(813) Autonomic Symptom Burden and Heart Rate Variability Are Associated With Disease Severity in Ménière's Disease

Introduction: Ménière’s disease (MD) is characterized by episodic vertigo and fluctuating hearing loss, yet objective markers reflecting disease severity and progression remain limited. Autonomic dysfunction has been proposed to play a role in MD. This study aimed to evaluate the association between autonomic symptom burden, objective heart rate variability (HRV) measures, and the severity of cochleovestibular symptoms in patients with MD.

Methods: Patients diagnosed with definite MD were prospectively enrolled. Autonomic symptom burden was assessed using the Composite Autonomic Symptom Score-31 (COMPASS-31). Heart rate variability (HRV) was measured under standardized resting conditions, and the low-frequency to high-frequency (LF/HF) ratio was calculated as an index of sympathovagal balance. Disease severity was evaluated using the pure-tone average (PTA) of the affected ear, the Dizziness Handicap Inventory (DHI), and the Tinnitus Handicap Inventory (THI).

Results: A total of 25 patients with MD were included. Higher autonomic symptom burden, as reflected by COMPASS-31 scores, was significantly associated with greater dizziness (DHI) and tinnitus (THI) severity. Objective HRV analysis demonstrated a significant negative correlation between the LF/HF ratio and hearing thresholds (r = −0.47, P = 0.027), with lower LF/HF ratios observed in patients with more advanced hearing loss.

Conclusions: Autonomic symptom burden and physiologic autonomic markers are associated with clinical severity in MD. These findings suggest that autonomic assessment may provide objective information relevant to disease stratification and prognosis, and support further investigation into the role of autonomic dysfunction in the clinical course of MD.