Università degli studi di Modena e Reggio Emilia

: Older adults with hearing loss have difficulties during conversation with others because an elevated auditory threshold reduces speech intelligibility, especially in noisy environments. Listening and comprehension often become exhausting tasks for hearing-impaired elders, resulting in social isolation and depression. The aim of the present study was to investigate the advantages of hearing aid use in relation to relief from listening-related fatigue, which is still controversial. Participants included a sample of 49 hearing-impaired elders affected by presbycusis for whom hearing aids were prescribed. The Modified Fatigue Impact Scale was used to assess cognitive, physical and psychosocial fatigue. The vitality subscale of the Short Form Health Survey 36 and a single item of the multi-dimensional Speech, Spatial and Quality Hearing Scale ("Do you have to put a lot of effort to hear what is being said in conversation with others?") were also used. The Cognitive Failures Questionnaire was used to investigate daily errors related to lack of memory and reduced mindedness. Hearing aids rehabilitation resulted in improved speech intelligibility in competing noise, and a significant reduction in cognitive and psychosocial fatigue and listening effort in conversation. Vitality was also improved and a significant reduction in the Cognitive Failures Questionnaire scores was observed. Findings from the study indicate that the use of hearing aids in older impaired-listeners provide them not only with an increased auditory function but also with a reduction in listening-related fatigue and mindedness.

Background: Disorientation, nausea, confusion, dizziness, and displacement are frequently complained by headache-suffering children. Anyhow, the cause of these symptoms is still unclear, and a dysfunction of vestibular pathways or their alteration due to central pain pathways hyper-activation, has been proposed. The aim of this study is to use posturography to explore the balance function of headache-suffering children during pain-free periods. Methods: Posturography was performed on 19 migraineurs, 11 tension-type headache sufferers, and 20 healthy controls. Posturographic measures were performed during headache-free periods under different conditions: with eyes opened, eyes closed, and during right and left optokinetic stimulation. The last 2 conditions were used to mimic unreliable visual signals that can confound vestibular system. Results: During eyes-closed conditions, headache-suffering children displayed higher displacements than healthy controls, since statokinesiogram surface was higher in tension-type headache sufferers and migraineurs compared with controls (P value = 0.0095). Romberg’s index, indicating the overall stability of the subject, was lower in healthy controls than in headache sufferers (P = 0.0139), thus suggesting a vestibular impairment in the seconds. Moreover, both during right and left optokinetic stimulation, the statokinesiogram length was higher in headache-suffering children (P < 0.0001). Thereafter, statokinesiogram surface was higher in migraineurs during right optokinetic stimulation (P = 0.0388) than in tension-type headache sufferers when stimulation was directed on the opposite side (P = 0.0249). Conclusions: These results suggest a central alteration of vestibular pathways in headache-suffering children, that makes balance function more dependent from visual inputs than healthy subjects, even in inter-ictal phases.

Nasal solutions are part of the recommended therapy of chronic rhinosinusitis (CRS). Formulations containing hyaluronic acid (HA) may represent a promising topical treatment in CRS patients in light of the anti-inflammatory and protective effect of HA on the sinonasal mucosa.

The aim of the study was to test whether acquired hearing loss (AHL)-related perceived disability mediates the association between AHL and psychological outcomes, including anger. Two-hundred ninety-seven consecutive outpatients with AHL assessed by pure tone average (PTA) loss completed the following: Hearing Handicap Inventory for Adults (HHIA), State-Trait Anger Expression Inventory-2 (STAXI-2), Brief Symptom Inventory (BSI), Diagnostic Criteria for Use in Psychosomatic Research (DCPR), and Social Functioning Questionnaire. In the sample, composed of 44.5% males with a mean age of 53.8 and a mean PTA of 30.7, AHL was associated to perceived hearing handicap, also correlating to all psychological measures except DCPR demoralization. Associations were stronger between the HHIA-Emotional Subscale, STAXI-2 State Anger and Feeling Angry, and BSI-Somatization, Interpersonal Sensitivity, Depression, and Psychoticism. Perceived disability predicted the presence of almost all psychosocial outcomes and confirms to be the most significant target of clinical action.

Human postural control is dependent on the central integration of vestibular, visual and proprioceptive inputs. Psychological states can affect balance control: anxiety, in particular, has been shown to influence balance mediated by visual stimuli. We hypothesized that patients with eating disorders would show postural destabilization when exposed to their image in a mirror and to the image of a fashion model representing their body ideal in comparison to body neutral stimuli. Seventeen females patients attending a day centre for the treatment of eating disorders were administered psychometric measures of body dissatisfaction, anxiety, depression and underwent posturographic measures with their eyes closed, open, watching a neutral stimulus, while exposed to a full length mirror and to an image of a fashion model corresponding to their body image. Results were compared to those obtained by eighteen healthy subjects. Eating disordered patients showed higher levels of body dissatisfaction and higher postural destabilization than controls, but this was limited to the conditions in which they were exposed to their mirror image or a fashion model image. Postural destabilization under these conditions correlated with measures of body dissatisfaction. In eating disordered patients, body related stimuli seem to act as phobic stimuli in the posturographic paradigm used. If confirmed, this has the potential to be developed for diagnostic and therapeutic purposes.

Background and aims: Posturography is a non invasivetechnique to objectively assess postural control. Weinvestigated the relationship between stabilization indexesafter mirror exposure and body image psychologicalappraisal measures in a diagnosed eating disorderpopulation, comparing it with a healthy subject one.Methods: Clinical population (N=17) and control healthypopulation (N=17) were matched for age and sex. BMI wasrecorded and every subject was administered the Italianversions of psychometric instruments assessing body imageself-perception. Static posturography (S.Ve.P. Amplifon)was performed measuring body sway with eyes open (EO)or closed (EC) during exposure to a full size mirror (M) ofa fashion model (FM) a neutral object (NO) or a verticalbar (VB). We reported descriptive statistics for sociodemographicdata and t test to compare psychometric andposturographic scores.Results: Cases and controls significantly differed inpsychometric scoring scales measuring body imageconcerns and phobic reaction (p<.001). Posturographicmeasures were significantly only in the EO and VBcondition (p<.05) and in the M and FM ones (p<.01).Conclusions: Results confirm the hypothesis thatposturography measures of female eating disorderedpatients differ from those of a control group.

The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach's alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach's alpha = 0.93) and its Danish (Cronbach's alpha = 0.93) and Portuguese (Cronbach's alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach's alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale scores indicating a good construct validity. Moreover, these statistically significant correlations (p < 0.005) confirmed that the self-report tinnitus handicap is largely related to psychological distress and a deterioration in the quality of life. On the other hand, it was confirmed that the tinnitus perceived handicap is totally independent (p > 0.05) from its audiometrically-derived measures of loudness and pitch thus supporting previous studies that focused on the importance of non-auditory factors, namely somatic attention, psychological distress and coping strategies, in the generation of tinnitus annoyance. Finally the results of the present study suggest that the THI-I maintains its original validity and should be incorporated, together with other adequate psychometric questionnaires, in the audiological examination of patients suffering from tinnitus and that psychiatric counselling should be recommended for the suspected co-morbidity between tinnitus annoyance and psychological distress.

Affective states, anxiety in particular, have been shown to negatively influence human postural control efficiency as measured by posturographic means, while exposure to a full-length mirror image of one's body exerts a stabilizing effect. We tested the hypothesis that body image concerns and preoccupations would relate negatively to this stabilising effect. Sixty-six healthy students, who screened negative for psychiatric disorders, completed rating scales for anxiety, depression and body image concerns. Posturography recordings of body sway were taken under three conditions: with eyes closed, looking at a vertical bar and looking at a full-length mirror. The Eyes Open/Mirror Stabilometric Quotient [EOMQ=(sway path with eyes closed/sway path looking at the mirror)x100], an index of how much postural control is stabilized by mirror feedback in comparison to the visual vertical bar condition, was significantly inversely related to body image concerns and preoccupations, and to trait anxiety. This finding confirms the impact of emotional factors on human postural control, which warrant further studies. If confirmed in clinical populations characterized by high levels of body image disturbances, e.g. eating disorders, it could lead to developments in the assessment and monitoring of these patients.

One of the most recent and promising theoreticalhypotheses for compensation of persistent asymmetry ofdynamic vestibulo-ocular gain is sensory substitution. Asa switch between oculomotor and vestibulo-ocular systems,saccadic eye movements are engaged in humans to compensatethe angular displacement of the head towards thelabyrinthine defective side thus preserving the foveal fixationof the target. This study focused on the possibility thatsaccadic eye movements might also compensate for theimpaired vestibulo-spinal reflexes and force the posturalsystem to a more effective control on upright stance andverified whether this sway-stabilizing effect could beapplied to patients with vestibular disorders and balancedysfunction. In the first experiment, 27 patients with unilaterallabyrinthine hypofunction, 24 patients with centralvestibular disorders and 24 healthy volunteers were evaluatedby static posturography in 3 different visual conditions:a) eye open with fixation of a steady target, b) eyeclosed, and c) while performing horizontal visually-guidedsaccades. The percentage of individuals with a decreasedbody sway area during the oculomotor task was found tobe higher in labyrinthine-defective patients as compared tothose with central vestibular disorders and controls. In thesecond experiment, 46 patients with vestibular disordersboth of central and peripheral origin, whose postural controlimproved by eye-tracking, as assessed by posturography,were later submitted to 12 consecutive training sessionsbased on repeated visually-guided saccades. Both thesaccadic performances and postural control improved in allpatients but a more pronounced effect was observed in thosewith peripheral vestibular disorders. Outcome of this rehabilitationtechnique was also corroborated by a generalreduction of the perceived overall impairment from balancedisorders as tested by a specific questionnaire.