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The published publication [...].
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In aviation, any detail can have massive consequences. Among the potential sources of failure, human error is still the most troublesome to handle. Therefore, research concerning the management of mental workload, attention, and stress is of special interest in aviation. Recognizing conditions in which a pilot is over-challenged or cannot act lucidly could avoid serious outcomes. Furthermore, knowing in depth a pilot's neurophysiological and cognitive-behavioral responses could allow for the optimization of equipment and procedures to minimize risk and increase safety. In addition, it could translate into a general enhancement of both the physical and mental well-being of pilots, producing a healthier and more ergonomic work environment. This review brings together literature on the study of stress and workload in the specific case of pilots of both civil and military aircraft. The most common approaches for studying these phenomena in the avionic context are explored in this review, with a focus on objective methodologies (e.g., the collection and analysis of neurophysiological signals). This review aims to identify the pros, cons, and applicability of the various approaches, to enable the design of an optimal protocol for a comprehensive study of these issues.
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Aviación , Humanos , Carga de Trabajo , Aeronaves , Análisis y Desempeño de Tareas , AtenciónRESUMEN
Orexins are hypothalamic neuropeptides that regulate several physiological functions, such as appetite, arousal, cognition, stress, sleep and metabolism. Emerging pieces of evidence suggest an orexinergic dysfunction in several neuropsychiatric disorders, including depression, anxiety and addiction. A syndromic overlap between behavioural variant frontotemporal dementia (bvFTD) and several psychiatric disorders was recently demonstrated. Therefore, we analysed cerebrospinal fluid (CSF) orexin A concentrations of 40 bvFTD and 32 non-demented patients, correlating neuropeptide concentrations with several clinical characteristics. A significant increase of orexin A concentrations was found in bvFTD patients when compared to controls (p<0.001). CSF orexin A concentration showed a correlation with Mini-Mental State Examination scores, drug assumption, history of compulsive behaviour and extrapyramidal signs. Moreover, we found a relationship between CSF markers of neurodegeneration, total tau and Aß1-42 and CSF orexin A concentrations. Our study provides evidence of an orexinergic dysfunction in bvFTD, correlating with several clinical symptoms. Further larger studies are needed to confirm our data.
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Demencia Frontotemporal , Orexinas/líquido cefalorraquídeo , Estudios de Casos y Controles , Demencia Frontotemporal/líquido cefalorraquídeo , HumanosRESUMEN
Motor impairments are among the most relevant, evident, and disabling symptoms of Parkinson's disease that adversely affect quality of life, resulting in limited autonomy, independence, and safety. Recent studies have demonstrated the benefits of physiotherapy and rehabilitation programs specifically targeted to the needs of Parkinsonian patients in supporting drug treatments and improving motor control and coordination. However, due to the expected increase in patients in the coming years, traditional rehabilitation pathways in healthcare facilities could become unsustainable. Consequently, new strategies are needed, in which technologies play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. The paper proposes a vision-based solution using the new Azure Kinect DK sensor to implement an integrated approach for remote assessment, monitoring, and rehabilitation of Parkinsonian patients, exploiting non-invasive 3D tracking of body movements to objectively and automatically characterize both standard evaluative motor tasks and virtual exergames. An experimental test involving 20 parkinsonian subjects and 15 healthy controls was organized. Preliminary results show the system's ability to quantify specific and statistically significant (p < 0.05) features of motor performance, easily monitor changes as the disease progresses over time, and at the same time permit the use of exergames in virtual reality both for training and as a support for motor condition assessment (for example, detecting an average reduction in arm swing asymmetry of about 14% after arm training). The main innovation relies precisely on the integration of evaluative and rehabilitative aspects, which could be used as a closed loop to design new protocols for remote management of patients tailored to their actual conditions.
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Enfermedad de Parkinson , Realidad Virtual , Humanos , Enfermedad de Parkinson/diagnóstico , Videojuego de Ejercicio , Calidad de Vida , MovimientoRESUMEN
The accurate and reliable assessment of gait parameters is assuming an important role, especially in the perspective of designing new therapeutic and rehabilitation strategies for the remote follow-up of people affected by disabling neurological diseases, including Parkinson's disease and post-stroke injuries, in particular considering how gait represents a fundamental motor activity for the autonomy, domestic or otherwise, and the health of neurological patients. To this end, the study presents an easy-to-use and non-invasive solution, based on a single RGB-D sensor, to estimate specific features of gait patterns on a reduced walking path compatible with the available spaces in domestic settings. Traditional spatio-temporal parameters and features linked to dynamic instability during walking are estimated on a cohort of ten parkinsonian and eleven post-stroke subjects using a custom-written software that works on the result of a body-tracking algorithm. Then, they are compared with the "gold standard" 3D instrumented gait analysis system. The statistical analysis confirms no statistical difference between the two systems. Data also indicate that the RGB-D system is able to estimate features of gait patterns in pathological individuals and differences between them in line with other studies. Although they are preliminary, the results suggest that this solution could be clinically helpful in evolutionary disease monitoring, especially in domestic and unsupervised environments where traditional gait analysis is not usable.
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Trastornos Neurológicos de la Marcha , Enfermedad de Parkinson , Marcha , Análisis de la Marcha , Trastornos Neurológicos de la Marcha/diagnóstico , Humanos , Enfermedad de Parkinson/diagnóstico , CaminataRESUMEN
Arm swinging is a typical feature of human walking: Continuous and rhythmic movement of the upper limbs is important to ensure postural stability and walking efficiency. However, several factors can interfere with arm swings, making walking more risky and unstable: These include aging, neurological diseases, hemiplegia, and other comorbidities that affect motor control and coordination. Objective assessment of arm swings during walking could play a role in preventing adverse consequences, allowing appropriate treatments and rehabilitation protocols to be activated for recovery and improvement. This paper presents a system for gait analysis based on Microsoft Azure Kinect DK sensor and its body-tracking algorithm: It allows noninvasive full-body tracking, thus enabling simultaneous analysis of different aspects of walking, including arm swing characteristics. Sixteen subjects with Parkinson's disease and 13 healthy controls were recruited with the aim of evaluating differences in arm swing features and correlating them with traditional gait parameters. Preliminary results show significant differences between the two groups and a strong correlation between the parameters. The study thus highlights the ability of the proposed system to quantify arm swing features, thus offering a simple tool to provide a more comprehensive gait assessment.
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Enfermedad de Parkinson , Brazo , Fenómenos Biomecánicos , Marcha , Humanos , CaminataRESUMEN
The aim of this review was to present an overview of the state of the art in the use of the Microsoft Kinect camera to assess gait in post-stroke individuals through an analysis of the available literature. In recent years, several studies have explored the potentiality, accuracy, and effectiveness of this 3D optical sensor as an easy-to-use and non-invasive clinical measurement tool for the assessment of gait parameters in several pathologies. Focusing on stroke individuals, some of the available studies aimed to directly assess and characterize their gait patterns. In contrast, other studies focused on the validation of Kinect-based measurements with respect to a gold-standard reference (i.e., optoelectronic systems). However, the nonhomogeneous characteristics of the participants, of the measures, of the methodologies, and of the purposes of the studies make it difficult to adequately compare the results. This leads to uncertainties about the strengths and weaknesses of this technology in this pathological state. The final purpose of this narrative review was to describe and summarize the main features of the available works on gait in the post-stroke population, highlighting similarities and differences in the methodological approach and primary findings, thus facilitating comparisons of the studies as much as possible.
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Hemiplejía , Accidente Cerebrovascular , Fenómenos Biomecánicos , Marcha , Humanos , Extremidad Inferior , Accidente Cerebrovascular/complicacionesRESUMEN
The progressive aging of the population and the consequent growth of individuals with neurological diseases and related chronic disabilities, will lead to a general increase in the costs and resources needed to ensure treatment and care services. In this scenario, telemedicine and e-health solutions, including remote monitoring and rehabilitation, are attracting increasing interest as tools to ensure the sustainability of the healthcare system or, at least, to support the burden for health care facilities. Technological advances in recent decades have fostered the development of dedicated and innovative Information and Communication Technology (ICT) based solutions, with the aim of complementing traditional care and treatment services through telemedicine applications that support new patient and disease management strategies. This is the background for the REHOME project, whose technological solution, presented in this paper, integrates innovative methodologies and devices for remote monitoring and rehabilitation of cognitive, motor, and sleep disorders associated with neurological diseases. One of the primary goals of the project is to meet the needs of patients and clinicians, by ensuring continuity of treatment from healthcare facilities to the patient's home. To this end, it is important to ensure the usability of the solution by elderly and pathological individuals. Preliminary results of usability and user experience questionnaires on 70 subjects recruited in three experimental trials are presented here.
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Enfermedades del Sistema Nervioso , Telemedicina , Telerrehabilitación , Humanos , Anciano , Telerrehabilitación/métodos , Telemedicina/métodos , Atención a la Salud , CogniciónRESUMEN
BACKGROUND: Prone positioning improves oxygenation in adult respiratory distress syndrome. This procedure has been widely used during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. However, this procedure can also be responsible for nerve damage and plexopathy. METHODS: We retrospectively reviewed a series of 7 infectious patients with coronavirus disease 2019 who underwent prone positioning ventilation at the San Raffaele Hospital of Milan, Italy, during the SARS-CoV-2 pandemic. RESULTS: Clinical and neurophysiological data of 7 patients with nerve compression injuries have been reported. CONCLUSIONS: Health care workers should take into consideration the risk factors for prone positioning-related plexopathy and nerve damage, especially in patients with coronavirus disease 2019, to prevent this type of complication.
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COVID-19/terapia , Síndromes de Compresión Nerviosa/etiología , Posicionamiento del Paciente/efectos adversos , Posición Prona , Respiración Artificial/efectos adversos , Adulto , Anciano , COVID-19/fisiopatología , Humanos , Italia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , SARS-CoV-2RESUMEN
PURPOSE: The main aim of the present study was to identify the long-term effects of continuous positive airway pressure (CPAP) treatment in patients co-affected by obstructive sleep apnea syndrome (OSAS) and mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (ADD). METHODS: This retrospective multicentre study included patients affected by MCI or ADD, diagnosed according to the core clinical and biomarkers criteria, and presenting comorbid OSAS. Only patients performing at least a 1-year visit during their follow-up to monitor cognitive deterioration and adherence with CPAP treatment were included. Both Mini-Mental State Examination (MMSE) and clinical dementia rating scale (CDR) were conducted during the baseline and the follow-up visits. RESULTS: Twenty-four patients were included in the study and were distributed according to the diagnosis in MCI (n = 8) or ADD (n = 16). There were no significant differences in the variables analysed at baseline between the CPAP non-adherent and CPAP adherent patients. In the whole group, a significant decrease was found in MMSE scores, and a significant increase was found in CDR scores between baseline and follow-up. No longitudinal changes in ESS scores were statistically significant from baseline to follow-up. A significant difference was found for the mean score change of the CDR since CPAP non-adherent patients showed a higher mean change of CDR compared to CPAP adherent patients. No significant differences were found for the mean change of MMSE. CONCLUSION: These findings highlight the clinical potential of treating OSAS with CPAP to delay cognitive deterioration in patients with MCI or ADD.
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Enfermedad de Alzheimer/terapia , Disfunción Cognitiva/terapia , Presión de las Vías Aéreas Positiva Contínua , Apnea Obstructiva del Sueño/terapia , Anciano , Enfermedad de Alzheimer/epidemiología , Enfermedad de Alzheimer/fisiopatología , Disfunción Cognitiva/epidemiología , Comorbilidad , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Estudios Retrospectivos , Apnea Obstructiva del Sueño/epidemiologíaRESUMEN
Stroke is one of the most significant causes of permanent functional impairment and severe motor disability. Hemiplegia or hemiparesis are common consequences of the acute event, which negatively impacts daily life and requires continuous rehabilitation treatments to favor partial or complete recovery and, consequently, to regain autonomy, independence, and safety in daily activities. Gait impairments are frequent in stroke survivors. The accurate assessment of gait anomalies is therefore crucial and a major focus of neurorehabilitation programs to prevent falls or injuries. This study aims to estimate, using a single RGB-D sensor, gait patterns and parameters on a short walkway. This solution may be suitable for monitoring the improvement or worsening of gait disorders, including in domestic and unsupervised scenarios. For this purpose, some of the most relevant spatiotemporal parameters, estimated by the proposed solution on a cohort of post-stroke individuals, were compared with those estimated by a gold standard system for a simultaneous instrumented 3D gait analysis. Preliminary results indicate good agreement, accuracy, and correlation between the gait parameters estimated by the two systems. This suggests that the proposed solution may be employed as an intermediate tool for gait analysis in environments where gold standard systems are impractical, such as home and ecological settings in real-life contexts.
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Personas con Discapacidad , Trastornos Motores , Accidente Cerebrovascular , Estudios de Factibilidad , Marcha , Humanos , Accidente Cerebrovascular/complicacionesRESUMEN
Clock drawing test (CDT) is a screening tool used in neuropsychological assessment for evaluating comprehensively multiple cognitive functions. Aberrant performance at CDT was observed in Parkinson's disease, due to impaired executive functioning as well as visuospatial difficulties. However, previous studies suffered from different limitations, such as reduced sample size as well as no comparison with healthy individuals. This retrospective study aimed to verify CDT accuracy in discriminating between 240 patients with idiopathic Parkinson's disease and 205 healthy subjects. We verified CDT accuracy in discriminating patients when classified according to their global cognitive functioning measured through the Mini-Mental State Examination and the Frontal Assessment Battery. Our results showed that affected individuals reported a worse performance in CDT than healthy controls. Instead, no difference was found between patients when categorized according to their performance at the Mini-Mental State Examination or Frontal Assessment Battery. We confirmed that patients with Parkinson's disease reported low performance at the CDT. We encouraged the use of CDT for early detection of possible cognitive difficulties in Parkinson's disease for clinical and research purposes.
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Disfunción Cognitiva/diagnóstico , Pruebas Neuropsicológicas/normas , Enfermedad de Parkinson/diagnóstico , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/etiología , Femenino , Humanos , Masculino , Pruebas de Estado Mental y Demencia , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Estudios RetrospectivosRESUMEN
Mixed findings characterize studies in Parkinson's disease (PD): some studies indicate a relationship between physical impairments and the ability to mentally represent the body, while others suggest spared abilities for this cognitive function. To clarify the matter, in the present study we explored the mental representations of the body in action in the same PD patients, taking also into account lateralization of symptoms and visual imagery skills. 10 PD patients with left- (lPD), 10 with right (rPD) lateralized symptoms (lPD), and 20 matched healthy controls have been recruited for the study. All patients were screened for neuropsychological impairments. To explore a more implicit component we used the hand laterality task (HLT), while the mental motor chronometry (MMC) was used to explore a more explicit one. Two control tasks, with objects instead of body parts, were administered to control for visual imagery skills. In the HLT, we detected the effects of biomechanical constraints effects in both controls and PD patients. In the latter group, importantly, this was true independently from lateralization of symptoms. In the MMC, we found the expected positive correlation between executed and imagined movements for both hands in controls only, while all PD patients, again independently form lateralization, only showed this effect for the left hand. In terms of visual imagery, only rPD patients differed from controls when asked to implicitly rotate letters, and in terms of accuracy only. However, this difference is explained by executive functions measured through the neuropsychological assessment rather than by a "pure" visual imagery impairment. In summary, our findings suggest that two different aspects of the mental representations of the body in action, one more implicit and the other more explicit, can be differently affected by PD. These impairments are unlikely explained by a basic visual imagery deficit. When present, impairments concern a higher dimension, related to motor functions and awareness, and not driven by sensory impairments, as shown by the independence of effects from physical laterality of symptoms.
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Cuerpo Humano , Movimiento/fisiología , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/psicología , Cognición/fisiología , Femenino , Lateralidad Funcional/fisiología , Mano/fisiopatología , Humanos , Imágenes en Psicoterapia/métodos , Imaginación/fisiología , Masculino , Persona de Mediana Edad , Pruebas NeuropsicológicasRESUMEN
A self-managed, home-based system for the automated assessment of a selected set of Parkinson's disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation of posture and motor tasks, which are specified according to the Unified Parkinson's Disease Rating Scale (UPDRS). Posture, lower limb movements and postural instability are characterized by kinematic parameters of the patient movement. During an experimental campaign, the performances of patients affected by Parkinson's disease were simultaneously scored by neurologists and analyzed by the system. The sets of parameters which best correlated with the UPDRS scores of subjects' performances were then used to train supervised classifiers for the automated assessment of new instances of the tasks. Results on the system usability and the assessment accuracy, as compared to clinical evaluations, indicate that the system is feasible for an objective and automated assessment of Parkinson's disease at home, and it could be the basis for the development of neuromonitoring and neurorehabilitation applications in a telemedicine framework.
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Extremidad Inferior/fisiopatología , Enfermedad de Parkinson/fisiopatología , Anciano , Fenómenos Biomecánicos , Femenino , Humanos , Aprendizaje Automático , Masculino , Persona de Mediana Edad , Equilibrio Postural/fisiología , Interfaz Usuario-ComputadorRESUMEN
The increment of the prevalence of neurological diseases due to the trend in population aging demands for new strategies in disease management. In Parkinson's disease (PD), these strategies should aim at improving diagnosis accuracy and frequency of the clinical follow-up by means of decentralized cost-effective solutions. In this context, a system suitable for the remote monitoring of PD subjects is presented. It consists of the integration of two approaches investigated in our previous works, each one appropriate for the movement analysis of specific parts of the body: low-cost optical devices for the upper limbs and wearable sensors for the lower ones. The system performs the automated assessments of six motor tasks of the unified Parkinson's disease rating scale, and it is equipped with a gesture-based human machine interface designed to facilitate the user interaction and the system management. The usability of the system has been evaluated by means of standard questionnaires, and the accuracy of the automated assessment has been verified experimentally. The results demonstrate that the proposed solution represents a substantial improvement in PD assessment respect to the former two approaches treated separately, and a new example of an accurate, feasible and cost-effective mean for the decentralized management of PD.
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Enfermedad de Parkinson/diagnóstico , Telemedicina/instrumentación , Fenómenos Biomecánicos , Análisis de Datos , Humanos , Extremidad Inferior/fisiopatología , Encuestas y Cuestionarios , Extremidad Superior/fisiopatología , Interfaz Usuario-Computador , Tecnología InalámbricaRESUMEN
A home-based, reliable, objective and automated assessment of motor performance of patients affected by Parkinson's Disease (PD) is important in disease management, both to monitor therapy efficacy and to reduce costs and discomforts. In this context, we have developed a self-managed system for the automated assessment of the PD upper limb motor tasks as specified by the Unified Parkinson's Disease Rating Scale (UPDRS). The system is built around a Human Computer Interface (HCI) based on an optical RGB-Depth device and a replicable software. The HCI accuracy and reliability of the hand tracking compares favorably against consumer hand tracking devices as verified by an optoelectronic system as reference. The interface allows gestural interactions with visual feedback, providing a system management suitable for motor impaired users. The system software characterizes hand movements by kinematic parameters of their trajectories. The correlation between selected parameters and clinical UPDRS scores of patient performance is used to assess new task instances by a machine learning approach based on supervised classifiers. The classifiers have been trained by an experimental campaign on cohorts of PD patients. Experimental results show that automated assessments of the system replicate clinical ones, demonstrating its effectiveness in home monitoring of PD.
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Autoevaluación Diagnóstica , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Enfermedad de Parkinson/fisiopatología , Anciano , Anciano de 80 o más Años , Automatización , Fenómenos Biomecánicos/fisiología , Calibración , Vestuario , Estudios de Cohortes , Diseño de Equipo , Femenino , Dedos/fisiología , Mano/fisiología , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Programas Informáticos , Interfaz Usuario-ComputadorRESUMEN
Introduction: Post-stroke hemiplegia commonly occurs in stroke survivors, negatively impacting the quality of life. Despite the benefits of initial specific post-acute treatments at the hospitals, motor functions, and physical mobility need to be constantly stimulated to avoid regression and subsequent hospitalizations for further rehabilitation treatments. Method: This preliminary study proposes using gamified tasks in a virtual environment to stimulate and maintain upper limb mobility through a single RGB-D camera-based vision system (using Microsoft Azure Kinect DK). This solution is suitable for easy deployment and use in home environments. A cohort of 10 post-stroke subjects attended a 2-week gaming protocol consisting of Lateral Weightlifting (LWL) and Frontal Weightlifting (FWL) gamified tasks and gait as the instrumental evaluation task. Results and discussion: Despite its short duration, there were statistically significant results (p < 0.05) between the baseline (T0) and the end of the protocol (TF) for Berg Balance Scale and Time Up-and-Go (9.8 and -12.3%, respectively). LWL and FWL showed significant results for unilateral executions: rate in FWL had an overall improvement of 38.5% (p < 0.001) and 34.9% (p < 0.01) for the paretic and non-paretic arm, respectively; similarly, rate in LWL improved by 19.9% (p < 0.05) for the paretic arm and 29.9% (p < 0.01) for non-paretic arm. Instead, bilateral executions had significant results for rate and speed: considering FWL, there was an improvement in rate with p < 0.01 (31.7% for paretic arm and 37.4% for non-paretic arm), whereas speed improved by 31.2% (p < 0.05) and 41.7% (p < 0.001) for the paretic and non-paretic arm, respectively; likewise, LWL showed improvement in rate with p < 0.001 (29.0% for paretic arm and 27.8% for non-paretic arm) and in speed with 23.6% (p < 0.05) and 23.5% (p < 0.01) for the paretic and non-paretic arms, respectively. No significant results were recorded for gait task, although an overall good improvement was detected for arm swing asymmetry (-22.6%). Hence, this study suggests the potential benefits of continuous stimulation of upper limb function through gamified exercises and performance monitoring over medium-long periods in the home environment, thus facilitating the patient's general mobility in daily activities.
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A meditative 'technique' is conceived as a continuum of different affective states involving mind and body jointly. Meditative practices can involve cognitive effort (e.g., focused attention and open-minded techniques), as well as automatic and implicit practices (e.g., transcendental techniques). The NGALSO tantric self-healing meditation technique is a brief, comprehensive meditation technique relying on mind and body connection. In this study, we aimed to investigate the state and the trait neurophysiological correlates of NGALSO meditation practice. First, 19 EEG channels and a 3-lead ECG signal were recorded from 10 expert meditators (more than 7 years of daily meditation) and 10 healthy inexpert participants (controls) who underwent the same meditative procedure. The neuropsychological profiles of experts and controls were compared. Results showed that expert meditators had significantly higher power spectra on alpha, theta and beta, and a higher sympathetic tone with lower parasympathetic tone after meditation. Conversely, the control group had significantly less power spectra on alpha, theta and beta, and a higher parasympathetic tone with lower sympathetic tone after meditation. A machine learning approach also allowed us to classify experts vs. controls correctly by using only EEG Theta bands before or after meditation. ECG results allowed us to show a significantly higher effort by expert meditators vs. controls, thus suggesting that a higher effort is required for this meditation, in line with the principle 'no pain, no gain' in body and mind.
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Meditación , Humanos , Sistema Nervioso PeriféricoRESUMEN
BACKGROUND: Tinnitus, which is often associated with reduced quality of life, depression, and sleep disturbances, lacks a definitive treatment targeting its pathophysiological mechanism. Inflammatory markers like TNF-α have been linked to tinnitus, thereby underlining the necessity for innovative therapies. This case study investigates the potential benefits of a multi-approach rehabilitation intervention involving whole-body cryostimulation (WBC) for a 47-year-old male suffering from chronic neurophysiologic tinnitus, who had underwent various unsuccessful treatments from 2005. METHODS: the patient underwent a personalized, multidisciplinary rehabilitation intervention covering diet, pharmacotherapy, physiotherapy and physical activity classes tailored to the patient's needs and capacities, repetitive transcranial magnetic stimulation (rTMS), and whole-body cryostimulation (WBC). RESULTS: The adjunctive WBC intervention resulted in a significant progressive improvement in tinnitus severity (tinnitus handicap inventory Δ% = -46.3%, VAS tinnitus score Δ% = -40%). Additional positive outcomes were noted in sleep quality (PSQI Δ% = -41.67%), emotional wellbeing (BDI Δ% = -41.2%), and quality of life (SF-36, WHO-5 Δ% = +16.5). CONCLUSIONS: This study supports the existing literature suggesting the potential of WBC as an adjunct in a multi-approach intervention in ameliorating tinnitus severity and tinnitus-associated disorders. However, randomized controlled trials in larger populations, which specifically consider WBC's effects on tinnitus, are necessary to confirm these findings and to explore the mechanisms that underlie the observed improvements.
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The Obstructive Sleep Apnea Syndrome (OSAS) significantly impacts cognitive functioning. The prolonged use (more than 3 months) of ventilotherapy with continuous positive airway pressure (CPAP) seems to have positive effects in restoring cognitive difficulties. However, there is poor evidence about its possible short-term effect. We investigated whether the short use (less than 15 days at testing) of CPAP improved the cognitive functioning in fifty individuals with OSAS by collecting retrospective neuropsychological measures about verbal memory and learning, information processing speed, attention (i.e., alerting, orienting, and executive system), and executive functions (i.e., strategic reasoning, problem-solving, and mental planning). The predictive role of days of CPAP use on the neuropsychological scores was assessed by hierarchical multiple linear regression analyses, over and above the possible role of demographics, body mass index, level of OSAS severity, and the level of anxiety and depression. The average number of days since CPAP adaptation was 4.70 (SD = 3.90; range = 0-15). As the days of CPAP adaptation increased, verbal learning and long-term memory significantly improved, contrary to the other assessed domains. Our results show a significant improvement in some cognitive functions even after a short treatment with CPAP, pointing to the importance of the early use of ventilotherapy to rapidly improve cognitive functioning. Identifying which cognitive functions can or cannot be restored with CPAP use may enable the design of complementary neuropsychological interventions focused on those residual difficulties, possibly enhancing patients' compliance to the treatment.