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.

Theory of Mind and Executive Functions in Individuals with Mild Cognitive Impairment or Healthy Aging

Social cognition involves skills for maintaining harmonious personal and social relationships throughout life. Social cognition issues, including Theory of Mind (ToM), can significantly impact the well-being of older individuals and intensify with the onset of neurological conditions. Mild Cognitive Impairment (MCI) is a state between healthy and pathological neurocognitive aging, where monitoring social functions is crucial. Despite numerous studies on ToM challenges in older adults and cognitive disorders, the underlying mechanisms remain debated. Uncertainty exists regarding whether ToM deficits are related to other cognitive functions, such as Executive Functions (EFs). Our study examined the correlation between EF and ToM performance in 32 MCI patients and 36 healthy elderly controls. The findings revealed a link between EF and ToM performance among healthy elderly individuals. Specifically, within the assessed EFs, the role of the working memory (WM) emerged. The study also highlighted distinctions between the MCI group and the healthy elderly group, showing that despite a general reduction in cognitive performance, the condition could impact these abilities in different ways. The study contributes to the literature, fostering comprehension of the mechanisms underlying ToM difficulties, while also paving the way for targeted interventions and enhanced clinical or preventative care.

Impact of depression on the perception of fatigue and information processing speed in a cohort of multiple sclerosis patients

BACKGROUND

Information processing speed is commonly impaired in people with multiple sclerosis (PwMS). However, depression and fatigue can affect the cognitive profile of patients: fatigue has a negative impact from the disease's earliest stage and a reduced information processing speed is often associated with higher levels of depression. Therefore, the aim of this study was to investigate the correlations between information processing speed and physical fatigue in a cohort of Italian PwMS from a single center, considering the effect of depression.

METHODS

Two hundred (W = 128; mean age = 39.83 years; SD = 11.86) PwMS, from the Bari University Hospital, underwent testing for processing speed (Symbol Digit Modalities Test [SDMT]), fatigue level (Fatigue Severity Scale [FSS]), and depression (Beck's Depression Inventory [BDI]).

RESULTS

Statistically significant correlations emerged between SDMT and FSS, SDMT and BDI, FSS and BDI. Mediation analyses revealed that while physical fatigue had no significant direct negative effect on information processing speed (z=-0.891; p > 0.05), depression predicted the relationship between fatigue and information processing speed (z=-2.181; p < 0.05).

CONCLUSION

Our findings showed that cognitive performance at SDMT was not affected by patients' perceived level of physical fatigue, but by depression. The presence of a high BDI score mediates the physical fatigue on cognitive performance impact.