Journal Article

A Two-Year Randomized Trial of Interventions to Decrease Stress Hormone Vasopressin Production in Patients with Meniere’s Disease—A Pilot Study

Ota, Ichiro, Sakagami, Masaharu, Ito, Taeko, Yamanaka, Toshiaki, Fukushima, Munehisa, Yamashita, Akinori, Kitahara, Tadashi, Okamoto, Hidehiko

2016

Overview

Meniere's disease, a common inner ear condition, has an incidence of 15-50 per 100,000. Because mental/physical stress and subsequent increase in the stress hormone vasopressin supposedly trigger Meniere's disease, we set a pilot study to seek new therapeutic interventions, namely management of vasopressin secretion, to treat this disease. We enrolled 297 definite Meniere's patients from 2010 to 2012 in a randomized-controlled and open-label trial, assigning Group-I (control) traditional oral medication, Group-II abundant water intake, Group-III tympanic ventilation tubes and Group-IV sleeping in darkness. Two hundred sixty-three patients completed the planned 2-year-follow-up, which included assessment of vertigo, hearing, plasma vasopressin concentrations and changes in stress/psychological factors. At 2 years, vertigo was completely controlled in 54.3% of patients in Group-I, 81.4% in Group-II, 84.1% in Group-III, and 80.0% in Group-IV (statistically I < II = III = IV). Hearing was improved in 7.1% of patients in Group-I, 35.7% in Group-II, 34.9% in Group-III, and 31.7% in Group-IV (statistically I < II = III = IV). Plasma vasopressin concentrations decreased more in Groups-II, -III, and -IV than in Groups-I (statistically I < II = III = IV), although patients' stress/psychological factors had not changed. Physicians have focused on stress management for Meniere's disease. However, avoidance of stress is unrealistic for patients who live in demanding social environments. Our findings in this pilot study suggest that interventions to decrease vasopressin secretion by abundant water intake, tympanic ventilation tubes and sleeping in darkness is feasible in treating Meniere's disease, even though these therapies did not alter reported mental/physical stress levels. ClinicalTrials.gov NCT01099046.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Animal behavior / Aquaporins / Betahistine - therapeutic use / Biology and Life Sciences / Care and treatment / Darkness / Disease control / Disease Management / Drinking / Female / Follow-Up Studies / Health aspects / Hearing loss / Hearing Loss - epidemiology / Hearing Loss - therapy / Hospitals / Humans / Inner ear / Male / Medical personnel / Medical research / Medicine and Health Sciences / Meniere disease / Meniere Disease - metabolism / Meniere Disease - therapy / Meniere's disease / Middle Aged / Middle Ear Ventilation - methods / Otolaryngology / Patients / Physical stress / Physicians / Pilot Projects / Pituitary hormones / Psychological factors / Secretion / Sleep / Sleep deprivation / Social Sciences / Stress / Stress (Psychology) / Studies / Surgery / Therapeutic applications / Tinnitus / Treatment Outcome / Tubes / Vasopressin / Vasopressins - blood / Ventilation / Vertigo / Vertigo - epidemiology / Vertigo - etiology / Water intake / Water intakes