Antonietta Argiuolo

Background and Objectives: Burning Mouth Syndrome (BMS) remains a challenging condition to manage, as current treatments show variable efficacy and are often limited by tolerability, particularly in older and medically complex patients. This has prompted interest in topical neuromodulatory strategies targeting peripheral mechanisms while minimizing systemic exposure, with topical pregabalin emerging as a potential option. Materials and Methods: In this prospective longitudinal real-world study, 100 patients with BMS treated at a tertiary referral center received topical pregabalin as an off-label intraoral swish-and-spit solution. Patients were assessed at baseline and after 3 months using validated measures of pain intensity (VAS), qualitative pain perception (SF-MPQ), anxiety (HAM-A), depression (HAM-D), sleep quality (PSQI, ESS), and global clinical severity (CGI-S). Results: After 3 months, median VAS decreased from 8 (IQR 7–9) to 5 (IQR 4–6) and SF-MPQ from 10 (IQR 7–17) to 6.5 (IQR 4–10) (both p < 0.001), with concurrent improvements in anxiety, depressive symptoms, and clinical severity. Overall, 46% of patients achieved ≥30% pain reduction, while 73% and 16% reached ≥20% and ≥50% reductions, respectively. Higher baseline pain predicted greater improvement. No serious adverse events were reported. Conclusions: These findings suggest that topical pregabalin may represent a safe and potentially effective option for BMS, although controlled studies are required to confirm its efficacy.

Background: Frailty reflects an age‐associated progressive decline in physiological reserve, increasing vulnerability to adverse outcomes. Burning Mouth Syndrome (BMS) is a chronic idiopathic orofacial pain disorder commonly seen in older individuals, yet its relationship with frailty remains uninvestigated. Objectives: This study aims to assess frailty in BMS patients using the SUNFRAIL+ multidimensional screening tool, which facilitates early detection of bio‐psycho‐social risk factors for frailty in community‐dwelling older adults. Methods: This multi‐centre case–control study included 104 adults aged ≥ 65 years (52 with BMS and 52 age and sex matched controls). The SUNFRAIL+ tool was used to identify risks and trigger further single‐domain evaluation with the Tool for Adherence to Therapies (TAS), Mini‐Nutritional Assessment (MNA), Mediterranean Diet Adherence Screener (PREDIMED), Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), Quick Mild Cognitive Impairment (Q mci ) screen, General Practitioner Assessment of Cognition (GPCOG), Geriatric Depression Scale (GDS), Social Provisions Scale (SPS), socio‐economic conditions self‐assessment questionnaire (MUSE) and 12‐item Short Form Health Survey (SF‐12). Results: Patients with BMS showed significantly higher levels of frailty, characterized by higher rates of polypharmacy (76.9% vs. 30.8%), reduced mobility (61.5% vs. 42.3%; p > 0.05), greater cognitive impairment (Q mci 56.8 vs. 75.5), more self‐reported depressive symptoms (GDS: 7.5 vs. 4), less social support (SPS: 30 vs. 36), and lower quality of life (SF‐12; p < 0.05). Conclusions: Older adults with BMS have a greater proportion of clinical markers of frailty. The SUNFRAIL+ model is effective in revealing hidden vulnerabilities, supporting early, multidisciplinary intervention in this cohort.

Artificial Intelligence (AI) is currently employed as psychological support. This study explored the ChatGPT-4.5 functioning following unstructured emotional prompts. Our results showed a relevant modulation of AI-generated responses according to complexity and nature of emotional requests.

Background: This study investigates how anxiety, depression, and sleep disturbances affect pain perception and clinical impairment in burning mouth syndrome (BMS).Methods: A cross‐sectional survey was conducted on 200 BMS patients. The Hamilton Rating Scale for Depression (HAM‐D) and Anxiety (HAM‐A), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Visual Analogue Scale (VAS), and short form of McGill pain questionnaire (SF‐MPQ) were used. The Clinical Global Impressions Severity of Illness (CGI‐S) assessed illness severity, and comorbidities were analyzed via the Age‐Adjusted Charlson Comorbidity Index (AACCI). Correlation tests and path analyses explored relationships among psychological factors, sleep quality, and BMS severity.Results: Pain intensity (VAS) correlated significantly with anxiety (HAM‐A, ρ = 0.25, p < 0.05), depression (HAM‐D, ρ = 0.15, p < 0.05), and shorter sleep duration (ρ = −0.19, p < 0.05). Path analyses revealed that anxiety significantly increased pain intensity (β = 0.24, p < 0.05), indirectly influencing clinical severity (CGI‐S: β = 0.07, p < 0.05). Depression strongly impacted poor sleep quality (PSQI, β = 0.33, p < 0.05). Shorter sleep duration affected both sleep quality (β = −0.46, p < 0.05) and clinical outcomes (CGI‐S, β = −0.17, p < 0.05). Pain quality (SF‐MPQ) showed weaker, non‐significant associations with psychological factors.Conclusions: Anxiety amplifies pain intensity, while depression worsens sleep quality, exacerbating clinical outcomes. Shorter sleep duration further contributes to worse outcomes. These findings emphasize the need for tailored interventions targeting psychological distress and sleep disturbances to improve pain management and quality of life in BMS patients.

The Enhanced Baking Tray Task (E-BTT) is a spatial task where disks are placed inside a modular frame and a Tangible Users Interface (TUI) system provides ordered coordinates for each disk. Recently two main innovations have been introduced in this version of the task: many quantitative measurements were applied, and it was adapted to children. E-BTT's new indexes refer to laterality (when calculated on the X axis) and verticality (when calculated on the Y axis); moreover, new measures about the quality of the sequence itself were used (some referred to the organization). We firstly calculated the list of indexes recently applied to E-BTT on 1) a sample of 137 school-aged children who completed the task, appropriately adapted to the new type of sample and 2) on a sample of 122 adults. We then applied a Support Vector Machine (SVM) model and cross-validation to the whole dataset to test its accuracy to discriminate, in terms of indexes, between adults and children. We then explored whether the dimensionality of E-BTT indexes reflected the pattern/structure of adults also in the sample of school-aged children. A Principal Component Analysis (PCA) on the indexes was then performed. Results on SVM model showed that it was indeed possibile to discriminate children from adults' indexes. Results on the dimensionality are totally overlapping to adults' results. A distinct component of Laterality and Verticality emerged; furthermore, four components containing indexes that referred to the quality of the spatio-temporal sequence resulted from the elaboration. We then discuss the differences and similarities of PCA dimensionality between adults and children. The fact that the indexes' dimensionality was overlapping in children and adults may confirm its soundness and justify their use for E-BTT data analysis. Moreover, our model supported the idea that, despite the indexes have the same dimensionality in adults and children, there are indeed peculiar differences between the two groups, what is a useful indication for spatial cognition development.

Introduction: The ecological assessment and the analysis of spatial organization behaviors, like the organization of objects in an empty space, in clinical and neurotypical conditions, is crucial. The Enhanced-Baking Tray Task (E-BTT) is as simple as that – placing objects inside a frame as evenly as possible, as if they were “cookies” to be baked in the oven. The E-BTT is the enhanced version of a task for neglect assessment, the Baking Tray Task, and has the advantage to register the coordinates of each object and their temporal order, meaning that it is easy to reconstruct the sequence of their placement. This sequence could be further analyzed, and, in this paper, we aim to do that with a series of indexes. Moreover, since they investigate the visual search organization of the sequence itself, their validity will be tested with a convergent measure of subjective organization.Methods: Therefore, we asked 100 observers (76 women) to evaluate the subjective organization of each of 97 E-BTT plots, on a scale that ranged from 0 = not at all to 100 = well organized.Results: A multiple regression model showed a significant association between subjective organization ratings (dependent variable) and Intersection rate, Total time of performance and distance to both optimal sequences (independent variables).Discussion: Therefore the above-mentioned indexes can be considered measures of the overall organization in the E-BTT.

Here we present the first prototype of the E-TAN ANALYST, an app that is able to analyse spatio-temporal data developed in Python. This app was developed to analyse the Enhanced Baking Tray Task (E-BTT) data, an innovative task that exploits Tangible User Interfaces (TUI) and returns a series of sixteen ordered coordinates as output. The E-TAN ANALYST allows the automatic computation of a series of indexes on these coordinates and the graphical representation of E-BTT performance. This elaboration can then be used by the clinician or by the experimenter to analyse the single subject’s performance and their spatial exploration.

The Baking Tray Task is an ecological task developed for the assessment of unilateral neglect that can also be used for research on neurotypical participants. In this task, participants are asked to place 16 objects inside a board as evenly as possible. In the case of impaired spatial exploration, consequent to right attentional networks damage, asymmetrical object disposition is observed as more objects are placed on the ipsilesional side (typically the right side). The E-BTT is a technology-enhanced version of the Baking Tray Task, implemented with a software platform, E-TAN, which detects the objects and automatically computes their spatial coordinates. This allows a complement to the traditional scoring methods with new measures to extract richer information from the data. In this study, we focus on neurotypical participants to explore if some new indexes, derived from the literature review on similar tasks, can be applied to BTT and E-BTT for research aims. A principal component analysis (PCA) was then performed to verify if these new indexes reflect some common dimensions. Results indicate the emergence of two principal dimensions: spatiality, which summarizes both laterality and verticality, and quality, which regards the explored space and (dis)organization in placing the items.