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pseudobulbar affect

N A Trusova, O S Levin, A V Arablinsky
AIM: To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). MATERIAL AND METHODS: Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Flora M Hammond, David N Alexander, Andrew J Cutler, Stephen D'Amico, Rachelle S Doody, William Sauve, Richard D Zorowitz, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, Andrea E Formella, Joao Siffert
No abstract text is available yet for this article.
2016: BMC Neurology
Mary I Butler, David Williams, David R Cotter
No abstract text is available yet for this article.
October 2016: Journal of Clinical Psychopharmacology
Flora M Hammond, David N Alexander, Andrew J Cutler, Stephen D'Amico, Rachelle S Doody, William Sauve, Richard D Zorowitz, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, Andrea E Formella, Joao Siffert
BACKGROUND: Phase 3 trials supporting dextromethorphan/quinidine (DM/Q) use as a treatment for pseudobulbar affect (PBA) were conducted in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). The PRISM II study provides additional DM/Q experience with PBA secondary to dementia, stroke, or traumatic brain injury (TBI). METHODS: Participants in this open-label, multicenter, 90-day trial received DM/Q 20/10 mg twice daily. The primary outcome was the Center for Neurologic Study-Lability Scale (CNS-LS), assessing change in PBA episode frequency and severity...
2016: BMC Neurology
Charles P Taylor, Stephen F Traynelis, Joao Siffert, Laura E Pope, Rae R Matsumoto
Dextromethorphan (DM) has been used for more than 50years as an over-the-counter antitussive. Studies have revealed a complex pharmacology of DM with mechanisms beyond blockade of N-methyl-d-aspartate (NMDA) receptors and inhibition of glutamate excitotoxicity, likely contributing to its pharmacological activity and clinical potential. DM is rapidly metabolized to dextrorphan, which has hampered the exploration of DM therapy separate from its metabolites. Coadministration of DM with a low dose of quinidine inhibits DM metabolism, yields greater bioavailability and enables more specific testing of the therapeutic properties of DM apart from its metabolites...
August 2016: Pharmacology & Therapeutics
Laurence P Perotti, Latiba D Cummings, Janyna Mercado
PURPOSE: To determine if it is possible to successfully treat pseudobulbar affect (PBA) using a behavioral approach. DESIGN AND METHODS: Two experiments were conducted, each a double reversal design with the same single subject in both. The first experiment tested the hypothesis that the rate of PBA could be controlled by manipulation of its consequences. The second experiment tested the hypothesis that use of a self-control procedure would control the rate of PBA...
April 2016: Perspectives in Psychiatric Care
Dynela Garcia-Baran, Thomas M Johnson, Joyce Wagner, Joann Shen, Michelle Geers
Pathological laughing and crying, or pseudobulbar affect (PBA), has been described in patients with neurological disorders such as multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer's disease, stroke, and traumatic brain injury (TBI) since the 19th century (Schiffer 2005). The syndrome is characterized by inappropriate episodes of laughing or crying after minor stimuli. It was first coined a disinhibition of cortical control by Kinnier Wilson in 1924. It was observed in brain disease and seen with mild TBI...
March 2016: Medicine (Baltimore)
Eman Bahrani, Chloe E Nunneley, Sylvia Hsu, Joseph S Kass
Life-threatening and benign drug reactions occur frequently in the skin, affecting 8 % of the general population and 2-3 % of all hospitalized patients, emphasizing the need for physicians to effectively recognize and manage patients with drug-induced eruptions. Neurologic medications represent a vast array of drug classes with cutaneous side effects. Approximately 7 % of the United States (US) adult population is affected by adult-onset neurological disorders, reflecting a large number of patients on neurologic drug therapies...
March 2016: CNS Drugs
Elias D Granadillo, Mario F Mendez
Humor, or the perception or elicitation of mirth and funniness, is distinguishable from laughter and can be differentially disturbed by neuropsychiatric disease. The authors describe two patients with constant joking, or Witzelsucht, in the absence of pseudobulbar affect and review the literature on pathological humor. These patients had involvement of frontal structures, impaired appreciation of nonsimple humor, and a compulsion for disinhibited joking. Current neuroscience suggests that impaired humor integration from right lateral frontal injury and disinhibition from orbitofrontal damage results in disinhibited humor, preferentially activating limbic and subcortical reward centers...
2016: Journal of Neuropsychiatry and Clinical Neurosciences
Young D Chang, Mellar P Davis, Joshua Smith, Terrence Gutgsell
No abstract text is available yet for this article.
May 2016: Journal of Pain and Symptom Management
Nimish J Thakore, Erik P Pioro
OBJECTIVE: To report an observational study of depression in a large cohort of patients with amyotrophic lateral sclerosis (ALS), including its prevalence, associations, longitudinal course, and effect on survival. METHODS: The Patient Health Questionnaire-9 (PHQ-9) (a validated depression instrument) and other self-reported measures were obtained from patients with ALS as part of routine clinical care via tablet devices using a software system (Knowledge Program)...
March 15, 2016: Neurology
David C Gillespie, Amy P Cadden, Rosalind Lees, Robert M West, Niall M Broomfield
BACKGROUND: Several studies have reported that emotional lability is a common consequence of stroke. However, there is uncertainty about the "true" prevalence of the condition because, across these studies, patients have been recruited at different stages of recovery, from different settings, and using different diagnostic methods. There have been no systematic reviews of the published evidence to ascertain how the prevalence of poststroke pseudobulbar affect (PBA) might vary according to these factors...
March 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Marian W Roman
No abstract text is available yet for this article.
2015: Issues in Mental Health Nursing
Paul A Lapchak
Until recently there was little understanding of the exact pathophysiology and treatment choices for stroke patients with Pseudobulbar affect (PBA). PBA is typically characterized by outbursts or uncontrollable laughing or crying and in the majority of patients, the outbursts being involuntary and incompatible with the patients' emotional state. PBA is a behavioral syndrome reported to be displayed in 28-52% of stroke patients with first or multiple strokes, and incidence may be higher in patients who have had prior stroke events, and higher in females...
October 2015: Journal of Neurology & Neurophysiology
Kevin Foley, R Tamara Konetzka, Anthony Bunin, Charles Yonan
OBJECTIVE: Pseudobulbar affect (PBA) is a neurological disorder of emotional expression, characterized by uncontrollable episodes of crying or laughing in patients with certain neurological disorders affecting the brain. The purposes of this study were to estimate the prevalence of PBA in US nursing home residents and examine the relationship between PBA symptoms and other clinical correlates, including the use of psychopharmacological medications. METHODS: A retrospective study was conducted between 2013 and 2014 with a convenience sample of residents from nine Michigan nursing homes...
July 2016: International Journal of Geriatric Psychiatry
James L Rudolph, Jennifer R Fonda, Phillip R Hunt, Regina E McGlinchey, William P Milberg, Matthew W Reynolds, Charles Yonan
No abstract text is available yet for this article.
January 15, 2016: Journal of Affective Disorders
Rachelle S Doody, Stephen D'Amico, Andrew J Cutler, Charles S Davis, Paul Shin, Fred Ledon, Charles Yonan, João Siffert
BACKGROUND: Dextromethorphan (DM)/quinidine (Q) is an approved treatment for pseudobulbar affect (PBA) based on trials in amyotrophic lateral sclerosis or multiple sclerosis. PRISM II evaluated DM/Q effectiveness and tolerability for PBA secondary to dementia, stroke, or traumatic brain injury; dementia cohort results are reported. METHODS: This was an open-label, multicenter, 90 day trial; patients received DM/Q 20/10 mg twice daily. Primary outcome was change in Center for Neurologic Study-Lability Scale (CNS-LS) score...
October 16, 2015: CNS Spectrums
Alexander Stocker, Tobias Struffert, Tobias Engelhorn, Hagen B Huttner
BACKGROUND: The pseudobulbar palsy affects both corticobulbar tracts leading to symptoms of the caudal brain nerves. These bulbar symptoms often may be misinterpreted and lead to a false localization of the ischemic lesion. Here we report on a patient with an acute small lacunar ischemic lesion who presented clinically with severe affection because of an identical old contralateral lesion. CASE REPORT: The patient presented with sudden onset of dysphagia, anarthria, and glossplegia...
July 2015: Neurologist
Erik P Pioro
Pseudobulbar affect (PBA) is a dysfunction of emotional expression characterized by involuntary outbursts of crying or laughing disproportionate or unrelated to mood, occurring in patients with various underlying neurologic disorders. This review describes the clinical data supporting dextromethorphan (DM) hydrobromide combined with quinidine sulfate (Q) as treatment of PBA and briefly surveys the ongoing debates concerning the terminology for dysfunction of emotional expression, as well as the ongoing searches for its brain substrates...
June 2014: Neurology and Therapy
Monica Saini, Marlie Jane Mamauag, Rajinder Singh
Central pontine myelinolysis (CPM) is classically described as a demyelinating condition that results from the rapid correction of hyponatraemia. CPM has also been reported to arise from hyperglycaemia in association with concomitant acidosis, hypernatraemia and hyperosmolar syndrome. Herein, we report a rare presentation of CPM, which was purely secondary to hyperosmolar hyperglycaemia. The patient presented with ataxia and pseudobulbar affect, which evolved subacutely over a duration of two weeks. It is important to note that, in addition to acute changes in osmolality, a subacute shift secondary to hyperglycaemia may also lead to CPM...
April 2015: Singapore Medical Journal
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