Meniere’s disease (MD) represents one of the vertigo disorders characterized by triad symptoms (recurrent vertigo, fluctuating hearing loss, tinnitus or ear fullness). The diagnosis of MD relies on the accurate and detailed taking of medical history, and the differentiation between MD and vestibular migraine (VM) is of critical importance from the perspective of the treatment efficacy. VM is a highly prevalent vertigo condition and its typical symptoms (headache, vestibular symptoms, cochlear symptoms) mimic those of MD. Furthermore, the misdiagnosis in MD and VM could lead to VM patients mistakenly receiving the traumatic treatment protocol designed for MD, and sustaining unnecessary damage to the inner ear. Fortunately, thanks to the advances in examination technologies, the barriers to their differentiation are being gradually removed. These advances enhance the diagnostic accuracy of vertigo diseases, especially VM and MD. This review focused on the differentiation of VM and MD, with an attempt to synthesize existing data on the relevant battery of differentiation diagnosis (covering core symptoms, auxiliary tests [audiometry, vestibular tests, endolymphatic hydrops tests]) and longitudinal follow-up. Since the two illnesses are overlapped in all aspects, no single test is sufficiently specific on its own, however, patterns containing all or at least some features boost specificity.

Background: This systematic review pooled all the latest data and reviewed all the relevant studies to look into the effect of multisensory integration on the balance function in the elderly. Methods: PubMed, Web of Science and Scopus were searched to find eligible studies published prior to May 2019. The studies were limited to those published in Chinese and English language. The quality of the included studies was assessed against the Newcastle-Ottawa Scale or an 11-item checklist, as recommended by Agency for Healthcare Research and Quality (AHRQ). Any disagreement among reviewers was resolved by comparing notes and reaching a consensus. Results: Eight hundred thirty-nine records were identified and 17 of them were included for systematic review. The result supported our assumption that multisensory integration works on balance function in the elderly. All the 17 studies were believed to be of high or moderate quality. Conclusions: The systematic review found that the impairment of multisensory integration could predispose elderly people to fall. Accurate assessment of multisensory integration can help the elderly identify the impaired balance function and minimize the risk of fall. And our results provide a new basis for further understanding of balance maintenance mechanism. Further research is warranted to explore the change in brain areas related to multisensory integration in the elderly.

The vestibular system may have a critical role in the integration of sensory information and the maintenance of cognitive function. A dysfunction in the vestibular system has a significant impact on quality of life. Recent research has provided evidence of a connection between vestibular information and cognitive functions, such as spatial memory, navigation and attention. Although the exact mechanisms linking the vestibular system to cognition remain elusive, researchers have identified various pathways. Vestibular dysfunction may lead to the degeneration of cortical vestibular network regions and adversely affect synaptic plasticity and neurogenesis in the hippocampus, ultimately contributing to neuronal atrophy and cell death, resulting in memory and visuospatial deficits. Furthermore, the extent of cognitive impairment varies depending on the specific type of vestibular disease. In the present study, the current literature was reviewed, potential causal relationships between vestibular dysfunction and cognitive performance were discussed and directions for future research were proposed.

Meniere’s disease (MD) is a chronic disorder of inner ear, characterized by audial and vestibular symptoms. It presents a great variability among patients in terms of clinical features, etiology, p...