Neuropsychological Correlates and Frequency of Tinnitus in Patients Injured in Motor Vehicle Accidents

Background: There is a lack of data on the frequency and neuropsychological correlates of tinnitus in distinct clinical populations such as persons injured in high impact motor vehicle accidents (MVAs). Method: Tinnitus severity and frequency were analyzed statistically in de-identified data of 106 post-MVA patients (mean age=39.5, SD=13.1; 31 males and 75 females). Correlations of tinnitus to the patients’ scores on the Rivermead Post-Concussion Symptoms Questionnaire, Subjective Neuropsychological Symptoms Scale (SNPSS), Brief Pain Inventory, Insomnia Severity Index, PTSD measure (PCL-5), and to ratings of depression, anger, and anxiety on the Whiplash Disability Questionnaire were evaluated. The patients were interviewed an average of 53.6weeks (SD=39.9) after their MVA; all continued to suffer from post-MVA symptoms requiring therapy. Results: Tinnitus was reported by 70 of the 106 post-MVA patients (66%). Slightly less than a half of the 70 rated their tinnitus as “frequent” or “persistent” and slightly more than a half as “occasional.” With respect to Rivermead and SNPSS items, the severity and frequency of tinnitus correlated significantly (at p<.01, 2-tailed) with oversensitivity to light, restlessness, word finding difficulty, hand tremor, stutter, and instances of reduced muscular control over hand or arm (rs ranging from .28 to .37). Tinnitus severity correlated also with tingling in the limbs (r=.31), and with impaired balance (r=.28). Tinnitus frequency correlated also with difficulty articulating words (r=.28). Tinnitus also significantly correlated with ratings of pain and of insomnia (rs ranging from .26 to .32), but not with variables such as PTSD, depression, or anxiety. Discussion and Conclusions: Tinnitus is correlated with some aspects of whiplash trauma and the post-concussion syndrome. However, the size of these relationships is rather weak.

Review of Neuropsychological and Electrophysiological Correlates of Callous-unemotional Traits in Children: Implications for EEG Neurofeedback Intervention

Conduct disorder is a significant psychiatric disorder of childhood and adolescence. The Diagnostic and Statistical Manual of Mental Disorders, fifth version (DSM-5), added the limited prosocial specifier to identify those individuals who exhibit a more severe pattern of behavior characterized by a callous and unemotional (CU) interpersonal style across multiple settings and relationships. This review has attempted to summarize the relevant research focusing on the significance of CU interpersonal style in the development of psychopathy. The primary focus was on the electrophysiological and neuropsychological correlates of CU traits and their implication on the treatment protocol using neurofeedback training for children with such traits. The source of the literature search was PubMed, which majorly uses the MEDLINE database. The keywords used included CU traits, conduct disorder, child psychopathy, empathy, electrophysiology, criminal behavior, neuropsychology, neurofeedback training, and so on. Studies from the last 15 years were considered for the review. This review revealed that children with conduct disorder and high-CU traits with a combination of reactive and proactive aggression are more likely to develop psychopathy. Evidence suggests that these children have distinct forms of electrophysiological and neuropsychological correlates. However, research in this area is still not conclusive as they yield variation in findings. Studies on the efficacy of neurofeedback training on reducing symptoms such as impulsivity, hostility, and psychopathy indicate that neurofeedback training can be a promising treatment alternative for children with severe conduct disorder.