11-112016-10-24Frejo L, Soto-Varela A, Santos-Perez S, Aran I, Batuecas-Caletrio A, Perez-Guillen V, et al. Clinical Subgroups in Bilateral Meniere Disease. Front Neurol. 2016; 7:182http://hdl.handle.net/10668/2516Journal Article;Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD.enCluster analysisVestibular disordersHearing lossTinnitusMeniere’s diseaseMigraineAutoimmune disordersInner earComorbilidadSorderaPérdida auditivaPérdida auditiva sensorineuralHumanosEnfermedad de MeniereTrastornos migrañososAcúfenoVestíbulo del laberintoMedical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::ComorbidityMedical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Hearing Loss::DeafnessMedical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Hearing LossMedical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::Hearing Loss::Hearing Loss, SensorineuralMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Labyrinth Diseases::Endolymphatic Hydrops::Meniere DiseaseMedical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders, Primary::Migraine DisordersMedical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Hearing Disorders::TinnitusMedical Subject Headings::Anatomy::Sense Organs::Ear::Ear, Inner::Vestibule, Labyrinthresearch article27822199open access10.3389/fneur.2016.001821664-2295PMC5075646