The effect of cochlear implant and bimodal stimulation on tinnitus: a multinational survey.

BACKGROUND: Tinnitus is a frequent symptom in cochlear implant (CI) patients. Many studies have shown that a CI leads to a significant change in the perception of tinnitus. AIMS: The aim of the present study was to evaluate the effect of CI on tinnitus in patients with Unilateral Cochlear Implant (UCI), Bilateral Cochlear Implant (BCI), and Bimodal Stimulation (BMS). MATERIAL AND METHODS: A survey was administered online to CI patients. The Tinnitus Handicap Inventory (THI) score was calculated. Emotional, functional, and catastrophic subscales scores were calculated. The intensity and annoyance of tinnitus were graded using a scale from 1 to 10. RESULTS: 130 participants represented the study group; the Average THI score was 38.3 (SD: 26.3) in UCI, 32.4 (SD 25.8) in BCI users, and 42.5 (SD 28.2) in BMS: no significant difference was found among the three groups. CI users for less than 1 year showed significantly higher THI scores compared to CI users for more than 5 years (p = .0275). The intensity and annoyance of tinnitus significantly decreased with the CI on compared to the CI off condition. CONCLUSIONS AND SIGNIFICANCE: Taken together, our findings support CI's efficacy in reducing the perception of tinnitus. No significant differences were evident between unilateral and bilateral electrical stimulation in terms of tinnitus improvement.

Cognitive functioning and psychosomatic syndromes in a subjective tinnitus sample.

Introduction: Tinnitus is the perception of a sound in the absence of any corresponding external sound source. Current research suggests a relationship among emotional, cognitive, and psychosomatic symptoms and the occurrence or maintenance of chronic tinnitus. This study aimed to detect the prevalence and role of psychosomatic conditions, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), and cognitive functioning in a group of patients with tinnitus. Methods: Sixty-two patients with subjective tinnitus and 62 non-tinnitus controls were recruited from the Otorhinolaryngology Unit of the University of Bari. Pure-tone audiometry was performed in all tinnitus subjects, and sound level tolerance was evaluated. Additionally, tinnitus handicap (Tinnitus Handicap Inventory [THI]), psychopathological symptoms (Symptom Checklist-90, Revised [SCL-90-R]), anxiety (State-Trait Anxiety Inventory [STAI-Y1/2]), depression (Beck Depression Inventory [BDI]), cognitive impairment (Mini-Mental State Examination [MMSE]), executive functions (Frontal Assessment Battery [FAB]), and psychosomatic syndromes (DCPR) were evaluated. Parametric and non-parametric tests were used to detect cognitive and symptomatological differences between patients and controls. The predictivity of these factors for tinnitus severity was studied using multiple regression (Backward Elimination). All tests were considered significant at p < 0.05 (family wise error corrected for each comparison). Results: 69.4% tinnitus patients met multiple DCPR criteria, compared to 32.3% of controls. Tinnitus patients exhibited elevated rates of illness denial (ꭓ2 = 9.02; p < 0.009), demoralization (ꭓ2 = 8.05; p < 0.018), somatization (ꭓ2 = 4.92; p < 0.063) and functional symptoms (ꭓ2 = 5.21; p < 0.06) scoring significantly higher on the BDI, STAI-Y1, and STAI-Y2, and SCL-90-R compared to controls. Patients with tinnitus showed lower MMSE scores, compared to controls (t = -2.282; p < 0.001). No association between tinnitus severity and global cognitive impairment emerged. Conversely, executive function deficits were associated to tinnitus severity. Among the cognitive and psychological factors, only trait anxiety, one or more psychosomatic syndromes, and somatization clusters were strongly correlated with tinnitus severity. Discussion: Our findings suggest a relationship between tinnitus severity, psychological, psychosomatic symptoms, and frontal impairment. Additionally, the influence of tinnitus on cognitive functions paves the way for integrated, multidisciplinary diagnostic and treatment options for patients. Although preliminary, our findings highlight the importance of early cognitive and psychological screening to improve patients' quality of life.

A childhood case of symptomatic essential and psychogenic palatal tremor.

Palatal tremor is a rare movement disorder characterized by rhythmic contractions of the soft palate. It is most often symptomatic, secondary to brainstem or cerebellar disease and, in rarer cases, is categorized as essential in the absence of documented brain lesions. There have also been reports in the literature of cases of palatal tremor described as psychogenic because they were associated with psychological or psychiatric disorders. We describe the case of a 12-year-old boy with palatal tremor presenting clinical features of symptomatic essential and psychogenic palatal tremor, thus suggesting a neuropsychopathological continuum between the different forms of disease.