BACKGROUND:Triple Semicircular Canal Occlusion (TSCO) has been developed in recent years as a surgical method for treating Meniere's disease(MD). AIMS/OBJECTIVES:To explore the effectiveness of TSCO surgery in the treatment of patients with Tumarkin crisis associated with MD. MATERIALS AND METHODS:Clinical data of 7 patients with Tumarkin crisis secondary to unilateral MD were analyzed. All 7 patients with Tumarkin crisis were treated with TSCO surgery. Audiological and vestibular function assessment was performed. RESULTS:None of the 7 patients in the Tumarkin group experienced drop attacks after TSCO surgery. Regarding vertigo control, 6 out of 7 patients (85.7%) achieved grade A improvement while 1 patient (14.3%) achieved grade B. No statistically significant differences were found in disease duration, pure tone average, ACS-cVEMP, or ACS-oVEMP between the two groups (all p > 0.05). However, vHIT gain values in both the lateral and posterior semicircular canals were significantly higher in the Tumarkin group than in the control group (p = 0.03 and p = 0.01, respectively), but not in the superior semicircular canal (p = 0.29). CONCLUSIONS AND SIGNIFICANCE:TSCO surgery can probably serve as an alternative treatment for patients with Tumarkin crisis associated with MD before labyrinthectomy or vestibular neurectomy.

Objective:This study aimed to assess the clinical application of subjective visual vertical（SVV） and subjective visual horizontal（SVH） tests at different head deflection angles in the diagnosis of vestibular neuritis（VN）, offering insights for a more precise evaluation of otolith dysfunction. Methods:A total of 40 patients with VN who were diagnosed at the Hearing Impairment and Vertigo Centre, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, between January and December 2024 were retrospectively analysed, and 31 healthy adults served as the control group. All participants underwent computer-assisted SVV/SVH tests at three head tilt angles: upright head position 0°（0°）, left head deflection 45°（L45°）, and right head deflection 45°（R45°）, and the deviation values were recorded and compared with those of the healthy control group for statistical analysis. Results:①Compared with normal controls, the difference in the rate of SVV/SVH abnormalities at 0°, L45° and R45° deflection angles was statistically significant in patients with VN（P<0.05）, with the highest rate of abnormality at 0°; ②The rate of abnormalities on the affected side of SVV and SVH was significantly higher in VN patients than on the healthy side（P<0.05）; ③Statistically significant differences were found in the comparison of the absolute values of different head deflection angles of SVV between VN patients and healthy controls（P<0.05）, and in the comparison of the absolute values of SVH in upright head position 0° and L45° between VN patients and healthy controls（P<0.05）, while the difference in the comparison of the absolute values of R45° was not statistically significant（P>0.05）. Conclusion:The SVV and SVH tests are important tests for assessing otolith dysfunction in patients with VN, with high sensitivity, and can quickly determine the side and degree of damage, of which the upright head position 0o is the most helpful for diagnosis, and is recommended as a routine examination head position, and this test can be an important method for the refined assessment of otolith dysfunction in patients with VN.

Gentamicin-induced inner-ear injury can cause disabling vestibular dysfunction and hearing loss; however, the regulated death programs driving vestibular and cochlear hair-cell loss remain incompletely defined. In this study, we identify ferroptosis as a shared and central mechanism of gentamicin-induced vestibular and cochlear toxicity in mice. Gentamicin exposure induced robust lipid peroxidation in both cochlear and vestibular tissues and altered the expression of ferroptosis-associated proteins, most notably glutathione peroxidase 4 (GPX4), a key antioxidant enzyme that was markedly downregulated and closely associated with hair-cell degeneration. We further identify ammonium tetrathiomolybdate (TM) as a novel agonist of nuclear factor erythroid 2-related factor 2 (NRF2) and evaluate its therapeutic potential via semicircular canal injection. Mechanistically, TM promoted NRF2 nuclear accumulation and upregulated downstream antioxidant programs, restoring GPX4 expression and suppressing lipid peroxidation and ferroptosis-linked signaling in inner-ear hair cells. Structurally and functionally, TM preserved cochlear and vestibular hair-cell integrity after gentamicin exposure and significantly improved auditory and vestibular performance. Together, these findings establish ferroptosis as a convergent mechanism underlying gentamicin-induced cochleovestibular injury and identify TM as a pathway-directed candidate for mitigating gentamicin-induced cochleovestibular ototoxicity.

Objective:To explore the cognitive function of sensory age-related hearing loss（ARHL） patients and compare it with healthy control group. Methods:Twenty-two patients with bilateral symmetrical sensory ARHL and 21 healthy elderly controls with normal hearing were recruited. All participants were evaluated for cognitive function using the Montreal Cognitive Assessment（MoCA） and the P300 objective electrophysiological test, respectively. P300 latency, amplitude, the total MoCA score, and scores of different dimensions of the MoCA scale were recorded and statistically analyzed. Results:①The healthy control group showed a significantly higher total MoCA score than the sensory ARHL group（P=0.038）. This difference was primarily driven by the visuospatial/executive function（P<0.001）, attention（P=0.003）, and abstraction（P<0.001） domains. ②A significant difference in P300 latency was observed between the healthy control group and the sensory ARHL group（P=0.006）. ③No significant correlation was found between P300 latency and each dimension of the MOCA scale in both groups. Conclusion:Patients with sensory ARHL exhibit cognitive decline, which is primarily manifested as impairments in visuospatial/executive function, attention, and abstraction. The P300 test, as an objective electrophysiological measure, can serve as a crucial complementary tool to the subjective MoCA questionnaire, with prolonged latency being a key indicative parameter.

Objective:To investigate the relationship between symptoms of vertigo and vestibular functions and short-term hearing outcomes in patients with flat descending sudden sensorineural hearing loss （SSNHL）. Methods:A retrospective review was conducted of the vestibular symptoms observed in 48 patients with unilateral flat-down sudden sensorineural hearing loss treated at the Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Symptoms of vertigo and the results of cervical vestibular-evoked myogenic potentials （cVEMP）, ocular VEMP （oVEMP）, caloric test and video head-impulse test （vHIT） were collected to determine whether these factors could predict therapeutic efficacy. Results:The symptoms of vertigo was not correlated with prognosis （P>0.05） or with abnormal vestibular functions （P>0.05）. Patients with abnormal cVEMP, oVEMP, caloric test or vHIT showed significantly lower effective rates （32.0%, 44.0%, 32.0%, and 24.0%, respectively）; the greater the number of abnormal tests, the poorer the outcome. Patients with all four tests abnormal gained only （3.13±15.97） dB HL in hearing recovery, whereas those with normal cVEMP, oVEMP, caloric test or vHIT showed better chances of hearing improvements by （29.22±20.31）, （31.18±21.59）, （26.17±21.31）, and （26.38±24.05） dB HL, respectively. Conclusion:Vestibular function effectively predicts prognosis in flat descending SSNHL. Patients with abnormal vestibular tests, regardless of symptoms of vertigo, responded poorly to treatment, whereas those with normal cVEMP, oVEMP, caloric test and vHIT results achieved better hearing recovery. Abnormal vestibular function implies more extensive and severe inner-ear lesions in patients with SSNHL.

To address the current lack of standardized protocols for vestibular infant screening (VIS), this clinical consensus aims to establish a clinical consensus on VIS in infants aged 0–12 months. Given a frequent co-occurrence of vestibular dysfunction in children with sensorineural hearing loss (SNHL) and the significant impact of vestibular dysfunction on early development, early identification and management are critical. This clinical consensus was developed by a panel of 28 international experts in pediatric otolaryngology and vestibular disorders through a structured, multi-round Delphi process. Panelists were selected based on clinical and academic expertise, representing 26 institutions across Asia and Europe. A comprehensive literature review (2000–2024) informed the initial draft of consensus statements. The consensus was reached through three iterative rounds of anonymous rating and feedback, followed by virtual discussions. Statements achieving ≥ 80

Objective This study aims to investigate the effect of camera positioning (left-sided vs right-sided) on the vestibulo-ocular reflex (VOR) gain values of normal subjects during the video head impulse test (vHIT), thereby providing valuable reference data for otology clinical practice. Methods Thirty healthy adults (60 ears) were recruited and examined by vHIT for the three pairs of semicircular canals (SCs). During the examination, we meticulously recorded and compared the VOR gain values in the six canal planes—right lateral (RL), left lateral (LL), right anterior-left posterior (RALP), and left anterior-right posterior (LARP)—with the camera positioned on the left side first, followed by repositioning on the right side. We evaluated instantaneous gain (40 ms, 60 ms, and 80 ms), 0–100 ms median gain, and regression gain in 0–100 ms for all SCs. Results For horizontal canals, higher VOR gain values were recorded when the camera was positioned on the same side as the canal being tested. The gain value in LARP was higher when the camera was on the left side than on the right side, while the gain value in RALP was higher when the camera was on the right side than on the left side. Conclusion This study underscores the importance of camera positioning on VOR gain values for both lateral and vertical canals during vHIT. To mitigate the effects of these variables, standardization of operational procedures and equipment settings is crucial.

OBJECTIVE:The objective of this study is to investigate the relationship between symptom duration of vestibular-related dizziness/vertigo and cognitive function in elderly patients, and to establish clinical guidance for assessing and intervening in vestibular-related cognitive impairments. METHODS:This study included 100 elderly patients with vestibular dysfunction presenting dizziness, vertigo, or balance disorders, categorized into short-duration (n = 64) and long-duration (n = 36) groups based on symptom duration. A control group of 21 healthy elderly individuals was included. Cognitive assessments comprised P300 event-related potentials (latency/amplitude) and Montreal Cognitive Assessment (MoCA) with domain-specific analysis. RESULTS:Significant between-group differences in P300 latency were observed (control vs short-duration vs long-duration: p < 0.001), whereas amplitude showed no difference (p  =  0.817). MoCA total scores differed significantly across groups (p  =  0.001), although abnormality rates were comparable (p  =  0.093). Domain analysis revealed significant differences in visuospatial (p < 0.001) and abstract abilities (p  =  0.005). Symptom duration correlated with: MoCA total (R 2  =  0.113), visuospatial ability (R 2  =  0.181), attention (R 2  =  0.068), and orientation (R 2  =  0.157). P300 latency correlated with: MoCA total (R 2  =  0.141), visuospatial ability (R 2  =  0.090), delayed recall (R 2  =  0.112), and orientation (R 2 = 0.082). CONCLUSION:Prolonged vestibular-related dizziness/vertigo in elderly patients is associated with cognitive deficits, particularly in visuospatial and executive functions. P300 latency demonstrates greater sensitivity than both P300 amplitude and MoCA screening, suggesting that combined electrophysiological and neuropsychological assessment enhances early detection of vestibular-related cognitive impairment. Highlights:Long-duration vestibular-related dizziness or balance disorders are associated with a higher risk of cognitive impairment in elderly patients.Among early assessment tools, P300 latency proves more sensitive than both P300 amplitude and the Montreal Cognitive Assessment (MoCA) questionnaire.A combined evaluation using P300 latency and MoCA provides a more effective measure of how dizziness affects cognitive function in this population.

BACKGROUND:Vestibular dysfunction is prevalent in severe/profound unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and may influence hearing recovery. This study investigates associations between vestibular function (cVEMP/oVEMP, vHIT, caloric tests) and short-term auditory outcomes. AIMS:To evaluate whether vestibular test abnormalities predict treatment response in severe/profound ISSNHL and identify independent prognostic factors. MATERIAL AND METHODS:Retrospective analysis of 133 patients (mean age 53.58 ± 18.56 years) treated with steroids/hyperbaric oxygen. Vestibular tests (cVEMP, oVEMP, vHIT, caloric) were performed pre-treatment. Outcomes were categorized as effective (complete/marked recovery) or ineffective (mild/no recovery). RESULTS:The ineffective group had higher vertigo prevalence (65/93 vs 14/40, p < 0.001) and older age (55.98 ± 17.85 vs 48.00 ± 19.22 years, p = 0.022). Univariate analysis showed abnormal vestibular tests (oVEMP/cVEMP/vHIT/caloric) correlated with outcomes (p < 0.05). Multivariate analysis identified three independent predictors of poor outcome: vertigo (OR 0.367), abnormal caloric test (OR 0.339), and abnormal vHIT (OR 0.316). cVEMP/oVEMP abnormalities were not independently associated (p > 0.05). CONCLUSIONS:Vertigo, abnormal caloric/vHIT results predict poorer short-term hearing recovery in severe/profound ISSNHL. Vestibular assessment aids prognosis but should not be used alone. Larger studies are needed for validation.

OBJECTIVE:To analyze the long-term effects of cochlear implantation (CI) on vestibular evoked myogenic potentials (VEMPs) in children. METHODS:CI surgery was performed in a unilateral ear of 31 patients in the department of otolaryngology, Second Affiliated Hospital of Xi'an Jiaotong University from 2011 to 2015. The group comprised 15 boys and 16 girls, with a mean age of 10.68±7.60 years old. All operations were performed by the same surgeon, and the round window approach was used for all. Both ocular VEMPs (oVEMPs) and cervical VEMPs (cVEMPs) were detected on bilateral ears before operation. These were tested again from 1 to 5 years after operation (with device ON and OFF). The ears with CI were analyzed as the study group, and the non-operated ears were used as a control. The response rate, threshold, p13 (15) and n10 (23) latencies, and amplitudes of the VEMPs were analyzed and compared between groups. RESULTS:Before CI, the response rates of the oVEMPs and cVEMPs in the implant ear were 58.06% and 61.29%, respectively. However, within 1 to 5 years after surgery, the oVEMP response rates decreased significantly to 16.13% (device ON, P <0.01) and 12.90% (device OFF, P <0.01). The response rates of the cVEMPs decreased to 22.58% (device ON, P <0.01) and 19.35% (device OFF, P <0.01). For those patients with elicited VEMPs, abnormal waveform parameters could be found in both the oVEMP and cVEMP, including elevated thresholds, decreased amplitudes, and changed p13 (15)/n10 (23) latencies. CONCLUSIONS:Cochlear implant surgery can affect vestibular function of the implanted ear, which can be detected by the oVEMP and cVEMP tests. These effects can last for years.

Objective: To evaluate the feasibility of vestibular screening in infants and investigate age-related changes in the characteristics of air-conducted sound cervical vestibular evoked myogenic potential (ACS-cVEMP) and bone-conducted vibration cervical vestibular evoked myogenic potential (BCV-cVEMP) in infants and children with normal hearing, aiming to provide new insights into the developmental trajectory of vestibular function during early childhood. Methods: A total of 159 subjects aged 3 months to 17 years old were divided into seven age groups. Additionally, 20 adults aged 18-30 years were included as controls to explore developmental changes in the sacculocollic reflex pathway. Results: The response rates of BCV-cVEMP in 3-month-olds were significantly higher than that of ACS-cVEMP (p = 0.048), while no significant difference was observed in other age groups (p > 0.05). Age-related changes were found in both latencies and amplitudes of ACS-cVEMP and BCV-cVEMP. ACS-cVEMP latencies reached adult levels at 13-17 years, while BCV-cVEMP latencies normalized by 7-12 years. ACS-cVEMP amplitudes increased with age, stabilizing at 4 years, whereas BCV-cVEMP amplitudes peaked at 4-6 years before gradually decreasing. Conclusions: This study demonstrates that cVEMP is not only a viable tool for vestibular screening in infants but also reveals crucial age-related developmental changes in the vestibular system. These findings contribute new insights into the maturation of the vestibular reflex pathways and provide normative data that can be used to guide early vestibular screening practices.

Objectives: Patients with severe to profound sudden sensorineural hearing loss (SSNHL) generally experience poorer hearing recovery; however, the associated risk factors have not been identified. This study synthesizes current evidence to explore prognostic risk factors in this patient group. Methods: Databases were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to 18 October 2025. Three researchers independently extracted and recorded patient information and relevant data from all selected studies. Any inconsistencies were clarified through discussion or by consulting a fourth researcher. Results: The study included 2632 patients from 15 articles published between 2002 and 2025 and evaluated 8 prognostic risk factors. The results showed that profound hearing loss (OR = 4.68; 95% CI: 3.57–6.13; p < 0.001) and vertigo (OR = 1.95; 95% CI: 1.28–2.98; p = 0.002) were correlated with poorer hearing recovery. Subgroup analyses based on different prognostic criteria confirmed the consistent impact of hearing loss severity on poor outcomes. The remaining 6 risk factors did not show statistically meaningful associations. Conclusions: Profound hearing loss and vertigo are significantly associated with poorer prognosis in patients with severe to profound SSNHL. These findings may help identify high-risk patients early and inform the design of personalized therapeutic approaches in clinical settings.

OBJECTIVES:Vestibular dysfunction is one of the most common complications of cochlear implantation (CI); however, the pathological changes and mechanisms underlying inner ear damage post-CI remain poorly understood. This study aimed to investigate the functional and histopathological changes in the cochlea and vestibule as well as endoplasmic reticulum (ER) stress-mediated apoptosis in guinea pigs after CI. DESIGN:Auditory brainstem response, ice water test, and vestibular evoked myogenic potentials were used to assess cochlear and vestibular function in guinea pigs before and after CI. Histopathological analyses were conducted at various time points post-CI to observe morphological changes in the cochlea and vestibule, as well as the impact of ER stress on these tissues. RESULTS:After CI, 10.7% (9/84) of the guinea pigs exhibited nystagmus and balance dysfunction. Auditory brainstem response thresholds increased significantly after CI, and air-conducted cervical and ocular vestibular evoked myogenic potential response rates decreased. The ice water test revealed a gradual reduction in nystagmus elicitation rates, along with decreased nystagmus frequency, prolonged latency, and shortened duration. Histopathological analysis of the cochlea revealed fibrous and osseous tissue formation in the scala tympani and a reduction in hair cells and spiral ganglion cells. In the vestibule, alterations included flattening the ampullary crista and disorganized sensory epithelial cells. Transmission electron microscopy revealed pathological changes including cytoplasmic vacuolization and chromatin uniformity in both cochlear and vestibular hair cells. ER stress was prominent in the cochlea, while no substantial stress response was observed in the vestibule. CONCLUSIONS:Our study highlights the various effects of CI surgery on cochlear and vestibular function and morphology in guinea pigs. ER stress-mediated apoptosis may contribute to secondary cochlear damage, whereas the vestibular system demonstrates adaptive responses that preserve cellular homeostasis. These findings provide insights into potential mechanisms underlying inner ear complications post-CI.

ObjectiveThe study aims to assess the high-frequency Vestibulo-Ocular Reflex (VOR) gain across three pairs of semicircular canals using the EyeSeeCam device and to determine normative values.MethodsA total of 105 volunteers, aged 19 to 69 years with no history of vestibular disorders, were enrolled. This cohort included 50 males (mean age 41.11 ± 15.98) and 55 females (mean age 35.52 ± 15.07), with no statistically significant age difference between the genders (P = 0.078). Participants were categorized into six age brackets: 11-20, 21-30, 31-40, 41-50, 51-60, and 61-70. For each test, the recording device was consistently positioned on the left side of the goggles, and the tests were conducted by a right-handed operator.ResultsThe average regression gain for left anterior-right posterior canals (LARP) was 1.44 ± 0.19, significantly surpassing that of right anterior-left posterior canals (RALP) at 1.09 ± 0.13 (p < 0.001) and horizontal semicircular canals (HSC) at 1.11 ± 0.07 (p < 0.001). No significant difference was observed between the VOR gains of RALP and HSC (p = 0.1077). Additionally, VOR gain values did not show significant variation across different age groups. In a gender-based analysis, a marginally higher HSC gain was observed in females (1.13 ± 0.07) compared to males (1.11 ± 0.07; p = 0.042), while no significant gender disparity was noted for RALP gains (females: 1.09 ± 0.11; males: 1.10 ± 0.14; p = 0.641). Females exhibited significantly higher LARP gain values (1.49 ± 0.18) than males (1.41 ± 0.20; p = 0.002).ConclusionThis study underscores the stability of high-frequency VOR gain values across ages. However, it also reveals a significant asymmetry in vertical canal gains (LARP vs RALP), suggesting a possible vertical canals monocular directional preponderance. This finding highlights that normative values can be highly specific to the recording and testing protocol. Thus, laboratories should develop their own normative values, customized to their equipment and testing protocols.

Objective To analyze the clinical significance of subjective visual vertical(SVV)tests at different head deflection angles in assessing utricle function in patients with benign paroxysmal positional vertigo(BPPV).Methods A total of 61 BPPV patients who were treated at the Hearing Impairment and Vertigo Diagnosis and Treatment Center of Otolaryngology Head and Neck Surgery,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine from August 2022 to May 2023 were retrospectively included,and 29 healthy adults were selected as controls.SVV tests were performed on all research subjects at different head deflection angles:upright head(0°),left head 45°(L45°),right head 45°(R45°).The test results between the two groups were compared.Results SVV absolute value at R45°in BPPV group was lower than that in the control group(P=0.003);there was no significant difference in SVV values at 0°and L45°between the two groups.There was no statistical difference in SVV values at different head deflection angles between the control group and the left BPPV group.SVV absolute value at R45°in right BPPV group was lower than that in the control group(P＜0.001);there was no statistical difference in SVV values at 0°and L45° between the two groups.Conclusions SVV test can provide subjective information about the utricle,and SVV tests at different head deflection angles can fine-tune evaluate the function of the utricle in BPPV patients.

Background Following successful canalith repositioning procedures (CRPs), some patients with benign paroxysmal positional vertigo (BPPV) may experience residual symptoms. There is currently no consensus on whether these residual symptoms are related to the disease duration. Objective To examine the impact of BPPV duration on the persistence of residual symptoms following successful CRP. Methods A total of 102 idiopathic BPPV patients were enrolled and categorized into short-course and long-course groups based on the duration of the disease. The course of disease in the short-course group was less than or equal to 7 days. The long course of disease was longer than 7 days. All patients underwent swivel-chair-assisted CRP and were followed up 7–10 days after successful CRP. The Dizziness Handicap Inventory (DHI) questionnaire was administered to all patients before and after CRP. Results Before CRP, significant differences were observed between the two groups in total DHI score and its subdomains: Physical (DHI-P), Functional (DHI-F), and Emotional (DHI-E) ( p < 0.05), indicating that long disease duration significantly affected all patient aspects. After CRP, significant differences remained in total DHI, DHI-P, DHI-F, and DHI-E scores ( p < 0.05), with the long-course group consistently scoring higher. However, no significant differences were found in the changes in DHI scores across dimensions before and after CRP between the two groups. Conclusion The duration of BPPV did not influence CRP outcomes, but patients with a longer disease course were more likely to experience residual symptoms after successful CRP.

Objective This study aimed to quantitatively analyze the characteristics of saccades in normal subjects during video head impulse test (vHIT), to establish a reference for clinical practice. Methods A cohort of 20 healthy individuals (40 ears) was recruited and compared with a matched group of 20 patients (20 ears) suffering from vestibular neuritis (VN), utilizing vHIT to evaluate the functionality of all three semicircular canals (SCCs). This study analyzed the quantitative characteristics of saccades observed in healthy individuals and patients with VN. Results Significant differences were observed between both groups in terms of lateral saccade frequency, latency, peak velocity, and duration for both the first and second saccades (all p < 0.05, with age as a covariate). Similarly, significant differences were found in vertical SCCs between groups for the frequency, latency, peak velocity, and duration of the first saccade (all p < 0.05, with age as a covariate). However, no significant differences were found in Perez-Rey (PR) scores either in lateral ( p = 0.259) or vertical ( p = 0.102) SCCs. Within the healthy group, significant differences were observed in the frequency, peak velocity, and duration of the first saccade in lateral and vertical SCCs (all p < 0.05). However, the latency ( p = 0.827) and PR scores ( p = 0.552) exhibited no significant variation. Conclusions Microsaccades characterized by prolonged latency and reduced amplitude can occur in healthy individuals during vHIT and are distinct from the saccades seen in patients with VN due to vestibular impairment. This highlights the need to carefully identify and interpret relevant saccades during clinical assessments.

BackgroundRecently, the prevalence of sensorineural hearing loss (SNL) has been increasing, and several studies have suggested that depression, anxiety, and SNL may be associated with each other, however, individual findings still have discrepancies. To the best of our knowledge, no scholars have systematically elucidated the bidirectional associations between SNL, depression, and anxiety disorders from the perspective of meta-analysis. In this study, we aimed to systematically evaluate the bidirectional associations between SHL and depressive and anxiety symptoms, and to provide evidence-based medical evidence for reducing SNL, depression, and anxiety disorders.MethodsWe performed systematic review based on priori protocol that was registered with PROSPERO (No. CRD42022365963). Systematic search of PubMed, Embase, and Web of Science databases identified articles published as of June 1, 2023, on the relationship between SNL and depression and anxiety. Meta-analysis was performed to calculate the odds ratios (OR) and 95% confidence intervals (CIs) for the outcome metrics, and the results were combined to assess bivariate associations between the disorders with fixed or random effects. Sensitivity and subgroup analyzes were conducted to analyze sources of heterogeneity, and Egger’s and Begg’s tests combined with funnel plots were applied to assess publication bias.ResultsSummary analysis of the results of 20 studies covering 675,291 individuals showed that the bidirectional association between SNL and depression and anxiety disorders. The incidence (OR = 0.17, 95% CI: 0.09–0.28) and risk (OR = 1.43, 95% CI: 1.32–1.55) of depression and morbidity were higher in SNL patients than the general population. Elevated prevalence (OR = 0.46, 95% CI: 0.28–0.65) and risk (OR = 1.30, 95% CI: 1.11–1.48) of SNL were also observed in depressed patients. The prevalence of anxiety disorders among SNL patients was about 40% (OR = 0.40, 95% CI: 0.24%-0.57), which was associated with higher risk (OR = 1.83, 95% CI: 1.42–2.24) of development than the general population. Incidence of SNL in patients with anxiety disorders was approximately 31% (OR = 0.31, 95% CI: 0.29–0.33). Additionally, subgroup analyzes showed that the bidirectional associations between SNL, depression, and anxiety disorders was influenced by age, region, and mode of diagnosis of the disorders (SNL, depression, anxiety).ConclusionThere are bidirectional associations between SNL and depression and anxiety disorders, which was influenced by age and region and the method the disorders (SNL, depression, anxiety) were diagnosed.