The international tinnitus journal
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A new strategy for idiopathic subjective tinnitus treatment - sound stimulation during sleep - has been applied. It was based on the acknowledgement that the auditory system also works during sleep, processing the incoming information. ⋯ All patients decreased their tinnitus intensity in the first month of treatment (statistically significant), most of them in the first week. Tinnitus intensity continued decreasing in the following weeks; three patients presented periods of total silence.
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Numerous treatment modalities for decompensated tinnitus incorporate psychological principles. Procedures of energy psychology and thought field therapy are introduced in two case studies. ⋯ The methods of thought field therapy can be taught to non-mental health professionals. Audiologists and psychotherapists should collaborate to develop more efficacious treatments.
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A final common pathway (FCP) for tinnitus has been hypothesized since 1989 for all clinical types of tinnitus, particularly subjective idiopathic tinnitus (SIT) of the severe disabling type. This was intended to explain the transformation-transition of the sensation of an aberrant auditory sensation-tinnitus (i.e., the sensory component)-to one of affect (i.e., the emotional-behavioral component) or, conversely, that an emotional-behavioral stimulus (affect) can result in the clinical manifestation of a sensation (a sensory stimulus). Understanding the pathophysiology of this transformation is fundamental for the diagnosis of tinnitus and the treatment of the patient, and it presents a dilemma to basic science, neuroscience, and clinical medicine. ⋯ The physiology and biochemistry underlying the neuroanatomical substrates of the FCP provide a basis for translation for tinnitus diagnosis and treatment. The neuroanatomical substrates of the FCP are presented as algorithms of (1) components of a sensation (i.e., sensory, affect, and psychomotor), a translation from basic sensory physiology for tinnitus; (2) clinically manifest biophysiological brain functions and underlying processes associated with the tinnitus; (3) a model for investigation of metabolic-electrophysiological correlates for tinnitus; (4) the basis for an integrated theory of tinnitus and brain function (i.e., tinnitus dyssynchrony-synchrony theory; (5) a model for the identification of underlying neurocircuitries and neurochemistries involved in brain for the sensory-affect transformation of an aberrant auditory stimulus (tinnitus); (6) a model for the selection-introduction of innovative therapies attempting tinnitus relief; and (7) its clinical translation for objective monitoring systems for the determination of the efficacy of modalities of therapy attempting tinnitus relief. The hypothesis of the FCP for tinnitus and the identified neuroanatomical substrates, when viewed in terms of the physiology of sensory processing, is considered to be expanded and broader in its application for all sensations, normal or aberrant.
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Comparative Study
The THI questionnaire: psychometric data for reliability and validity of the Italian version.
The main objective of this study was to determine reliability, validity, and reproducibility of the Italian version of the Tinnitus Handicap Inventory (THI) self-administered questionnaire aimed at evaluating the impact of tinnitus on the quality of life of subjects affected by this symptom. The questionnaire was presented to a sample of 443 subjects (285 men and 158 women; ages 19-86; mean age, 53) who were referred to our Tinnitus Centre in Rome and came from the entire national territory. ⋯ Statistical analysis carried out on THI questionnaire results showed high internal consistency and reliability for the total scale (Cronbach's alpha = .94). Despite the poor number of items, the THI proved useful for the functional scale (0.86), the emotional scale (0.89), and the catastrophic scale (0.75).