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Sharifi A, Steenerson KK, Alyono JC, Ghaffari ME, Zojaji M, Ghaedsharaf S, Salmani MH, Kouhi A. The effect of climate changes on incidence of benign paroxysmal positional vertigo; a systematic review with meta-analysis of 16144 patients. ENVIRONMENTAL RESEARCH 2024; 259:119551. [PMID: 38977157 DOI: 10.1016/j.envres.2024.119551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/09/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND There were controversial findings in terms of the association between the incidence of Benign Paroxysmal Positional Vertigo (BPPV) and climate changes, so the current systematic review plus meta-analysis is designed to discover this possible relationship. METHODS Web of science, PubMed, Scopus, Google Scholar, Embase, and Cochrane library were systematically searched up to August 2023. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. RESULTS In total, 15 studies including 16144 patients met the inclusion criteria. Ten studies reported the relation of BPPV to monthly mean temperature, 7 to monthly average humidity, 4 to monthly average rainfall, 6 to monthly sunlight time, and 2 to average solar radiation. The incidence of BPPV was associated significantly with atmospheric pressure (P: 0.003) and rainfall (P: 0.017). However, there was not any statistically significant correlation between incidence of BPPV and humidity, sunlight time, temperature, and solar radiation level (P > 0.05). CONCLUSIONS The incidence of BPPV was higher in cold months of a year in both northern hemisphere and southern hemisphere countries. Although it can be because of negative correlation with temperature, the current meta-analysis did not find any statistically significant negative correlation with temperature. In addition, the incidence of BPPV was associated significantly with atmospheric pressure (positive correlation) and rainfall (negative correlation).
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Affiliation(s)
- Alireza Sharifi
- Department of Otolaryngology Head and Neck Surgery, Amir A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kristen K Steenerson
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jennifer C Alyono
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Mohammad E Ghaffari
- Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Mohaddeseh Zojaji
- Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad H Salmani
- Student Research Committee, Qom University of Medical Sciences, Qom, Iran
| | - Ali Kouhi
- Department of Otolaryngology Head and Neck Surgery, Amir A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Zach H, Retter D, Schmoeger M, Rommer P, Willinger U, Schwarz FK, Wiest G. Seasonality of benign paroxysmal positional vertigo : A retrospective study from Central Europe. Wien Klin Wochenschr 2024; 136:25-31. [PMID: 37405489 PMCID: PMC10776474 DOI: 10.1007/s00508-023-02237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Although benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in clinical practice, factors influencing the pathophysiology remain not fully understood. OBJECTIVE Here we aim to investigate possible seasonal influences on the occurrence of BPPV in Vienna, a city located in a Central European country with pronounced seasonal fluctuations. METHODS We retrospectively investigated data from 503 patients presenting with BPPV to the outpatient clinics of the Medical University of Vienna between 2007 and 2012. Analyses included age, gender, type of BPPV, seasonal assignment, as well as daylight hours and the temperature in Vienna at symptom onset. RESULTS Out of 503 patients (159 male, 344 female, ratio 1:2.2; mean age 60 ± 15.80 years), most patients presented with posterior (89.7%) and left-sided (43.1%) BPPV. There was a significant seasonal difference (χ2 p = 0.036) with the majority of symptoms occurring in winter seasons (n = 142), followed by springtime (n = 139). Symptom onset did not correlate with the average temperature (p = 0.24) but on the other hand very well with daylight hours (p < 0.05), which ranged from 8.4 h per day in December, to an average of 15.6 h in July. CONCLUSION Our results show a seasonal accumulation of BPPV during winter and springtime, which is in line with previous studies from other climatic zones, suggesting an association of this seasonality with varying vitamin D levels.
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Affiliation(s)
- Heidemarie Zach
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria
| | - David Retter
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria
| | - Michaela Schmoeger
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria
| | - Paulus Rommer
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria
| | - Ulrike Willinger
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria
| | - Felix K Schwarz
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria
| | - Gerald Wiest
- Neurotology Outpatient Clinic, Dept. of Neurology, Medical University of Vienna, Waehringerguertel 18-20, 1090, Vienna, Austria.
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Basaran MM, Sahin L. Climatic variations and pollution on benign paroxysmal positional vertigo in Kars, Türkiye. ENVIRONMENTAL RESEARCH 2023; 237:116985. [PMID: 37625533 DOI: 10.1016/j.envres.2023.116985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 08/27/2023]
Abstract
Benign paroxysmal positional vertigo (BPPV) is the most common diagnosis for peripheral vertigo. Although pathophysiological mechanisms remain unclear, BPPV is mostly idiopathic and factors related to BPPV are still being investigated. Knowing these factors can contribute to the prevention and management of BPPV. In this study, we investigated the correlations between climatic variations, pollution, and BPPV retrospectively. 262 patients diagnosed with BPPV between 2019 and 2021 in Kars, Türkiye, were included in our study. Meteorological parameters were obtained from Turkish State Meteorological Service. Horizontal BPPV increased significantly with the humidity (p < 0.05). In addition, carbon monoxide levels significantly increased the potantial of BPPV (p < 0.05). Surprisingly, BPPV increased in the summertime and showed a significant relationship with humidity. We believe this change is related with the city-specific features as it is the coldest place in the country, emigrant province and crowded in the summer times.
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Affiliation(s)
- Mustafa Mert Basaran
- Department of Otorhinolaryngology, Kafkas University, Faculty of Medicine, Kars, 36000, Turkey.
| | - Levent Sahin
- Department of Emergency Medicine, Kafkas University, Faculty of Medicine, Kars, 36000, Turkey
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Huang FM, Luo CW, Lee SS, Ho YC, Li YC, Chang YC, Kuan YH. Relationship between periodontal disease and dizziness in Taiwanese adults: A nationwide population-based cohort study. Medicine (Baltimore) 2023; 102:e32961. [PMID: 36827024 PMCID: PMC11309663 DOI: 10.1097/md.0000000000032961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/25/2023] Open
Abstract
Periodontal disease is often neglected and overlooking its initial symptoms can lead to tooth loss and systemic diseases. Patients with otitis media are at high risk of vestibular and balance dysfunction, consequently, and vertigo. Vertigo and dizziness are conditions with high reported incidences; they worsen with age and can burden health systems. The present study investigated whether periodontal disease causes dizziness. Research data covering 2008 through 2013 were retrieved from the National Health Insurance Research Database of Taiwan. Patients who were newly diagnosed as having periodontal disease or dizziness after at least 1 hospital admission or 3 outpatient visits were enrolled as participants. For our controls, we randomly selected individuals without periodontal disease who were sex- and age-matched with the investigated participants. In total, we enrolled 445 patients with periodontal disease and 1780 controls. The Kaplan-Meier curve indicated that the cumulative incidence of dizziness was significantly higher among the patients with periodontal disease relative to the controls. After adjustment for sex, age, income level, urbanization level, month of onset, and comorbidities, Cox proportional-hazards analysis revealed that patients with periodontal disease had an increased risk of dizziness (hazard ratio [HR]: 1.306, 95% confidence interval (CI): 1.155, 1.475). Compared with the controls, the risk of dizziness among patients with periodontal disease was higher for both female (HR: 1.439, 95%: 1.203, 1.720) and male patients (HR: 1.284, 95%: 1.123, 1.468); this risk was higher even when January (HR: 1.302, 95% CI: 1.145, 1.480), February (HR: 1.337, 95% CI: 1.178, 1.518), or March was excluded (HR: 1.308, 95% CI: 1.151, 1.487) and for patients without Ménière disease. Therefore, periodontal disease is not only a risk factor for dizziness but also an independent risk factor for dizziness. Future studies could clarify the mechanisms linking periodontal disease to dizziness.
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Affiliation(s)
- Fu-Mei Huang
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Ci-Wen Luo
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shiuan-Shinn Lee
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Yung-Chuan Ho
- School of Medical Applied Chemistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Ching Li
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Chao Chang
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Hsiang Kuan
- Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
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Sideris G, Sapountzi MC, Malamas V, Korres G, Delides A, Nikolopoulos T. Climatic Variations as Indicators of Vitamin D Levels and Benign Paroxysmal Positional Vertigo. Cureus 2021; 13:e18811. [PMID: 34804669 PMCID: PMC8591250 DOI: 10.7759/cureus.18811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate the possible correlation between benign paroxysmal positional vertigo (BPPV), seasonality, and climatic variations as indicators of vitamin D deficiency, since otoconia are calcium carbonate crystals. Methods This is a study of patients who received the diagnosis of BPPV from September 2015 to August 2019. Gender, age, and month of diagnosis were factors recorded and analyzed. The cut-off age of 50 years is used to include osteoporotic patients and postmenopausal women. Meteorological and climatic data of latitude, temperature, sunshine hours, humidity, precipitation, wind force, atmospheric pressure, and horizontal solar irradiance were collected. Results Four hundred and eighty-five patients were included in the study; 206 were male (42%) and 279 were female (58%). The mean age was 57.8±15.4 and 54.9±13.9, respectively; 192 patients were ≤50 years old (121 female and 71 male) and 293 patients were over 50 years old (135 male and 158 female). A statistical significance in seasonal variation during autumn months was demonstrated (p-value= 5.2 e-05, z-statistic: 9.8164). There was no statistical correlation between the median number of BPPV patients and the median sunshine hours per month, horizontal solar irradiance, or other climatic variables. Conclusions Our study demonstrates seasonality in BPPV patients in Greece but no correlation between BPPV and climatic variations as a proxy for Vitamin-D levels was documented.
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Affiliation(s)
- Giorgos Sideris
- Second Ear-Nose-Throat Department, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Marilia C Sapountzi
- Second Ear-Nose-Throat Department, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | | | - George Korres
- Second Ear-Nose-Throat Department, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Alexander Delides
- Second Ear-Nose-Throat Department, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Thomas Nikolopoulos
- Second Ear-Nose-Throat Department, Attikon University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
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Abdelmaksoud AA, Fahim DFM, Bazeed SES, Alemam MF, Aref ZF. Relation between vitamin D deficiency and benign paroxysmal positional vertigo. Sci Rep 2021; 11:16855. [PMID: 34413436 PMCID: PMC8377140 DOI: 10.1038/s41598-021-96445-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 08/09/2021] [Indexed: 01/25/2023] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. Vitamin D deficiency may be one of the causes of its development. To assess the relation between recurrent attacks BPPV and Vitamin D deficiency. A case control study in which 40 patients were clinically diagnosed as posterior canal BPPV, Serum 25(OH) D was measured at 1st visit. Patients were divided into two groups; group A (20 patients) received Vitamin D supplementation in addition to canal repositioning maneuver and group B (20 patients) treated by canal repositioning maneuver only. Follow up of all patients for 6 months, neuro-otological assessment was repeated and recurrent attacks were recorded. Serum vitamin D was repeated after 6 month. This study included 14 males and 26 females age ranged from 35 to 61 years, Average serum of 25 (OH) D at the first visit was (12.4 ± 2 ng/ml) for group A, and (12.2 ± 1.7 ng/ml) for group B, all patients had low serum level of 25(OH) D (below 20 ng/ml). Recurrent BPPV episodes, were significantly lower in group A than that of group B. There is a relation between BPPV recurrence and low serum Vitamin D.
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Affiliation(s)
| | | | | | - Mohamed Farouk Alemam
- Clinical Pathology and Clinical Chemistry Department, South Valley University, Qena, Egypt
| | - Zaki Farouk Aref
- ENT Department, Faculty of Medicine, South Valley University, Qena, Egypt
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Jeong J, Eo TS, Oh J, Shin HA, Chung HJ, Choi HS. Monthly and seasonal variations in benign paroxysmal positional vertigo. J Vestib Res 2021; 31:101-107. [PMID: 33554929 DOI: 10.3233/ves-200030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several studies on seasonal variation in benign paroxysmal positional vertigo (BPPV) have been reported. However, the association between season and BPPV remains controversial; thus, further study is required. OBJECTIVE We analyzed patients with BPPV to evaluate monthly and seasonal variations. METHODS Patients with BPPV seen between 2013 and 2017 were retrospectively enrolled in this study. Differences among the months and seasons of BPPV visits were analyzed. Patients were divided into two groups according to age (65 years or older and younger than 65 years) and sex, respectively, and the differences were analyzed in each group. RESULTS There was no significant difference in the monthly or seasonal distribution of BPPV in the 1,216 patients. There was also no significant difference in the monthly or seasonal distribution in the older and younger groups or in male and female patients. CONCLUSIONS There was no significant difference in the monthly or seasonal distribution of patients with BPPV. Additional studies on seasonal variation in BPPV are required in terms of not only vitamin D levels but also other associated factors.
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Affiliation(s)
- Junhui Jeong
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Tae Seong Eo
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jangwon Oh
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyang Ae Shin
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyo Jin Chung
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyun Seung Choi
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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原 皞, 刘 海, 皇 甫, 周 丽, 李 莹, 杨 捷, 吴 佳, 王 湘, 陈 钢. [Climatic variations and vertigo diseases in outpatients clinic of ENT]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:101-104. [PMID: 33540987 PMCID: PMC10127890 DOI: 10.13201/j.issn.2096-7993.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Indexed: 06/12/2023]
Abstract
Objective:The aim of this study is to analyze the relationship between climatic variations and vertigo diseases in outpatients clinic of ENT. Methods:A retrospective analysis of patients in the vertigo clinic of the First Hospital of Shanxi Medical University in 2019 was performed, and basic information, onset date and related data were recorded, and 12 months of meteorological data were recorded. Spearman rank correlation was used for data analysis. To analyze the relationship between climatic variations and benign paroxysmal positional vertigo (BPPV) vestibular migraine (VM), Meniere's disease (MD). Results:There were correlations between BPPV patients and change in atmospheric pressure, the average water atmospheric pressure, minimum relative humidity or change in temperature. There was no correlation between BPPV patients and sunshine exposure or wind speed. There were correlations between VM patients and change in atmospheric pressure or change in temperature. There was no correlation between VM patients and humidity, sunshine exposure or wind speed. There were correlations between MD patients and change in atmospheric pressure, minimum relative humidity or average relative humidity. There was no correlation between MD patients and change in temperature, sunshine exposure or wind speed. Conclusion:The onset of BPPV, VM, and MD are all related to changes in air pressure. Two or three diseases in the same patient may have a common cause. In the future, we can learn more about the pathophysiological correlation of the three. Patients with vertigo should pay attention to weather changes and prepare medications in advance.
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Affiliation(s)
- 皞 原
- 山西省儿童医院耳鼻咽喉科(太原,030013)Department of Otolaryngology, Shanxi Children's Hospital, Taiyuan, 030013, China
| | - 海霞 刘
- 山西省儿童医院耳鼻咽喉科(太原,030013)Department of Otolaryngology, Shanxi Children's Hospital, Taiyuan, 030013, China
| | - 甫辉 皇
- 山西医科大学第一医院耳鼻咽喉头颈外科 耳鼻咽喉头颈肿瘤山西省重点实验室 山西医科大学耳鼻咽喉研究所Department of Otolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province
| | - 丽媛 周
- 山西医科大学第一医院耳鼻咽喉头颈外科 耳鼻咽喉头颈肿瘤山西省重点实验室 山西医科大学耳鼻咽喉研究所Department of Otolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province
| | - 莹 李
- 山西医科大学第一医院耳鼻咽喉头颈外科 耳鼻咽喉头颈肿瘤山西省重点实验室 山西医科大学耳鼻咽喉研究所Department of Otolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province
| | - 捷 杨
- 山西医科大学第一医院耳鼻咽喉头颈外科 耳鼻咽喉头颈肿瘤山西省重点实验室 山西医科大学耳鼻咽喉研究所Department of Otolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province
| | - 佳鑫 吴
- 山西医科大学第一医院耳鼻咽喉头颈外科 耳鼻咽喉头颈肿瘤山西省重点实验室 山西医科大学耳鼻咽喉研究所Department of Otolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province
| | - 湘 王
- 太原市中心医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Taiyuan Central Hospital
| | - 钢钢 陈
- 山西医科大学第一医院耳鼻咽喉头颈外科 耳鼻咽喉头颈肿瘤山西省重点实验室 山西医科大学耳鼻咽喉研究所Department of Otolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province
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Sen JR, Tampio AJF, Cavanaugh SM, Nicholas BD. Use of Google Trends to evaluate for environmental variations in search terms for benign paroxysmal positional vertigo. Laryngoscope Investig Otolaryngol 2021; 6:145-149. [PMID: 33614943 PMCID: PMC7883612 DOI: 10.1002/lio2.512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/18/2020] [Accepted: 12/07/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Climate variables are implied in the pathogenesis of certain otologic diseases, including benign paroxysmal positional vertigo (BPPV). Using internet search data obtained through Google Trends (GT), we explored the relationship between climate patterns and symptom search frequencies for BPPV. We hypothesized that increased latitude, as a proxy for decreased sunlight exposure, would lead to increase in BPPV symptom searches. METHODS GT searches for symptoms related to BPPV were obtained for five U.S. cities of different latitudes via the Google Trends online interface. Comparisons were made using SPSS via ANOVA analysis. Figures were made using Microsoft Excel. RESULTS Searches for BPPV-related symptoms increased with increasing latitude. BPPV-related symptoms did show seasonal variations, but not in predictable manners. CONCLUSIONS GT may be a viable research tool when comparing geographical differences in searches, but may be less sensitive in detecting time dependent changes. We offer suggestions as to how big data tools may be altered for research purposes. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Josh R. Sen
- Department of OtolaryngologySUNY Upstate Medical UniversitySyracuseNew YorkUSA
| | - Alex J. F. Tampio
- Department of OtolaryngologySUNY Upstate Medical UniversitySyracuseNew YorkUSA
| | | | - Brian D. Nicholas
- Department of OtolaryngologySUNY Upstate Medical UniversitySyracuseNew YorkUSA
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Oh SR, Min SJ, Kim CE, Chang M, Mun SK. The effects of climate on the incidence of benign paroxysmal positional vertigo. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:2119-2125. [PMID: 32829457 DOI: 10.1007/s00484-020-02002-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/04/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. An investigation into the factors related to BPPV could contribute to its prevention and appropriate management. We investigated the association between climatic factors and incidence of BPPV in this study. A total of 365 patients who were diagnosed with idiopathic BPPV in the emergency room of our hospital in 2015 were included. The number of patients diagnosed with BPPV per week was calculated (every week). Climatic factors, including daily average humidity, temperature, atmospheric pressure, cloud amount, sunshine amount, and daylight time, were documented daily. The weekly mean climatic value in each week was calculated. Simple correlation analysis and multivariate regression analyses were performed to identify climatic factors associated with the number of patients diagnosed with BPPV. Simple correlation analysis revealed a significant association between the humidity (r = 0.276, p = 0.048), temperature (r = 0.275, p = 0.049), and cloud amount (r = 0.293, p = 0.035) and the number of BPPV patients diagnosed per week. Multivariate regression analysis revealed that only the cloud amount was a statistically significant factor associated with the number of BPPV patients diagnosed every week. A significant positive association was discovered between the cloud amount and BPPV incidence. Cloud amount can therefore have an association with the incidence of BPPV.
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Affiliation(s)
- Seung Ri Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, 102 Heukseok-ro, Dongjak-gu, Seoul, 156-755, Republic of Korea
| | - Sung Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, 102 Heukseok-ro, Dongjak-gu, Seoul, 156-755, Republic of Korea
| | - Chang Eurn Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, 102 Heukseok-ro, Dongjak-gu, Seoul, 156-755, Republic of Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, 102 Heukseok-ro, Dongjak-gu, Seoul, 156-755, Republic of Korea.
| | - Seog-Kyun Mun
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, 102 Heukseok-ro, Dongjak-gu, Seoul, 156-755, Republic of Korea.
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Li S, Wang Z, Liu Y, Cao J, Zheng H, Jing Y, Han L, Ma X, Xia R, Yu L. Risk Factors for the Recurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2020; 101:NP112-NP134. [PMID: 32776833 DOI: 10.1177/0145561320943362] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Benign paroxysmal positional vertigo (BPPV) has a high recurrence rate, but the risk factor-associated recurrence are elusive. METHODS Searches were performed in PubMed, Embase, Cochrane library, Web of science, Chinese National Knowledge Infrastructure, and Sino Med up to November 3, 2019. The effect size was analyzed by odds ratio and 95% CI. Data from eligible studies were meta-analyzed using Stata version 15.0. RESULTS Our search resulted in a total of 4076 hits. Twenty-four outcomes of sixty articles were included in the meta-analysis. Risk factors for the recurrence of BPPV included female gender, age (≥65years), hyperlipidemia, diabetes, hypertension, migraine, cervical spondylosis, osteopenia/osteoporosis, head trauma, otitis media, abnormal vestibular evoked myogenic potential, and long use of computers. No significant differences were found in side, type of the involved semicircular canals, smoking, alcohol consumption, stroke, ear surgery, duration of vertigo before treatment, the times of repositioning, Meniere disease, sleep disorders, hypercholesterolemia, and 25-hydroxy vitamin D. CONCLUSION These findings strengthen clinical awareness of early warning to identify patients with potential relapse risk of BPPV and clinicians should counsel patients regarding the importance of follow-up after diagnosis of BPPV.
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Affiliation(s)
- Shichang Li
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Zijing Wang
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Yan Liu
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Jie Cao
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Hongwei Zheng
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Yuanyuan Jing
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Lin Han
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Xin Ma
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Ruiming Xia
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
| | - Lisheng Yu
- Department of Otorhinolaryngology Head and neck surgery, 71185Peking University People's Hospital, Beijing, China
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Cao Z, Zhao X, Ju Y, Chen M, Wang Y. Seasonality and Cardio-Cerebrovascular Risk Factors for Benign Paroxysmal Positional Vertigo. Front Neurol 2020; 11:259. [PMID: 32328027 PMCID: PMC7160367 DOI: 10.3389/fneur.2020.00259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/20/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, especially in the elderly. Several studies have revealed a possible seasonality to BPPV. However, whether the seasonality of BPPV also exists in China is unclear. The characteristics of cardio-cerebrovascular risk factors for BPPV in the cold season have not yet been investigated. Objectives: (1) To investigate the seasonality of BPPV; (2) To explore the relationship between cardio-cerebrovascular risk factors and seasonality of BPPV. Methods: A retrospective observational study was performed in Beijing Tiantan Hospital from Jan 2016 to Dec 2018. The study included 1,409 new-onset BPPV patients aged 18-88 years. The demographic data, onset time, and medical history of BPPV were collected. The meteorological data, including temperature, atmospheric pressure, rainfall, and insolation, was obtained from Beijing Meteorological service. The x 2 goodness of fit test was used to evaluate whether BPPV patients' numbers were significantly different among different months of the year. The Spearman correlation was used to detect the correlation between numbers of BPPV patients diagnosed monthly with each climatic parameter. The chi-square test for linear-by-linear association were used to investigate the relationship between cardio-cerebrovascular risk factor and seasonality of BPPV. Results: November to next March is the top 5 months with higher BPPV patient numbers (P < 0.001). The numbers of BPPV diagnosed monthly were conversely correlated with temperature and rainfall (r = -0.736, P = 0.010; r = -0.650, P = 0.022, respectively), positively correlated with atmospheric pressure (r = 0.708, P = 0.010), but no significant correlated with insolation. BPPV in the cold season (including January, February, March, November, and December) had a higher proportion, accounting for 54.2% of all BPPV patients. Among BPPV patients with ≥2, 1, and none cardio-cerebrovascular risk factors, the cold season accounted for 57.0, 56.0, 49.8%, respectively. As the number of cardio-cerebrovascular risk factors increased, the proportion of patients in the cold season of BPPV increased (P = 0.025). Conclusions: BPPV patients are seen more in the months with low temperature, low rainfall, and high atmospheric pressure. Compared with the non-cold season, BPPV patients have more risk factors for cardio-cerebrovascular diseases in the cold season.
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Affiliation(s)
- Zhentang Cao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Clinical Center for Vertigo and Balance Disturbance, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Clinical Center for Vertigo and Balance Disturbance, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi Ju
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Clinical Center for Vertigo and Balance Disturbance, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Meimei Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Clinical Center for Vertigo and Balance Disturbance, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Clinical Center for Vertigo and Balance Disturbance, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Wang Z, Yao G, Tao X, Zhang J, Zhang T, Wu Z. Evaluation of bone mineral density and 25-(OH) vitamin D levels in middle-aged and elderly women with recurrent benign paroxysmal positional vertigo. Acta Otolaryngol 2020; 140:89-93. [PMID: 31876211 DOI: 10.1080/00016489.2019.1692146] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Middle-aged and elderly perimenopausal women are prone to developing BPPV without definite cause. Objectives: This study aimed to investigate the correlation between bone mineral density (BMD), 25-(OH) vitamin D, and serum calcium levels in patients with benign paroxysmal positional vertigo (BPPV) in middle-aged and elderly women.Material and methods: A total of 103 women with two or more recurrent BPPV episodes (group A) and 80 age-matched healthy controls (group B) were recruited. All subjects had BMD and serum 25-(OH) D levels measurements taken, and the results were compared.Results: BMD was reduced in group A, and the proportion of osteoporosis was higher than in group B (p = .039). The BMD T-score and 25-(OH) vitamin D level were lower in group A than in group B (p = .004 and p < .0001, respectively). In group A, the BMD T-score was lower (p = .017) and serum 25-(OH) vitamin D level was higher (p < .0001) in premenopausal women than in menopausal women.Conclusions and Significance: Our study found that middle-aged and elderly women with recurrent BPPV, especially postmenopausal women, may present decreased BMD and serum vitamin D levels.
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Affiliation(s)
- Zhibin Wang
- Department of Otorhinolaryngology, Department of Otolaryngology, Bengbu Third People's Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Guanghui Yao
- Department of General Medicine, Bengbu Third People's Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Xiangming Tao
- Department of Otorhinolaryngology, Department of Otolaryngology, Bengbu Third People's Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Jincui Zhang
- Department of Otorhinolaryngology, Department of Otolaryngology, Bengbu Third People's Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Ting Zhang
- Department of Otorhinolaryngology, Department of Otolaryngology, Bengbu Third People's Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Ziming Wu
- Department of Otorhinolaryngology, Head and Neck Surgery and Vertigo Center, Chinese PLA General Hospital, Beijing, China
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Shu L, Wu J, Jiang CY, Sun XH, Pan H, Fang J, Tang Y, Wu SC, Liu JR, Chen W. Seasonal variation of idiopathic benign paroxysmal positional vertigo correlates with serum 25-hydroxyvitamin D levels: a six-year registry study in Shanghai, China. Sci Rep 2019; 9:16230. [PMID: 31700074 PMCID: PMC6838600 DOI: 10.1038/s41598-019-52803-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/23/2019] [Indexed: 11/28/2022] Open
Abstract
Seasonal variation of benign paroxysmal positional vertigo (BPPV) occurrence has been reported in recent years. Whether the seasonality of BPPV also exists in Chinese patients and whether it correlates with serum vitamin D levels is unexplored. We retrospectively analyzed the data of 1269 new-onset idiopathic BPPV patients registered in our vertigo outpatient clinic over a six-year period. Additionally, serum 25-hydroxyvitamin D levels during this period were measured in 877 patients by chemiluminescence immunoassay. We delineated the changing trend of the monthly BPPV patient numbers and serum 25-hydroxyvitamin D levels, and the correlation between them was explored. December to next March is the top 4 months with higher BPPV patient numbers. The median BPPV patient numbers in winter group were higher than those in summer group (20 vs. 16 patients, p < 0.05). Median 25-hydroxyvitamin D levels in winter group were much lower than those in summer group (16.3 vs. 20.8 ng/ml, p < 0.001) and autumn group (16.3 vs. 19.3 ng/ml, p < 0.05). A moderate negative correlation was observed between median serum 25-hydroxyvitamin D levels and BPPV patient numbers each month. The onset of BPPV also shows a seasonal fluctuation in Chinese patients. This phenomenon may be related to serum vitamin D levels.
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Affiliation(s)
- Liang Shu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Wu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun-Yan Jiang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu-Hong Sun
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Pan
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Fang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Tang
- Department of Clinical Laboratory, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Si-Cheng Wu
- Biostatistics Office of Clinical Research Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Ren Liu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wei Chen
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Barometric pressure and the incidence of benign paroxysmal positional vertigo. Am J Otolaryngol 2019; 40:641-644. [PMID: 31147143 DOI: 10.1016/j.amjoto.2019.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the relationship between barometric pressure and the incidence of benign paroxysmal positional vertigo (BPPV). METHODS 181 patients diagnosed with classic BPPV seen between 2011 and 2016 were identified. Demographic information, data of onset, and date of presentation were recorded. Historical barometric data for each of the 60 months were recorded. In addition, monthly counts of other atmospheric, infectious, and allergic variables for that time period were recorded. Correlation analysis compared monthly incidence of BPPV with absolute and relative changes in atmospheric conditions. RESULTS The incidence of BPPV onset demonstrated a statistically significant positive correlation with barometric pressure, where every one-unit increase in barometric pressure leads to an expected increase of 6.1 diagnoses (p = 0.0008). The correlation coefficient (r) between barometric pressure and BPPV diagnoses was 0.66 (95% CI 0.14-0.90) with a p-value of 0.0131. Other seasonal variables demonstrated correlation, though none as strong as barometric pressure. CONCLUSIONS Barometric pressure has been long been associated with conditions of the inner ear, though its relationship to the pathogenesis of BPPV has not been investigated. Monthly changes in barometric pressure, rather than the absolute value, may be responsible for the observed changes in incidence. These findings demonstrate a clear association between barometric pressure and BPPV that may help to explain both the etiology of BPPV and its possible connection to migraine-related conditions.
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Zuma e Maia FC, de Fraga RB, Ramos BF, Cal RV, Mangabeira Albernaz PL. Seasonality and solar radiation variation level in benign paroxysmal positional vertigo. Acta Otolaryngol 2019; 139:497-499. [PMID: 30957689 DOI: 10.1080/00016489.2019.1590636] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Several studies have shown that the incidence of benign paroxysmal positional vertigo (BPPV) presents seasonal variations and there is evidence that the variation in time is dependent on the patient's amount of vitamin D. OBJECTIVES This is a retrospective study to verify if there is a correlation between the incidence of BPPV and the level of solar radiation, essential for the synthesis of vitamin D in the skin. MATERIAL AND METHODS This study comprised 214 patients with BPPV seen from 2012 to 2017, in a city Latitude: -30.0277, Longitude: -51.2287 30° 1' 40″ South, 51° 13' 43″ West. The amounts of monthly solar radiation were analyzed in relation to the dates of their first consultations. Statistical tests were employed to verify the existence of a correlation between solar radiation and the incidence of the disease. RESULTS The statistical analysis revealed a significant difference between the incidence of BPPV and the amount of radiation during the month of the diagnosis of the disease. There was also a significant statistical correlation with the climatic variation. CONCLUSION More patients with benign paroxysmal positional vertigo (BPPV) are seen in consultation in the months with low solar radiation and in the autumn and winter seasons, in this geographic city.
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Affiliation(s)
| | | | - Bernardo Faria Ramos
- Otolaryngology, Universidade Federal do Espirito Santo Centro de Ciencias da Saude, Vitoria, Brazil
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