Involvement of cortico-subcortical circuits in normoacousic chronic tinnitus: A source localization EEG study

To better characterize brain circuits dysfunctions in normoacousic tinnitus sufferers. Methods: 17 normoacousic chronic, unilateral high-pitched tinnitus sufferers (6 females, 43.6 ± 9.8 y.o, disease duration 22 ± 35 months) underwent a 29-channel resting-state electroencephalography (EEG – 5 min opened-eyes, 5 min closed-eyes) and auditory oddball paradigm for event-related potentials analyses (ERPs – N1, P2 and P300). Cortical 3D distribution of current source density was computed with sLORETA. Results were compared with 17 controls (9 females, 45.7 ± 15.1 y.o). Results: Eyes opened, tinnitus sufferers had lower alpha and beta sources in the left inferior parietal lobule. Eyes closed, tinnitus sufferers had decreased alpha sources in the left inferior temporal and post-central gyri, and low gamma sources in the left middle temporal gyrus. EEG data did not correlate with tinnitus sufferers’ clinical features. Subjects with tinnitus had shorter N1 and P2 latencies. P300 did not differ between groups. sLORETA solutions showed decreased sources of these ERPs in the left inferior temporal gyrus in the tinnitus group. Conclusions: We showed cortico-thalamo-cortical involvements in normoacousic tinnitus with hyperexcitability of the left auditory cortex and inferior temporal gyrus. Significance: This might reflect processes of maladaptive cortical plasticity and memory consolidation. Further validation is needed to establish the value of this tool in customizing therapeutic approach

Rehabilitation of COVID-19 patients

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COVID-19 rehabilitation units are twice as expensive as regular rehabilitation units

Objective: The COVID-19 pandemic has caused significant motor, cognitive, psychological, neurological and cardiological disabilities in many infected patients. Functional rehabilitation of infectious COVID-19 patients has been implemented in the acute care wards and in appropriate, ad hoc, multidisciplinary COVID-19 rehabilitation units. However, because COVID-19 rehabilitation units are a clinical novelty, clinical and organizational benchmarks are not yet available. The aim of this study is to describe the organizational needs and operational costs of such a unit, by comparing its activity, organization, and costs with 2 other functional rehabilitation units, in San Raffaele Hospital, Milan, Italy. Methods: The 2-month activity of the COVID-19 Rehabilitation Unit at San Raffaele Hospital, Milan, Italy, which was created in response to the emergency need for rehabilitation of COVID-19 patients, was compared with the previous year's activity of the Cardiac Rehabilitation and Motor Rehabilitation Units of the same institute. Results: The COVID-19 Rehabilitation Unit had the same number of care beds as the other units, but required twice the amount of staff and instrumental equipment, leading to a deficit in costs. Discussion: The COVID-19 Rehabilitation Unit was twice as expensive as the 2 other units studied. World health systems are organizing to respond to the pandemic by expanding capacity in acute intensive care and sub-intensive care units. This study shows that COVID-19 rehabilitation units must be organized and equiped according to the clinical and rehabilitative needs of patients, following specific measures to prevent the spread of infection amongs patients and workers

Kinematic analysis of thumb trajectory.

<p>Data represent the velocity and acceleration of the thumb as a function of the SOA (No-TMS, 50ms–100ms pooled and 200ms–300ms pooled conditions) and for the different sites stimulated (occipito-temporal complex, motor cortex, premotor cortex).</p

Effect of the SOA and the site where TMS was delivered on reaction times in the right-left decision task.

<p>(a) Data represent absolute reaction times (ms) and standard deviations in for the different SOA conditions (no TMS, 50ms, 100ms, 200ms, 300ms) and the different sites stimulated (occipito-temporal complex, motor cortex, premotor cortex). (b). Data represent relative reaction times (ms) and standard deviations according to the no-TMS condition in the different conditions.</p

A schematic representation of the experimental apparatus and target display in the right-left decision task, the judgement of what is reachable task and the grasping task.

<p>(a) When looking into the apparatus, the bottom part is visible only through optical projection upon the mirror of information coming from the upper part of the apparatus. (b) Targets display in the right-left decision task, the judgement of what is reachable task and the grasping task. (c) Kinogramme of actual grasping movement.</p

Effect of the SOA and the site where TMS was delivered on reaction times in the perceptual judgement of what is reachable task.

<p>(a) Data represent absolute reaction times (ms) and standard deviations in for the different SOA conditions (no TMS, 50ms, 100ms, 200ms, 300ms) and the different sites stimulated (occipito-temporal complex, motor cortex, premotor cortex). (b). Data represent relative reaction times (ms) and standard deviations according to the no-TMS condition in the different conditions.</p