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.

Background: The aim of this pilot study was to verify the role of olfactory test and volumetric magnetic resonance imaging measure of hippocampus to predict conversion from mild cognitive impairment to Alzheimer disease (AD). Materials and Methods: Eighteen patients with amnesic mild cognitive impairment, broadly defined, were followed at 12 months. Hypothesized baseline predictors for follow-up conversion to AD were olfactory deficit and hippocampal volumes loss. Results: In the 1-year follow-up, 5 patients converted to AD. The 2 clinical predictors olfactory test and hippocampal volume loss showed the same sensitivity of 92.3% but the olfactory test showed a higher specificity than the hippocampal volume loss (75% vs. 60%). Conclusions: Our findings suggest the potential utility of olfactory test and hippocampal volume loss for early detection of AD.

Misophonia is a chronic condition in which specific sounds cause intense negative emotions and autonomic arousal. Misophonia is considered a psychological disorder without any relationship with specific alterations of hearing receptors and independent from physical characteristics of the sound. Moreover if misophonia can be defined as a specific psychiatric disorder or a correlate of other conditions is still under debate. The patients were two women and one man. In this case series we first identified the presence of triggers sounds inducing misophonia as reported during the psychotherapy sessions. At a qualitative level all the three patients perceived that the others were intentionally acting with the purpose of underline their maladaptive interpersonal schemas. All the patients were evaluated with the use of questionnaires. Regarding personality disorders (PD) all three patients suffered from at least one PD. As regard depression, one had moderate depression and one had severe depression. Two patients had moderate/severe anxiety. All the three patients can be considered as highly problematic in the interpersonal domain. Our findings have clinical implications for the treatment of misophonia because it seems to be sustained by underlying PD or maladaptive interpersonal schemas. The qualitative analysis of these cases has highlighted how patients with misophonia tended to ascribe intentionality to the people who emit the sounds that trigger their negative emotional reactions. Further studies are necessary to evaluate which kind of interpersonal patterns occur in these patients.