By Current diagnostic criteria, Meniere's disease affects both the hearing and balance components of the inner ear. To date, however, testing of only vestibular function has been unable to distinguish Meniere's disease from other peripheral vestibular pathologies and often even normality. This proposal aims to make two improvements which will solely use vestibular testing to differentiate Meniere's disease from other diagnostic groups and improve our understanding of its pathophysiology. One improvement is to increase the resolving power of vestibular tests. Multivariate statistical methods will be used to extract the key features from the myriad of results that a contemporary vestibular test battery produces. Using these key features, it should be possible to discriminate between a group of patients with Meniere's disease and those with other peripheral vestibulopathies to such an extent that classification of an individual into one of these groups will be improved. The second improvement is to relate the predicted changes in pathophysiology to the predicted changes in the test results. Existing biophysical models will be modified to be consistent with the histopathological data obtained from the temporal bones of Meniere's disease patients and thus provide a basis for the predictions. The feasibility of this approach is demonstrated by preliminary data from only one vestibular test. If successful, this approach will make it possible to increase our understanding about the pathology associated with Meniere's disease itself and to improve the diagnosis of individuals. While this effort concentrates upon Meniere's disease, the general approach can later be expanded to other vestibular disorders.
