Endolymphatic hydrops in patients with migraine: a correlative study.

OBJECTIVE

Endolymphatic hydrops (EH), Menière's disease (MD) pathological hallmark, is visualized via 3 T delayed phase MRI. This study examines MRI correlations between EH severity and migraine brain biomarkers.

METHODS

Retrospective review of 144 inner ear MRI scans yielded 108 patients with confirmed EH. Two blinded radiologists graded EH, assessed migraine markers (white matter lesions (WML), frontal predominance of WML, enlarged perivascular spaces), and measured cranial nerve volumes. Binary logistic regression tested associations.

RESULTS

Mean age 53.6 ± 15.8 years (56.5% female). Grade 2 vestibular EH predominated bilaterally; grade 2 cochlear EH affected 34-43%. No EH associations with migraine biomarkers or cranial nerve volumes were found (all p > 0.05). Left vestibular EH grade 1 linked to sudden hearing loss (OR 5.205, p = 0.018); left cochlear EH grade 1 to aural fullness (OR 5.019, p = 0.016).

CONCLUSION

EH severity was not associated with established migraine MRI biomarkers in this cohort. These findings support the concept that EH and migraine-related structural brain changes may represent distinct imaging phenomena.