Association between sleep disorders, hyperacusis and tinnitus: evaluation with tinnitus questionnaires.

Patients with tinnitus are heterogeneous and several factors influence the impact of this symptom on the quality of life. The aim of the study is to evaluate the relationship between age, gender, sleep disorders, hyperacusis and tinnitus annoyance and to demonstrate the utility of tinnitus questionnaires as screening tools for sleep disorders and hyperacusis in patients with tinnitus. 37 consecutive patients (18 males and 19 females) with subjective tinnitus lasting over 3 months were evaluated with a complete interview, otological examination, pure tone audiometry, Italian version of tinnitus sample case history (TSCH) and tinnitus handicap inventory (THI). Statistical analysis was performed with the Wilcoxon's rank sum test, the Spearman's rho non-parametric correlation and the logistic regression analysis. THI grades were slight (16%), mild (32%), moderate (30%), severe (19%) and catastrophic (3%). Based on the answers to TSCH 20 patients reported sleep disorders (54%) and 20 patients reported hyperacusis (54%). 11 patients (30%) reported sleep disorders and hyperacusis. No significant correlation was found between the severity of tinnitus and patients' age and gender. Significant correlation was found between sleep disorders (P = 0.0009) and tinnitus annoyance and between hyperacusis (P = 0.03) and tinnitus annoyance. TSCH and THI may be considered as screening tools in the clinical practice to evidence sleep disorders and hyperacusis in patients with tinnitus.

Smell and preclinical Alzheimer disease: study of 29 patients with amnesic mild cognitive impairment.

OBJECTIVES: To evaluate the olfactory function in patients with amnesic mild cognitive impairment (aMCI) and the relationship to the progression from aMCI to Alzheimer disease (AD). DESIGN: Cohort prospective study on aMCI patients at the first evaluation (T0) and at the 18-month follow-up (T1). SETTING: Alzheimer Unit of the University of L'Aquila, Italy. METHODS: Twenty-nine aMCI patients were enrolled in this study. MAIN OUTCOME MEASURES: Olfactory function was studied with the Sniffin' Sticks Screening Test (SSST) and the Sniffin' Sticks Extended Test (SSET). Olfactory functions were related to neurocognitive functions assessed by the Mini-Mental State Examination (MMSE) and the Mental Deterioration Battery (MDB). RESULTS: At T0, aMCI patients showed an olfactory impairment and all of the aMCI patients had lower olfaction scores at T1. At T1, 9 of the 29 aMCI patients (31%) developed AD and had lower mean SSST and SSET scores than 20 aMCI patients who did not develop AD. The most significant relationship was found between olfactory discrimination and visuospatial ability, language skill, and the Rey Immediate test of the MDB and between olfactory identification and the Rey Delayed test. CONCLUSION: Odour discrimination and identification performance correlated more prominently than detection thresholds with performance on neuropsychological tests. We concluded that the olfactory deficit occurs early in aMCI, so we suggest introducing the clinical routine use of the olfactory test for early identification of the progression of the decline from aMCI to AD.