PseudoBulbar Affect (PBA) symptoms are frequent, uncontrollable outbursts of crying or laughing in people with certain neurologic conditions or brain injuries. Episodes may occur several times per day and can last seconds to minutes. PBA is not a new condition. In fact, it was first described in medical literature over 130 years ago by Charles Darwin.
Over the years, doctors have called PBA by different names such as “emotional incontinence” or “pathological laughing and crying”. As research into brain activity expanded the medical community’s understanding of these symptoms, physicians are increasingly using the term pseudobulbar affect.
Though the names have changed over time, the explanation for the symptoms remains the same. PBA can occur when certain neurologic diseases or brain injuries damage the areas in the brain that control normal expression of emotion. This damage can disrupt brain signaling, causing a ‘short circuit’ and triggering involuntary episodes of crying or laughing.
Conditions or injuries that PBA can occur in include: Alzheimer’s disease or other dementias, Stroke, Traumatic brain injury (TBI), Multiple sclerosis (MS), Parkinson’s disease, and Lou Gehrig’s disease (ALS).
Who gets PBA?
Though you may have never heard of PBA, you’re not alone. Nearly two million Americans with certain neurologic conditions or brain injuries are estimated to suffer from it. PBA doesn’t discriminate. It can affect men and women, old and young. A recent national registry of more than 5,000 participants showed the percentages of people with certain neurologic conditions and brain injuries who had symptoms suggestive of PBA.*
* The PRISM Registry was a nationwide study of adult patients with Alzheimer’s disease (1799), amyotrophic lateral sclerosis-ALS (125), multiple sclerosis-MS (1215), Parkinson’s disease (804), stroke (757) or traumatic brain injury-TBI (590). PBA symptoms were defined as a Center for Neurologic Study Lability Scale (CNS-LS) score >= 13. This CNS-LS score may suggest PBA symptoms and merits further diagnostic assessment. Patients or caregivers completed the assessment.