Pathological Laughing and Crying

Dark, Frances; McGrath, John J.; Ron, María A.

doi:10.3109/00048679609065020

Cited by 76 publications

(81 citation statements)

References 41 publications

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“…1,3,8,33 We conducted an online survey among patients in the USA with six underlying conditions commonly associated with PBA -ALS, MS, stroke, AD/dementia, TBI, and PD -in order to prospectively estimate the overall prevalence of PBA and quantify the extent to which PBA is diagnosed and treated. Secondary goals were to investigate patterns of physician recognition, diagnosis, and treatment of PBA.…”

Section: Introductionmentioning

confidence: 99%

“…1,6 Clinical case and study data have shown that PBA may cause severe distress, embarrassment, and social disability among patients. 3,[7][8][9][10] In addition, studies have shown that patients with PBA or similar syndromes experience an increased incidence of depression, 11 impairments in executive function 12 and sexual function, 13 and ability to perform activities of daily living 14 10,11,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] ). This variability is probably due to differences in the populations studied and in the criteria and methods used for identifying PBA.…”

Section: Introductionmentioning

confidence: 99%

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Pseudobulbar affect: an under-recognized and under-treated neurological disorder

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pseudobulbar affect: an under-recognized and under-treated neurological disorder

et al. 2011

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“…Tateno et al (2004) mostraram que aqueles que apresentavam IEED eram significativamente mais depressivos, ansiosos e agressivos quando comparados com pacientes sem o transtorno. Na esclerose lateral amiotrófica (ELA), a presença de sintomas que sugiram acometimento bulbar, como distúrbios da fala e da deglutição, constitui um preditor para o aparecimento de choro e riso patológicos (Schiffer et al, 2006;Dark et al, 1996). Uma prevalência de 49% de IEED foi reportada por Gallagher (1989) em um estudo realizado com 73 pacientes portadores de ELA, dos quais 27% apresentavam ambos, choro e riso patológicos; 12%, apenas choro patológico e 9,5%, apenas riso patológico.…”

Section: Epidemiologiaunclassified

Transtorno da expressão emocional involuntária

Sartori¹,

Barros

Tavares³

2008

Rev. psiquiatr. clín.

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Contexto: O transtorno da expressão emocional involuntária (involuntary emotional expression disorder ou IEED)consiste em um transtorno do afeto, caracterizado por uma dificuldade em controlar a expressão emocional, que se apresenta por episódios breves e estereotipados de riso e/ou choro incontroláveis. Pode estar relacionado a diversas patologias encefálicas, em variadas localizações anatômicas. Objetivos: Revisar aspectos clínicos, epidemiológicos e fisiopatológicos envolvidos no transtorno da expressão emocional involuntária e apresentar as opções atuais e futuras na abordagem terapêutica. Métodos: Pesquisa de base de dados MEDLINE/PUBMED e LILACS utilizando os termos transtorno da expressão emocional involuntária, afeto pseudobulbar, riso e choro patológicos, acidente vascular cerebral, doença de Alzheimer, esclerose múltipla, esclerose lateral amiotrófica. Resultados: No trantorno da expressão emocional involuntária, as crises de choro e/ou riso, além de serem incontroláveis, tendem a ser desproporcionais ao estímulo recebido, podendo estar completamente dissociada do estado de humor do paciente ou mesmo ser contraditória ao contexto no qual o estímulo está inserido. Outros termos são usados na nosografia desse transtorno, como afeto pseudobulbar, riso e choro patológicos, labilidade emocional, emocionalismo e desregulação emocional. Termos como choro forçado, choro involuntário, emocionalidade patológica e incontinência emocional também têm sido utilizados com menor freqüência. Os mecanismos fisiopatológicos específicos envolvidos nesse transtorno ainda não estão bem esclarecidos. Lesões que podem causá-lo estão amplamente distribuídas no encéfalo, mas parecem envolver o lobo frontal, o sistema límbico, o tronco cerebral e o cerebelo, assim como a substância branca que interconecta essa rede. Seu principal diagnóstico diferencial é a depressão. As terapias farmacológicas hoje disponíveis se baseiam em inibidores seletivos de recaptação de serotonina (ISRS), antidepressivos tricíclicos e, em menor extensão, em drogas dopaminérgicas. O composto AVP-923 está sendo estudado como um possível tratamento específico. Conclusão: Apesar de ser conhecido há séculos, ainda que sob diferentes nomenclaturas, o IEED permanece subdiagnosticado e, considerando a possibilidade dos efeitos deletérios desse transtorno no funcionamento social, ocupacional e familiar do paciente acometido, seu reconhecimento e conduta adequados são decisivos para possibilitar uma melhoria na qualidade de vida do paciente. , H.C.S. et al. / Rev. Psiq. Clín 35 (1); 20-25, 2008 Palavras-chave: Transtorno da expressão emocional involuntária, afeto pseudobulbar, riso e choro patológicos, acidente vascular cerebral, doeça de Azheimer, esclerose múltipla, esclerose lateral amiotrófica. Sartori AbstractBackground: Involuntary emotional expression disorder (IEED) is an affect disturbance caracterized by a difficulty of controlling emotional expression, that is presented as short, stereotyped and uncontrollable episodes of laugh-

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“…[1–3] This syndrome occurs secondary to neurological disease or brain injury, including Alzheimer’s disease or dementia, multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis, stroke and traumatic brain injury, among other conditions. [2] PBA episodes often cause severe embarrassment and social dysfunction, and can lead to social isolation, reduced quality of life and impaired function for patients, independent of the burdens of the underlying, primary disorder.…”

Section: Introductionmentioning

confidence: 99%

A Study of Potential Pharmacokinetic and Pharmacodynamic Interactions between Dextromethorphan/Quinidine and Memantine in Healthy Volunteers

Pope

Schoedel²,

Bartlett³

et al. 2012

Clin Drug Invest

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Background and Objective: Dextromethorphan/quinidine (DMQ) is the first agent indicated for the treatment of pseudobulbar affect. Dextromethorphan, the active ingredient, is a low-affinity, uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist. This study evaluated the potential for a drug-drug interaction (DDI) of DMQ with memantine, which is also an NMDA receptor antagonist.Methods: This open-label, randomized, parallel-group study enrolled healthy adults who were randomized into one of two treatment groups. Group 1 subjects were administered memantine at a starting dose of 5 mg once daily, which was titrated over a 3-week period to a dose of 10 mg twice daily (every 12 hours) and continued for another 11 days to attain steady state; DMQ 30mg (dextromethorphan 30mg/quinidine 30mg) every 12 hours was then added for a further 8 days. Group 2 subjects received DMQ 30 mg every 12 hours for 8 days to attain steady state; memantine was then added, titrated on the same schedule as in group 1, and continued at 10 mg every 12 hours for an additional 11 days. Pharmacokinetic blood sampling was performed to assess the primary endpoints of the 90% confidence intervals (CIs) for the geometric mean ratios of the areas under the plasma concentration-time curves (AUCs) for memantine, dextromethorphan, dextrorphan — the dextromethorphan metabolite — and quinidine during concomitant therapy versus monotherapy. Safety/tolerability and pharmacodynamic variables were also assessed.Results: A total of 52 subjects were randomized. In both group 1 (n=23) and group 2 (n=29), the 90% CIs for the ratios of the AUCs during concomitant therapy versus monotherapy were within the predefined range to indicate similarity (0.8–1.25) for memantine, dextromethorphan and dextrorphan, indicating no pharmacokinetic DDI. The 90% CI for the AUC ratio for quinidine was slightly above the predefined range; however, the mean AUC increased by only 25%. In both groups, incidence of adverse events was similar, and pharmacodynamic variables were either similar or slightly improved with DMQ added to memantine and memantine added to DMQ, compared to monotherapy with either agent.Conclusion: Minimal pharmacokinetic and pharmacodynamic interactions were observed between memantine and DMQ, suggesting they can be coadministered without dose adjustment.

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Pathological Laughing and Crying

Cited by 76 publications

References 41 publications

Pseudobulbar affect: an under-recognized and under-treated neurological disorder

Pseudobulbar affect: an under-recognized and under-treated neurological disorder

Transtorno da expressão emocional involuntária

A Study of Potential Pharmacokinetic and Pharmacodynamic Interactions between Dextromethorphan/Quinidine and Memantine in Healthy Volunteers

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