Cerebrovascular Burden and Its Association with Ménière’s Disease: A Case-Control Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Authors,

I read with great interest your manuscript about associated pathology to Meniere disease.

However, there are some aspects that require your attention.

There are many abbreviations in the text, please include a list of abbreviations at the end of the manuscript in order to increase accesability.

In the discussion section you need to expand about ather possible neurimaging modalities for cerebrovascular disease imaging. Reference this to the article by Nukovic, J.J.; Opancina, V.; Ciceri, E.; Muto, M.; Zdravkovic, N.; Altin, A.; Altaysoy, P.; Kastelic, R.; Velazquez Mendivil, D.M.; Nukovic, J.A.; et al. Neuroimaging Modalities Used for Ischemic Stroke Diagnosis and Monitoring. Medicina 2023, 59, 1908. https://doi.org/10.3390/medicina59111908

In the limitations paragraph add also other possible cause for othic patology such as vascular-nervous loops at the level of the brainstem.

In the conclusions underline the fact that the present study is of interest to ENT specialists, neurologists, imaging specialists and other allied healthcare workers.

Please update the references, there is a title from 1987, I am sure there are newer articles worth mentioning.

Looking forward to receiving the improved version of your manuscript.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Reviewing ohbm-316871

 

I have read with interest the Article entitled 

Cerebrovascular Burden and Its Association with Ménière’s Disease: A Case-Control Study

 

The authors in this  cross sectional case-control study (IRB (2024-048(044-DEFI/044-CE, 19th March 2024) present new arguments to the  supporters of the vascular pathophysiology in MD. They report in this retrospective study (conducted from 2015 to 2023) in 70 definite MD patients (ICVD Barany society; Acta  Otorinolaringol Esp 2016) vs 75 controls (pituitary data set patients) significant MRI modifications concerning the assessment for small-vessel disease (SVD) markers (including Fazekas and EPVS scores) etc...

In the much debated and prolific context of MD probable multifactory physiopathology, the lead of a vascular background has been frequently evoked but never proven and this study tries to clarify a few ideas about the “brain- ear” concern.

Minor remarks

Typing errors.

In the abstract line 17 Gap or Interval before “A total”…..

Line19 “Statistical analyses” should be replaced by : “Statistical analysis”

In the chapter Conclusion: line 305 the word at the beginning of the sentence “In conclusion” is possibly not useful and could be deleted.

Other remarks:

In the discussion: “Insufficient  gradient echo  T2* sequences “are signaled in the chapter limitation line 288. However authors do not give access to a precise table about the % of different techniques and mention in the Chapter Material & Methods Line 124:

MRI specifications line 121- 126 mention: “Philips 3T but also General Electric Signa Explorer 1.5 T . T2 Weighted sequences, 3D T2 weighted FLAIR or axial T2 FlAIR, diffusion -weighted (DWI), gradient echo and T1 weighted sequences”.  Otherwise the authors  for the endolymphatic Hydrops (EH) evaluation which was probably also performed do not report the repartition of MRI 1.5T & 3T  Gado T2 FLAIR Sequences?

The authors report  that radiological results were blindly evaluated by one single experienced neuroradiologist. However one can regret the lack of evaluation independently  by 2 different radiologists which could have been more relevant and as mentioned in the discussion a multicentric study could have been more convincing. Nevertheless this works is contributing and well presented and does not show important flaws.

Comments on the Quality of English Language

English language looks correct

Author Response

Please see the attachment

Author Response File: Author Response.pdf