Potassium currents induced by hydrostatic pressure modulate membrane potential and transmitter release in vestibular type II hair cells

Correlation Between Quantitative Value of Endolymphatic Hydrops and Hearing Threshold Using Magnetic Resonance Imaging

OBJECTIVES

This study investigated the relationship between quantitative value of endolymphatic hydrops in the affected ear and the hearing threshold in patients with unilateral Meniere's disease.

STUDY DESIGN

Prospective study.

METHODS

Forty patients with unilateral definite Meniere's disease were diagnosed in outpatient clinic. We recorded their clinical symptoms (duration of vertigo and tinnitus and duration of vertigo attacks), and obtained the hearing thresholds of high, middle, and low by pure tone audiometry. A 3D-FLAIR MRI revealed endolymphatic hydrops and assessed quantitative values of cochlear and vestibular endolymphatic hydrops. We assessed the correlation between hearing thresholds and quantitative values of endolymphatic hydrops.

RESULTS

All patients showed varying degrees of endolymphatic hydrops in the affected ear. With the duration of vertigo, tinnitus and vertigo attacks as control variables, partial correlation analysis showed that the correlation coefficients between quantitative value of cochlear hydrops and hearing thresholds of low, middle, and high tone in the affected ear were 0.581, 0.610, and 0.125, respectively. The correlation coefficients between quantitative value of vestibular hydrops and hearing thresholds of low, middle, and high tone in the affected ear were 0.727, 0.569, and 0.201, respectively.

CONCLUSIONS

The degree of endolymphatic hydrops in Meniere's disease can be revealed and assessed by 3D-FLAIR MRI after intravenous administration of double doses of gadoterate meglumine. Clinical evaluation of endolymphatic hydrops in Meniere's disease can be assisted by low- and middle-tone hearing thresholds, thereby providing anatomical support for the clinical symptoms of Meniere's disease.

The Correlation Between Endolymphatic Hydrops and blood-labyrinth barrier Permeability of Meniere Disease

OBJECTIVES

This study was designed to assess the correlation between the grades of endolymphatic hydrops and the blood-labyrinth barrier permeability in the affected ear in Meniere's disease, following the administration of intravenous gadolinium contrast.

STUDY DESIGN

Prospective study.

METHODS

The quantitative values of endolymphatic hydrops were determined after intravenous injection of a double-dose of gadobutrol in 39 patients with unilateral definite Meniere's disease. Additionally, the signal intensity ratio of bilateral cochlear basal turns was evaluated and analyzed; The correlation between the grades of the endolymphatic hydrops and the signal intensity ratio of the cochlear basal turns in the affected ear was examined.

RESULTS

The grades of the endolymphatic hydrops can be quantitatively evaluated using magnetic resonance imaging (MRI). The signal intensity ratio of the cochlear basal turns in the affected ear was significantly higher than in the unaffected ear (P = .001); there was a positive correlation between the signal intensity ratio of the cochlear basal turn and the grades of cochlear (r = 0.634, P = 0.000) and vestibular(r = 0.559, P = .000) hydrops in the affected ear.

CONCLUSIONS

The increased permeability of the blood-labyrinth barrier may play a role in the process of endolymphatic hydrops in Meniere's disease.

A synaptic F-actin network controls otoferlin-dependent exocytosis in auditory inner hair cells

We show that a cage-shaped F-actin network is essential for maintaining a tight spatial organization of Cav1.3 Ca²⁺ channels at the synaptic ribbons of auditory inner hair cells. This F-actin network is also found to provide mechanosensitivity to the Cav1.3 channels when varying intracellular hydrostatic pressure. Furthermore, this F-actin mesh network attached to the synaptic ribbons directly influences the efficiency of otoferlin-dependent exocytosis and its sensitivity to intracellular hydrostatic pressure, independently of its action on the Cav1.3 channels. We propose a new mechanistic model for vesicle exocytosis in auditory hair cells where the rate of vesicle recruitment to the ribbons is directly controlled by a synaptic F-actin network and changes in intracellular hydrostatic pressure.

DOI:http://dx.doi.org/10.7554/eLife.10988.001

To hear a sound, the pressure produced by sound waves must be converted into an electrical nerve signal. The cells inside the ear that perform this transformation are called hair cells, which are so named because they have hundreds of hair-like structures on their upper surface. Pressure from sound waves causes movements in the inner ear that bend these ‘hairs’. This causes the hair cells to release chemical signals to neighboring nerve cell terminals that ultimately transmit information about the sound to the brain.

The chemical signals are stored inside the hair cells in bubble-like compartments called vesicles. To release the chemicals from the cell, the vesicles merge with the membrane that surrounds the hair cell. Most cells that communicate in this way are limited in how long they can transmit such messages. However, hair cells can continuously fuse vesicles to the membrane even when a sound lasts for a long time. This suggests that the hair cells have a different way of producing vesicles and getting them to the membrane than other cell types.

Inside the hair cells, vesicles are stored in regions called active zones. Each active zone contains a “ribbon” (attached to which are hundreds of vesicles) and also ion channels that allow calcium ions to flow into the cell. (An increase in calcium ion concentration inside the cell is necessary for the vesicle to fuse with the cell membrane and so release its chemical content). Now, Vincent et al. show that in hair cells, a cage-like network made from a protein called actin surrounds each active zone. This network helps to position the calcium ion channels. Treating the hair cells with a compound that disorganized the actin networks speed up the process of vesicle movement, which suggests that the actin network also controls the rate at which vesicles reach the membrane.

Next, it will be important to identify how the actin network interacts with other molecules that help vesicles to release their contents; in particular a protein called otoferlin, which is thought to act as a calcium ion sensor.

DOI:http://dx.doi.org/10.7554/eLife.10988.002

Semi-quantitative vs. volumetric determination of endolymphatic space in Menière's disease using endolymphatic hydrops 3T-HR-MRI after intravenous gadolinium injection

Magnetic resonance imaging enhances the clinical diagnosis of Menière's disease. This is accomplished by in vivo detection of endolymphatic hydrops, which are graded using different semi-quantitative grading systems. We evaluated an established, semi-quantitative endolymphatic hydrops score and with a quantitative method for volumetric assessment of the endolymphatic size. 11 patients with Menière's disease and 2 healthy subjects underwent high resolution endolymphatic hydrops 3 Tesla MRI with highly T2 weighted FLAIR and T2DRIVE sequences. The degree of endolymphatic hydrops was rated semi-quantitatively and compared to the results of 3D-volumetry. Moreover, the grade of endolymphatic hydrops was correlated with pure tone audiometry. Semi-quantitative grading and volumetric evaluation of the endolymphatic hydrops are in accordance (r = 0.92) and the grade of endolymphatic hydrops correlates with pure tone audiometry. Patients with a sickness duration of ≥ 30 months showed a significant higher total labyrinth fluid volume (p = 0.03). Fast, semi-quantitative evaluation of endolymphatic hydrops is highly reliable compared to quantitative/volumetric assessment. Endolymphatic space is significantly higher in patients with longer sickness duration.

Enhanced vestibulo-ocular reflex to electrical vestibular stimulation in Meniere's disease

Meniere's disease is characterized by sporadic episodes of vertigo, nystagmus, fluctuating sensorineural hearing loss, tinnitus and aural pressure. Since Meniere's disease can affect different regions of the vestibular labyrinth, we investigated if electrical vestibular stimulation (EVS) which excites the entire vestibular labyrinth may be useful to reveal patchy endorgan pathology. We recorded three-dimensional electrically evoked vestibulo-ocular reflex (eVOR) to transient EVS using bilateral, bipolar 100-ms current steps at intensities of 0.9, 2.5, 5.0, 7.5 and 10.0 mA with dual-search coils in 12 unilateral Meniere's patients. Their results were compared to 17 normal subjects. Normal eVOR had tonic and phasic spatiotemporal properties best described by the torsional component, which was four times larger than horizontal and vertical components. At EVS onset and offset of 8.9 ms latency, there were phasic eVOR initiation (M = 1,267 °/s(2)) and cessation (M = -1,675 °/s(2)) acceleration pulses, whereas during the constant portion of the EVS, there was a maintained tonic eVOR (M = 9.1 °/s) at 10 mA. However in Meniere's disease, whilst latency of EVS onset and offset was normal at 9.0 ms, phasic eVOR initiation (M = 1,720 °/s(2)) and cessation (M = -2,523 °/s(2)) were enlarged at 10 mA. The initiation profile was a bimodal response, whilst the cessation profile frequently did not return to baseline. The tonic eVOR (M = 20.5 °/s) exhibited a ramped enhancement of about twice normal at 10 mA. Tonic eVOR enhancement was present for EVS >0.9 mA and disproportionately enhanced the torsional, vertical and horizontal components. These eVOR abnormalities may be a diagnostic indicator of Meniere's disease and may explain the vertigo attacks in the presence of declining mechanically evoked vestibular responses.

Pharmacological modulation of transmitter release by inhibition of pressure-dependent potassium currents in vestibular hair cells

Vestibular vertigo may be induced by increases in the endolymphatic pressure that activate pressure-dependent K(+) currents (I(K,p)) in vestibular hair cells. I(K,p) have been demonstrated to modulate transmitter release and are inhibited by low concentrations of cinnarizine. Beneficial effects against vestibular vertigo of cinnarizine have been attributed to its inhibition of calcium currents. Our aim was to determine the extent by which the inhibition of I(K,p) by cinnarizine may alter the voltage response to stimulating currents and to analyze whether such alterations may be sufficient to modulate the activation of Ca(2+) currents and transmitter release. Vestibular type II hair cells from guinea pigs were studied using the whole-cell patch-clamp technique. In current clamp, voltage responses to trains of stimulating currents were recorded. In voltage clamp, transmitter release was assessed from changes in the cell capacitance, as calculated from the phase shift during application of sine waves. Cinnarizine (0.05-3 microM) concentration dependently reversed the depressing effects of increases in the hydrostatic pressure (from 0.2 to 0.5 cm H(2)O) on the voltage responses to stimulating currents. Voltage protocols that simulated these responses were applied in voltage clamp and revealed a significantly enhanced transmitter release in conditions mimicking an inhibition of I(K,p). Cinnarizine (< or =0.5 microM) did not inhibit calcium currents. We conclude that cinnarizine, in pharmacologically relevant concentrations, enhances transmitter release in the presence of elevated hydrostatic pressure by an indirect mechanism, involving inhibition of I(K,p), enhancing depolarization, and increasing the voltage-dependent activation of Ca(2+) currents, without directly affecting Ca(2+) current.