Papers by Andrea Crocetti
Vagally mediated heart rate variability (HRV) has been proposed to be an index of cognitive and a... more Vagally mediated heart rate variability (HRV) has been proposed to be an index of cognitive and affective self-regulation. Negative emotions such as anxiety are related to reduced HRV and incoherent heart rhythm patterns whereas cardiac coherence refers to a high amplitude sinus-like heart rhythm characterized by increased vagal activity, and it is associated with a psychological state of a positive emotion. HRV biofeedback (BFB) devices display the heart rhythms in real time and are useful to teach patients to self-generate coherent oscillations in the heart rate. A combination of Cognitive Behaviour Therapy (CBT) and HRV biofeedback training could be effective in reducing symptoms of anxiety while increasing HRV and the ability to sustain cardiac coherence. Three patients suffering from different severity degrees of anxiety disorders undertaken sessions of CBT integrated with HRV BFB training. Psychotherapist then provided patients with a portable biofeedback unit for home practic...
OBJECTIVE: Psychophysiological stress profile examination is useful to quantify the level of indi... more OBJECTIVE: Psychophysiological stress profile examination is useful to quantify the level of individual stress reactivity. The aim of this study is to find differences between healthy subjects and subjects with psychopathological features. METHODS: We have recruited 20 healthy subjects, aged between 25 and 40 years. Subjects with a history of psychopathological episodes, epilepsy, head injuries, drug abuse were excluded. This group was compared with one group of subjects with Major Depressive Disorder (MD), one with Panic Attack Disorder (PAD) and one with Obsessive Compul-sive Disorder (OCD). Assessment of the psychophysiological stress profile was performed while the participants underwent a stress test, and included the simultaneous recording of the following variables: electrodermal activity, heart rate, surface electromyogram. The schedule of the stressors was: 2 minutes baseline, tactile stimulus, visual stimulation, painful stimulus, mental calculation, hyperpnoea. The total ...
B-ENT
The aims of this study were to evaluate the efficacy of open ear canal hearing aids in tinnitus t... more The aims of this study were to evaluate the efficacy of open ear canal hearing aids in tinnitus treatment and to investigate the influence of gender, age, medication usage, tinnitus cause, tinnitus perception side, tinnitus pitch, pure tone audiometry, distortion product otoacoustic emissions, and minimal masking level on outcome. One hundred tinnitus patients were evaluated by the tinnitus handicap inventory (THI) at the beginning of the study and after nine months of treatment. All subjects were submitted to counselling and sound enrichment from the simple sound amplification provided by the open ear canal hearing aids. Initial mean THI score was 54.22 (+/- 20.37) and final mean score was 28.32 (+/- 16.50), p < 0.0001. No statistically significant correlations were found between THI value reduction and the studied parameters. Open ear canal hearing aids were useful in all tinnitus patients with mild hearing loss.
Tinnitus: Pathophysiology and Treatment, 2007
Otolaryngology - Head and Neck Surgery, 2009
The aim of this study was to evaluate the correlation between the most common instruments used to... more The aim of this study was to evaluate the correlation between the most common instruments used to quantify tinnitus and the level of anxiety and depression experienced by patients in order to provide a guideline for otolaryngologists. Cross-sectional survey. A total of 108 tinnitus patients were submitted to a series of instruments, including Visual Analogue Scales (VAS), Tinnitus Handicap Inventory (THI), State Trait Anxiety Inventory Form Y (STAI-T), and Beck Depression Inventory (BDI). These instruments were chosen based on their psychometric properties, time of administration, and validity in many countries. Of the patients studied, 24 percent had severe tinnitus, 35 percent had anxiety disorders, and 13 percent had a depressive pathosis. Significant correlations between STAI-T and THI scores (P &amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and between BDI and THI scores were shown (P &amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The same results were found with VAS. If a patient reports a THI greater than 38, the otolaryngologist should supplement diagnostic studies with a psychological consultation.
International Journal of Audiology, 2010
Tinnitus patients without hearing loss or hyperacusis often start tinnitus retraining therapy but... more Tinnitus patients without hearing loss or hyperacusis often start tinnitus retraining therapy but do not return to the tinnitus clinic for follow-up visits. The aim of this study was to evaluate how these &amp;amp;amp;amp;amp;amp;amp;amp;#39;missing patients&amp;amp;amp;amp;amp;amp;amp;amp;#39; feel and whether they still use their sound generators after they discontinue retraining therapy. We interviewed 269 tinnitus patients by phone who never returned to the clinic after receiving initial counseling and a generator for sound enrichment. Twenty-six percent did not have tinnitus anymore, 30.5% still used the sound generator to treat their tinnitus, and 43.5% did not use their sound generator but still suffered from tinnitus. This study suggests that therapists need to contact missing patients periodically to follow their improvement, encourage them, and decide on new therapeutic approaches as necessary.
Auris Nasus Larynx, 2011
Objective: Previous studies report that enhanced power in the delta range (1.5-4 Hz) and reduced ... more Objective: Previous studies report that enhanced power in the delta range (1.5-4 Hz) and reduced power in the alpha frequency band (8-12 Hz) were most pronounced in the temporal regions. These studies referred to the 8-12 Hz activity as tau activity, and they created a new neurofeedback protocol to treat tinnitus using a temporally generated tau rhythm (8-12 Hz) and slow waves in the delta range (3-4 Hz) for feedback. This study aims to repeat this protocol and to evaluate its effect on tinnitus. Methods: Fifteen normal-hearing patients with tinnitus were treated with the neurofeedback protocol. The Tinnitus Handicap Inventory and Visual Analogue Scales were administered before and after treatment and at 1, 3 and 6 months post-treatment. Results: After therapy, all questionnaires scores were significant improved, and the improvements persisted throughout the followup period. Moreover, an increasing trend in the tau/delta ratio was observed; specifically, the trend was more stable respect of the pre-recording measure. However, only in some subjects may the signal alone be enough to develop the correct behaviors. Conclusion: Further studies are necessary to characterize the tinnitus subjects who recovered from and adapted to this psychophysical condition and, therefore, responded to neurofeedback therapy. #
Audiology and Neurotology, 2009
Tinnitus retraining therapy (TRT) is a useful treatment for tinnitus. The aim of this study was t... more Tinnitus retraining therapy (TRT) is a useful treatment for tinnitus. The aim of this study was to evaluate the results obtained after 18 months of TRT as well as 18 months after completion of therapy, i.e. 36 months after initiation of TRT. Forty-five subjects suffering from an idiopathic tinnitus with or without hyperacusis for at least 6 months were recruited. There were significant improvements during therapy (p &lt; 0.001) and the mean Tinnitus Handicap Inventory (THI) was lowered by more than 20 points. These improvements persisted 18 months after treatment completion. Furthermore, the percentage of patients reporting the disappearance of their difficulties in various activities (relaxation, concentration, sleep, social relations and work) increased continuously after treatment completion. TRT improved self-perceived disability induced by chronic tinnitus for a long time after the end of therapy.
International Journal of Audiology, 2007
The aim of this study was to evaluate the efficacy of TRT in patients suffering from tinnitus. Th... more The aim of this study was to evaluate the efficacy of TRT in patients suffering from tinnitus. The tinnitus disorder affects about 10-15% of the population and, in one person out of a hundred, it is a disabling disorder. TRT treatment is based on Jastreboff&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s neurophysiological model. TRT consists of two parts: counselling, and sound therapy by means of dedicated hearing aids and sound generators. It proved to be useful to reduce the symptoms related to tinnitus. Jastreboff&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s structured interviews were proposed to a sample of 51 patients with tinnitus belonging to the I-II-III-IV classes according to Jastreboff. These patients were treated for 18 months. Sixty-eight percent of patients reported a reduction in the symptoms related to tinnitus, such as sleep disturbance, problems in concentration, and inability to relax. A percentage (64.7%) of patients thought that their quality of life was improved. Patients who had suffered from tinnitus for less than one year achieved significantly better results than patients who had suffered for a longer period of time. TRT is an effective tool in the treatment of tinnitus.
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Papers by Andrea Crocetti