Giulia Cartocci

Sleep architecture variation in chronic tinnitus patients.

Objectives: The aim of the study was to evaluate the sleep architecture and its possible alterations in chronic tinnitus patients, and investigate any possible correlation between sleep architecture modifications and tinnitus perception, adaptation, and the degree of discomfort in these patients. Design: In a prospective, case-control, nonrandomized study, 18 patients affected by chronic tinnitus were compared with a homogeneous control group consisting of 15 healthy subjects. The experimental group was enrolled at the Tinnitus ambulatory at Policlinico Umberto I Department of Sensory Organs, and the control group was composed of voluntary subjects. A full overnight polysomnography was performed on both groups. Tinnitus patients answered two questionnaires: the tinnitus handicap inventory (THI) and a questionnaire concerning their subjective sleep quality, tinnitus intensity before bedtime, tinnitus intensity at remembered nocturnal wake-up periods, and tinnitus intensity at morning wake-up. Controls completed only the sleep quality questionnaire. Results: All tinnitus patients had a statistically significant alteration in sleep stages. Average percentage of stage 1 + stage 2 was 85.4% ± 6.3, whereas, in the control group, the average percentage of stage 1 + stage 2 was 54.9 ± 11.2 (p < 0.001). Stages 3 and 4 and rapid eye movement (REM) sleep was lacking in all tinnitus patients with an average percentage of 6.4 ± 4.9 of REM sleep, and 6.4 ± 4.9 of stages 3 + 4. The control group showed an average percentage of 21.5 ± 3.6 of REM sleep and 21.5 ± 3.6 of stages 3 + 4 (p < 0.001). No correlation was found between the decrease of REM and the increase of the THI score in the tinnitus group (r = 0.04). However, a mild correlation was found between the increase of light sleep (stage 1 + stage 2) and the THI score reported by the tinnitus group. Therefore, patients with light sleep report a higher THI score (r = 0.4). Conclusions: The significant alteration of sleep parameters assessed in tinnitus patients underlines the necessity to consider an adequate therapy that could improve patients’ sleep quality and also opens avenues for further investigations.

EEG-Based Cognitive Control Behaviour Assessment: An Ecological study with Professional Air Traffic Controllers

Several models defining different types of cognitive human behaviour are available. For this work, we have selected the Skill, Rule and Knowledge (SRK) model proposed by Rasmussen in 1983. This model is currently broadly used in safety critical domains, such as the aviation. Nowadays, there are no tools able to assess at which level of cognitive control the operator is dealing with the considered task, that is if he/she is performing the task as an automated routine (skill level), as procedures-based activity (rule level), or as a problem-solving process (knowledge level). Several studies tried to model the SRK behaviours from a Human Factor perspective. Despite such studies, there are no evidences in which such behaviours have been evaluated from a neurophysiological point of view, for example, by considering brain activity variations across the different SRK levels. Therefore, the proposed study aimed to investigate the use of neurophysiological signals to assess the cognitive control behaviours accordingly to the SRK taxonomy. The results of the study, performed on 37 professional Air Traffic Controllers, demonstrated that specific brain features could characterize and discriminate the different SRK levels, therefore enabling an objective assessment of the degree of cognitive control behaviours in realistic settings.

Mental workload estimations in unilateral deafened children.

Despite of technological innovations, noisy environments still constitute a challenging and stressful situation for words recognition by hearing impaired subjects. The evaluation of the mental workload imposed by the noisy environments for the recognition of the words in prelingually deaf children is then of paramount importance since it could affect the speed of the learning process during scholar period.The aim of the present study was to investigate different electroencephalographic (EEG) power spectral density (PSD) components (in theta4-8 Hz - and alpha - 8-12 Hz - frequency bands) to estimate the mental workload index in different noise conditions during a word recognition task in prelingually deaf children, a population not yet investigated in relation to the workload index during auditory tasks. A pilot study involving a small group of prelingually deaf children was then subjected to EEG recordings during an auditory task composed by a listening and a successive recognition of words with different noise conditions. Results showed that in the pre-word listening phase frontal EEG PSD in theta band and the ratio of the frontal EEG PSD in theta band and the parietal EEG PSD in alpha band (workload index; IWL) reported highest values in the most demanding noise condition. In addition, in the phase preceding the word forced-choice task the highest parietal EEG PSD in alpha band and IWL values were reported at the presumably simplest condition (noise emitted in correspondence of the subjects deaf ear). These results could suggest the prominence of EEG PSD theta component activity in the pre-word listening phase. In addition, a more challenging noise situation in the pre-choice phase would be so “over-demanding” to fail to enhance both the alpha power and the IWL in comparison to the already demanding “simple” condition.

Oral versus Short-Term Intratympanic Prednisolone Therapy for Idiopathic Sudden Hearing Loss

Objectives: To assess the therapeutic effectiveness of an intratympanic (IT) steroid protocol compared to a systemic steroid protocol. Methods: A total of 265 consecutive patients presenting unilateral idiopathic sudden sensorineural hearing loss were divided into 2 groups. One group comprised 131 patients enrolled between May 2009 and May 2010, and the other consisted of 134 patients enrolled between June 2010 and June 2011; a total of 48 patients were excluded among the 2 groups. The first group received oral prednisone for 8 days in tapering doses; the second group had IT prednisolone at a dose of 62.5 mg/ml once a day for 3 consecutive days. Audiological examinations were performed at study entry and 30 days after the beginning of therapy. Mean pure tone audiometry (PTA) of both groups and hearing outcomes following the criteria of Furuhashi et al. [Clin Otolaryngol 2002;27:458-463] and Siegel [Otolaryngol Clin North Am 1975;8:467-473] were investigated. Results: The strong efficacy of steroid therapy was evident in both groups, observing both PTA and hearing threshold improvement. The evaluation of the hearing outcomes shows a significantly better result for the short-term IT protocol; this result is ascribable to two types of audiometric curves: down- and up-sloping. Conclusion: The results show a significant efficacy of both steroid therapeutic approaches. There was no significant difference in PTA improvement between the 2 study groups; the short-term IT protocol led to better results in the evaluation of the hearing outcomes (following the criteria of Siegel and Furuhashi et al.) for up- and down-sloping audiometric curves.

Long-term results of intratympanic prednisolone injection in patients with idiopathic sudden sensorineural hearing loss

Abstract Conclusion: The results demonstrate the stability of the efficacy over time of the intratympanic prednisolone protocol and they suggest that the spontaneous recovery does not significantly influence the long-term evaluation of intratympanic therapy. A 10-day follow-up after 3 days of intratympanic prednisolone administration can be considered a sufficient period to evaluate the effectiveness of the undertaken therapy. Objective: To assess the stability of the efficacy over time of intratympanic steroid therapy for patients with idiopathic sudden sensorineural hearing loss. Methods: A total of 122 patients received an intratympanic steroid injection of prednisolone daily for 3 days. Audiograms were performed before therapy and at 10 days and 1 year after therapy. Successful recovery was defined as complete and partial recovery using Siegels criteria and complete and marked recovery following Furuhashis criteria. Results: The comparison of audiometric data at study entry, at 10 days, and at 1 year after the treatment showed a statistically significant improvement of the mean pure tone audiometry. The evaluation of the hearing outcomes demonstrated a statistically significant improvement, with similar success rates when evaluated 10 days and 1 year after the treatment. Comparing the hearing outcomes at 1 year with the results at 10 days, no significant difference was detected between these two time points.

Neuroelectrical Indexes for the Study of the Efficacy of TV Advertising Stimuli

In this chapter, we present the findings of an experiment aimed to investigate cognitive and emotional changes of cerebral activity during the observation of TV commercials. In particular, we recorded the electroencephalographic (EEG), galvanic skin response (GSR) and heart rate (HR) from a group of 24 healthy subjects during the observation of a series of TV advertisements. The group was equally divided also by gender (male, female) and age (young, old). Comparisons of cerebral and emotional indices previously defined have been performed to highlight gender differences between TV commercial and scenes of interest of specific commercials. Findings show how EEG methodologies, along with the measurements of autonomic variables, could be used to obtain information not obtainable otherwise with verbal interviews. These cerebral and emotional indexes could help to analyze the perception of TV advertisements according to the consumer’s gender and age.

A pilot study on the neurometric evaluation of “effective” and “ineffective” antismoking public service announcements

Tobacco use is the leading cause of preventable death and smoking-related illness worldwide. Research has shown that antismoking advertising may help reduce this habit. Nowadays, public service announcements (PSAs) are considered “Effective” or “Ineffective” on the base of official reports concerning behavioral/attitudinal changes toward healthier patterns and health-related savings following the exposure to the PSA. In this pilot study, we described the results of the use of three neurometric indexes for the evaluation of the efficacy of a couple of antismoking PSAs in a reduced sample of voluntary participants. The study applied the gathering of the electroencephalographic (EEG) rhythms variations, as well as the heart rate (HR) and galvanic skin response (GSR). The neurometric indicators here employed were the Approach-Withdrawal (AW), the Effort (EfI) and the Emotional (EI) indexes. Results suggest a significant higher values for AW, Effort and Emotional indexes (p=0,02; p= 0,03 and p= 0,01 respectively) related to the perception of the “Effective” antismoking PSAs against the perception of the “Ineffective” one. Since this is a pilot study, the results obtained need further investigation, in terms of enlarged stimuli sample and number of participants to provide indications concerning the relevant features to be included in the realization of effective anti-smoking PSAs.

Gender and Age Related Effects While Watching TV Advertisements: An EEG Study

The aim of the present paper is to show how the variation of the EEG frontal cortical asymmetry is related to the general appreciation perceived during the observation of TV advertisements, in particular considering the influence of the gender and age on it. In particular, we investigated the influence of the gender on the perception of a car advertisement (Experiment 1) and the influence of the factor age on a chewing gum commercial (Experiment 2). Experiment 1 results showed statistically significant higher approach values for the men group throughout the commercial. Results from Experiment 2 showed significant lower values by older adults for the spot, containing scenes not very enjoyed by them. In both studies, there was no statistical significant difference in the scene relative to the product offering between the experimental populations, suggesting the absence in our study of a bias towards the specific product in the evaluated populations. These evidences state the importance of the creativity in advertising, in order to attract the target population.

An electrophysiological approach to tinnitus interpretation

INTRODUCTION Serotonin seems to play a central role in tinnitus. The intensity dependence of auditory evoked potential (IDAP) is considered an index of central serotonergic activity in the auditory cortex. The higher the steepness of the N1/P2 component amplitude-stimulus function slope (N1/P2 ASF slope as calculated by IDAP), the lower the central serotonergic activity. Similarly, the N1 amplitude-stimulus function slope (N1 ASF slope) was investigated. Auditory brainstem responses (ABR) examine the auditory system functionality from the periphery and through the brainstem, where serotonergic projections have been identified. OBJECTIVES Assessing whether tinnitus perception neurotransmitters activity inbalance could be investigated by an electrophysiological approach. MATERIALS AND METHODS Ten normoacousic tinnitus patients and 14 healthy controls were included in the study. Subjects underwent EEG (IDAP) recording, ABR recording and psychometric questionnaires administration. RESULTS N1/P2 ASF slope and N1ASF slope tended to have a greater steepness in patients. N1ASF slope was significantly correlated with ABR wave V and interpeak III-V latencies in patients. ABR wave V and interpeak III-V latencies were significantly longer in patients than in controls. CONCLUSION N1/P2 ASF slope, N1 ASF slope and ABR components appear to be useful electrophysiologic methods to study possible functional alterations related to the serotonergic activity.

An eye tracking index for the salience estimation in visual stimuli

Every day we face visual stimuli able to catch our attention, but this aspect becomes crucial if the visual material has the purpose to spread a message aimed at engaging the observer. In this framework, a worthy aspect is how to measure the “visual engagement” produced by visual stimuli exposure. To this purpose, in the present study, employing the eye tracking technique, an index of visual attention (VA) has been proposed, and applied to pictures belonging to antismoking public service announcements, so to investigate the saliency of health-promoting messages in a young sample. The VA index is a non-dimensional index, defined as the ratio between the percentage of the total time spent fixating an area of interest (AOI) weighted on the total time the picture is showed on the screen, and the percentage of the area occupied by the AOI weighted on the total dimension of the picture. It could be predicted that AOI reporting higher VA values will be the ones having more saliency. Three antismoking Public Service Announcements (PSAs) images have been selected for the study and for each of them were identified: i) “picture” (such as a young man with a sarcastic expression depicted while smoking a cigarette, or the image of a lady who underwent a tracheotomy) and ii) “writing” (text of the antismoking message) AOIs. Main results of the analysis revealed that writing AOIs obtained statistically significant higher VA values than visual AOIs (p=0.03), but these held true only for an ineffective PSA, probably because the text was not perceived as pertinent with the surrounding image. On the other hand, an effective PSA obtained higher VA values in response to visual than writing AOIs observation (p=0.02). The VA index appears therefore to represent a useful tool to measure the saliency of visual stimuli elements.