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

Pseudobulbar Affect: Burden of Illness in the USA

“…To complete recruitment of the PBA group and to recruit the controls, invitations were then sent to a nationally representative sample of more than 6 million US adults (aged 18 years and over), registered in the HPOL, in a similar fashion to the recruitment procedure for the previous PBA prevalence survey [5]. At the time of recruitment, the HPOL included approximately 1.5 million individuals who had been screened by HI by means of a checklist for the presence of chronic illnesses.…”

“…At the time of recruitment, the HPOL included approximately 1.5 million individuals who had been screened by HI by means of a checklist for the presence of chronic illnesses. HPOL panel members previously identified by HI as either having AD, ALS, MS, PD, and stroke or being primary, nonpaid caregivers for a household member with one of these conditions were sent online invitations to participate in a survey about their "thoughts on and experiences with some important healthcare-related topics" [5].…”

“…The authors have recently published the results of a survey conducted using the CNS-LS to estimate the prevalence of PBA in the USA across six commonly associated underlying conditions: AD and other dementias, ALS, MS, PD, stroke, and TBI [5]. Adopting a conservative CNS-LS cutoff score of 21 or greater yielded an overall prevalence of 9.4%, which translated to 500,000 to 2 million individuals in the USA with PBA.…”

“…To adjust for the relative proportions of the six underlying conditions within the total US population (including the estimated prevalence of PBA within each condition), and thus increase generalizability to the total US patient population, additional post weights were applied to all outcomes reported for the total study population across PBA/control and disease subgroups ( Table 2) [5].…”

“…Although the etiology of PBA is not completely understood, it is strongly associated with neurological disease or injury that affects the frontal lobes and descending pathways to the brainstem, basis pontis, and cerebellum, and its symptoms appear to be similar across different patient populations [1][2][3]. PBA has been reported secondary to a wide variety of neurological conditions; available prevalence data suggest that neurological conditions commonly associated with PBA include Alzheimer's disease (AD) and other dementias, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Parkinson's disease (PD), stroke, and traumatic brain injury (TBI) [2,3,5].…”