Mood and cognition are of particular relevance in amyotrophic lateral sclerosis (ALS), Parkinson disease (PD), and atypical parkinsonism (aP) and should be evaluated when symptoms of pseudobulbar affect (PBA), a syndrome of affective disturbance associated with inappropriate laughter and crying independent of mood, are suspected. This according to a recent study that aimed to determine whether cognitive and psychiatric comorbidities correlated with patient-reported symptoms of PBA. 108 patients (PD, n=53; aP, n=29; ALS, n=26) completed a cognitive screener and self-reported measures of lability, depression, anxiety, apathy, and quality of life. Researchers found:
- PBA symptom severity did not vary between the 3 groups.
- Younger age and worse anxiety correlated with PBA symptom severity in all 3 groups, whereas depression and poor mental health/quality of life only correlated with PBA symptom severity in the PD and aP groups.
- PD and aP patients may be more likely to benefit from treatment with antidepressants.
- Results suggest the possibility of an alternate pathophysiologic mechanism for PBA, which may vary between neurological disorders and disease progression.
Patel N, Combs H, York M, Phan C, Jimenez-Shahed J. Pseudobulbar affect correlates with mood symptoms in parkinsonian disorders but not amyotrophic lateral sclerosis. [Published online ahead of print March 5, 2018]. J Neuropsychiatry Clin Neurosci. doi:10.1176/appi.neuropsych.17070131.