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• #1 The epidemiology and pathophysiology of pseudobulbar affect and its association with neurodegeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6065587/

  Pseudobulbar affect is a disorder resulting from neurologic damage manifesting as sudden, stereotyped affective outbursts that are not reflective of internal emotion. […] The disorder appears to result from a disruption of the cortico-limbic-subcortical-thalamic-pontocerebellar network involved in emotional expression and regulation with resulting disruptions of neurotransmitter systems. […] The pathophysiology of PBA is likely varied and best conceptualized as a focal or diffuse disruption in the complex neurocircuitry or neurochemistry involved in the inhibition of emotional expression. […] One of the original hypotheses about PBA came from Wilson, who proposed that there was disruption of the cortical inhibition to an upper brainstem center followed by release of lower bulbar nuclei that coordinate the motor responses associated with laughing and crying.

• #1 Pseudobulbar affect: prevalence and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3849173/

  Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of amyotrophic lateral sclerosis, extrapyramidal and cerebellar disorders, multiple sclerosis, traumatic brain injury, Alzheimers disease, stroke, and brain tumors. […] Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted. […] The underlying mechanism in PBA appears to be a lack of voluntary control, also termed disinhibition, but the pathways are complex and are as yet incompletely understood. […] The primary neurotransmitters believed to be involved in PBA are serotonin and glutamate. […] The serotonergic action of SSRIs and TCAs appears to be the most significant therapeutic mechanism in treatment of PBA, via an increase in availability of serotonin at the synapses in corticolimbic and cerebellar pathways. […] Although the mechanisms are not fully understood, serotonergic and glutamatergic transmission appear to play major roles, and there are clear therapeutic benefits in treatment with SSRIs, TCAs, or with dextromethorphan/quinidine.

• #1 Pseudobulbar Affect (PBA): Symptoms, Causes, & Treatment

  https://www.webmd.com/brain/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a nervous system disorder that can make you laugh, cry, or become angry without being able to control when it happens. […] Scientists believe that PBA may result from damage to the prefrontal cortex, the area of your brain that helps control emotions. Damage to other parts of the brain, as well as changes in brain chemicals linked to depression and hyper moods (mania), could also play a role. […] An injury or disease that affects your brain can lead to PBA. Other brain conditions commonly linked to PBA include: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumor, Dementia, Multiple sclerosis (MS), Parkinson’s disease, Traumatic brain injury. […] PBA can happen if you’ve had a brain injury or live with a neurological condition such as a stroke. Research shows that more than one-third of people who’ve had a stroke have symptoms that suggest PBA.

• #1 Pseudobulbar affect | ALS News TodayEnvelope icon

  https://alsnewstoday.com/pseudobulbar-affect-als/

  PBA is linked to neurological diseases or damage, including conditions such as ALS, Alzheimer’s disease, traumatic brain injury, and stroke. […] The exact cause of PBA is not completely known, but it is thought to be related to a disruption in the brain’s circuits that regulate the expression of emotions. […] Brain MRI scans of people with ALS have tied their inability to regulate emotional expression to changes in the frontal area of the brain, including alterations of the fronto-tempo-parietal-cerebellar circuits. PBA also has been linked to an abnormality of chemical messengers called neurotransmitters that regulate the expression of emotions. […] Pseudobulbar affect (PBA) is thought to be linked to neurological damage in the frontal area of the brain, including alterations of the fronto-tempo-parietal-cerebellar circuits. PBA has also been linked to an abnormality of chemical messengers called neurotransmitters that control the expression of emotions. […] It is estimated that around 38.5% of people living with amyotrophic lateral sclerosis (ALS) — also known as Lou Gehrig’s disease — experience pseudobulbar affect.

• #1 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  Pseudobulbar affect (PBA) describes a disorder that causes a person to experience uncontrollable episodes of crying, laughing, or other emotional displays that are out of context in their social interactions. […] Typically, pseudobulbar affect occurs secondary to other neurological conditions. […] Pseudobulbar affect typically occurs secondary to a neurological injury or disease, such as: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumors, Dementia, Multiple sclerosis, Stroke, Parkinson’s disease, Traumatic brain injury (TBI). […] But again, pseudobulbar usually does not develop unless a pre-existing neurological disorder or injury is present. […] Pseudobulbar affect may also occur in people who suffer a physiological disorder such as Graves disease, hyperthyroidism, or hypothyroidism.

• #1 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  The gate control theory proposes inhibition of the mechanism regulating emotional expression. MS and related neurological damage are thought to be involved in disrupting activity in the cortical structures related to sensory, motor, and emotional processes, along with overactive motor cortical areas. […] In the dysfunctional neurotransmitters theory, serotonin, dopamine, glutamate, and sigma-1 are disrupted in various brain pathways, leading to alterations in emotional expression. Therefore, medications that modulate these neurotransmitters may play a role in providing therapeutic benefit.

• #1 Pseudobulbar Affect Versus Depression: Issues in Diagnosis and Treatment

  https://www.psychiatrictimes.com/view/pseudobulbar-affect-versus-depression-issues-diagnosis-and-treatment

  Research also suggests that abnormal glutaminergic and serotonergic neurotransmission may contribute to PBA. However, numerous other neurotransmitters may also be involved given their impact on emotion, such as dopamine, norepinephrine, and acetylcholine. The exact etiology of PBA is unknown, but research supports a dysfunction of neural circuits and neurotransmitters that modulate the motor expression of emotion.

• #1 The epidemiology and pathophysiology of pseudobulbar affect and its association with neurodegeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6065587/

  In summary, as Rabins and Arciniegas have proposed, PBA is theorized to come from a disruption in a complex cortico-limbic-subcortico-thalamic-pontocerebellar network, which is often related to lesions in descending corticobulbar fibers that inhibit emotional motor networks, lesions in brainstem and cerebellum white matter pathways that modulate emotion expression, and multiple abnormalities in neurotransmitter function.

• #1 Pseudobulbar affect (pathological laughing and crying) | MS Trust

  https://mstrust.org.uk/a-z/pseudobulbar-affect-pathological-laughing-and-crying

  Pseudobulbar affect (PBA) is seen in many other conditions including amyotrophic lateral sclerosis (ALS), motor neurone disease (MND), Parkinson’s disease (PD), stroke, traumatic brain injury, Alzheimer’s disease (AD) and other dementias. […] The exact cause of PBA is unclear but it is thought to be due to a combination of damage to the central nervous system in the areas of the brain that are involved with controlling your emotions and the effect this has on how signals are carried between nerve cells by neurotransmitters chemicals which allow the cells to communicate with one another. […] It is thought that the area of the brain known as the cerebellum may have a key role in regulating emotional responses and keeping them proportional to the situation. So if you have lesions in the cerebellum you may be more susceptible to pseudobulbar affect.

• #1 Pseudobulbar affect | MedLink Neurology

  https://www.medlink.com/articles/pseudobulbar-affect

  Pathophysiologically, pathological laughing and crying involves white matter degeneration, which can impair voluntary control over emotional expressions. […] Emotional incontinence manifested as episodes of crying and laughter are frequent in patients with small lenticulocapsular stroke. […] A case of severe pathologic crying has been described after a limited left anterior choroidal artery territory infarction. […] Furthermore, a case pseudobulbar affect was reported in an elderly woman with small vessel ischemic disease and alcohol abuse disorder. […] In cases of unilateral lesions, the left-sided lesions are more often associated with crying and the right-sided lesions with laughter. […] In the circuitry involved in pathologic laughter and crying, ventral pons appears to be a crucial location, but further investigations are needed to determine how lesions in the basis pontis affect the activity of the cerebellum and the brainstem.

• #1 Pseudobulbar Palsy: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/pseudobulbar-palsy

  Pseudobulbar palsy happens when damage to a specific part of your brain (corticobulbar tract) causes a collection of neurological symptoms. […] Bilateral damage (affecting both sides) to a specific part of your brain called the corticobulbar tract causes pseudobulbar palsy. The function of the corticobulbar tract is to control muscles in your head and face. It supplies input to the cranial nerves that support these muscles. […] Many conditions can damage this tract and lead to pseudobulbar palsy, like: Traumatic brain injuries, Brainstem tumors, Inflammation and infections that affect your brain, Chronic (long-term) neurological conditions, Cerebrovascular conditions, like strokes and vascular malformations. […] Common causes of pseudobulbar palsy include the following chronic neurological conditions: Amyotrophic lateral sclerosis (ALS), Parkinson’s disease, Progressive supranuclear palsy, Multiple sclerosis (MS).

• #1 Pseudobulbar Affect (PBA) – Brain Injury Association of America

  http://biausa.org/brain-injury/about-brain-injury/psuedobulbar-affect-information

  Pseudobulbar affect (PBA) is a neurological condition involving involuntary, sudden, and frequent episodes of laughing or crying. It occurs secondary to neurological disease – meaning that PBA is caused by another disorder – and is most commonly found in patients with: […] Normally, the cerebral cortex communicates with the cerebellum to control our emotional responses to situations. Sometimes, the cerebellum becomes damaged by lesions or nerve problems, disrupting communication between these two areas. PBA is thought to result from this miscommunication. It’s almost like the brain “short circuits” and one can no longer control their emotional response. […] PBA is a condition that occurs secondary to a neurological disorder or brain injury. […] Because crying is a common symptom, people often confuse PBA with depression. But PBA is different. It’s neurological – caused by damage to the nervous system. Depression is psychological, so it’s related to a person’s emotional or mental state.

• #1 Pseudobulbar Affect (PBA) – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/abr9139

  Pseudobulbar affect (PBA) is a problem in the brain that causes you to laugh or cry for no reason. […] Brain damage from a stroke, brain tumor, or head trauma can lead to PBA. PBA can also happen along with such conditions as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, ALS, and dementia. […] Normally, the „feel” and „express” parts of your brain work together. But with PBA, the expressive part of your brain can trigger behavior on its own.

• #1 Pseudobulbar affect: When patients laugh or cry, but don’t know why | MDedge

  https://blogs.the-hospitalist.org/content/pseudobulbar-affect-when-patients-laugh-or-cry-dont-know-why

  Pseudobulbar affect (PBA) is a disorder of affective expression that manifests as stereotyped and frequent outbursts of crying (not limited to lacrimation) or laughter. Symptoms are involuntary, uncontrolled, and exaggerated or incongruent with current mood. Episodes, lasting a few seconds to several minutes, may be unprovoked or occur in response to a mild stimulus, and patients typically display a normal affect between episodes. […] PBA is caused by brain illnesses and injuries that disrupt neural circuitry that underpins the volitional control of affect. […] Lesions to the volitional pathway (or its associated feedback or processing circuits) are thought to cause PBA symptoms. […] Lesions of the volitional pathway have been correlated with conditions of PBA, whereas direct activation of the emotional pathway tended to lead to emotional lability or the crying and laughing behaviors observed in dacrystic or gelastic epilepsy.

• #1 Pseudobulbar Affect – Psycho Wellnesscenter

  https://www.psychowellnesscenter.com/Blog/pseudobulbar-affect/

  A neurological disease called pseudobulbar affect (PBA) causes fits of uncontrollable or inappropriate sobbing or laughter. […] PBA is brought on by a neurological disorder such as amyotrophic lateral sclerosis or a brain injury (ALS). […] The precise cause of pseudobulbar effect is unknown. They speculate that it occurs as a result of damage to the brains neurological connections that control how emotions are expressed. […] This disruption can be brought on by a number of neurological diseases that are linked to PBA, such as: Traumatic brain injury, Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrigs disease, Multiple sclerosis (MS), Alzheimers disease and other forms of dementia, Stroke, Parkinsons disease, Brain tumors, Epilepsy, Wilsons disease. […] Pseudobulbar affect (PBA), particularly depression, is frequently misunderstood as a form of mood illness. […] Depression may also be present in PBA patients, either as a result of PBA itself or owing to other factors. […] In contrast to depression, PBA, however, causes sobbing outbursts that: Onsets that are more explosive, Shorter in duration, Usually not accompanied by a deep inward sadness.

• #1 Pseudobulbar affect – MEpedia

  https://me-pedia.org/wiki/Pseudobulbar_affect

  Pseudobulbar affect is typically caused by neurological diseases or injuries including multiple sclerosis, stroke, amyotrophic lateral sclerosis (ALS), traumatic brain injury (a head injury causing loss of consciousness), or Parkinson’s disease. […] Pseudobulbar affect is often mistaken for depression, but in-between emotional outbursts the person’s mood is normal.

• #1 Pseudobulbar Affect – Psycho Wellnesscenter

  https://www.psychowellnesscenter.com/Blog/pseudobulbar-affect

  A neurological disease called pseudobulbar affect (PBA) causes fits of uncontrollable or inappropriate sobbing or laughter. […] PBA is brought on by a neurological disorder such as amyotrophic lateral sclerosis or a brain injury (ALS). […] The precise cause of pseudobulbar effect is unknown. They speculate that it occurs as a result of damage to the brains neurological connections that control how emotions are expressed. […] This disruption can be brought on by a number of neurological diseases that are linked to PBA, such as: Traumatic brain injury, Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrigs disease, Multiple sclerosis (MS), Alzheimers disease and other forms of dementia, Stroke, Parkinsons disease, Brain tumors, Epilepsy, Wilsons disease. […] Pseudobulbar affect (PBA), particularly depression, is frequently misunderstood as a form of mood illness. […] Depression may also be present in PBA patients, either as a result of PBA itself or owing to other factors.

• #1 When Tears Keep Falling: A Case Report of Pseudobulbar Affect

  https://www.psychiatrist.com/pcc/when-tears-keep-falling-case-report-pseudobulbar-affect/

  The likely pathophysiologic mechanism of PBA is the disruption of the cortico-ponto-cerebellar pathway. Creating proper affect depends on the involvement of multiple interconnected regions: executive functions in the prefrontal cortex, movement control in the motor cortex, cerebellar coordination, and brain pons (integration, conduction, and emergence of most of the cranial nerves). This mechanism postulates that affect expression is modulated by multiple cortical areas, with afferent connections between the motor cortex, the prefrontal cortex, and the cerebellum, through the ventral portion of the pons. Thus, any disorder, either degenerative or traumatic, that interrupts these connections might result in affect dysregulation. […] PBA is sometimes misinterpreted as a psychiatric disorder (depressive disorder, bipolar disorder, or posttraumatic stress disorder). Even though mood disorders may share some common symptoms with PBA, presentation and evolution are often different, and their diagnosis requires the exclusion of a medical condition. Although none of these disorders exclude PBA diagnosis, treatment usually directed against these disorders most likely will not improve affect dysregulation symptoms. The only approved pharmacologic treatment for PBA is dextromethorphan and quinidine (none are approved in Portugal for PBA treatment). Whenever possible, underlying conditions to PBA should be treated. Antidepressant treatment and behavioral approaches are also described in the literature.

• #1 What Is Pseudobulbar Affect? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pseudobulbar-affect/

  Dysfunction of Neurotransmitters Theory According to this theory, the neurotransmitters serotonin, dopamine, glutamate, and sigma-1 are disrupted in various brain pathways and cause the emotional expressions to be altered. […] Although PBA is associated with brain injury and different pre-existing neurological conditions, experts arent certain why some individuals develop it and others dont; there isnt a way to prevent or reduce the risk of developing pseudobulbar affect.

• #1 Pseudobulbar Affect (PBA) | American Stroke Association

  https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects/pseudobulbar-affect

  When the parts of the brain that control emotions are injures, pseudobulbar affect (PBA) occurs. This neurological condition is also known as emotional lability, reflex crying or involuntary emotional expression disorder, among others. […] PBA occurs as a result of several neurological diseases, such as: Stroke, Amyotrophic lateral sclerosis (ALS), Parkinson’s, Traumatic brain injury, Multiple sclerosis, Dementia. […] The cause is a neurological disconnect between the brain’s nerve connections or chemistry that interferes with accurate emotional expression. […] Ongoing research into stroke, traumatic brain injury, multiple sclerosis, Alzheimer’s disease and ALS continues to increase our knowledge about PBA.

• #1 Pseudobulbar affect | MedLink Neurology

  https://www.medlink.com/articles/pseudobulbar-affect

  Pathologic laughter and crying occur in several neurologic disorders. […] Disturbances at various levels of the central nervous system are involved, although lesions of the brainstem are associated with pathologic laughter and crying. […] Pathological laughter and crying are common and impair the quality of life, but treatment is available to manage these problems. […] Pseudobulbar affect may be related to white matter degeneration, particularly in corticobulbar tracts. […] Pathologic laughter and crying are due to damage of pathways that arise in the motor areas of the cerebral cortex and descend to the brainstem to inhibit the center for laughter and crying. […] Causes of pathological laughing and crying can be classified in two groups: (1) Altered behavior with unmotivated happiness: Angelman syndrome, schizophrenia, manias, dementia, etc. (2) Interference with the inhibitory and excitatory mechanisms: gelastic epilepsy, fou rire prodromique in strokes, multiple sclerosis, amyotrophic lateral sclerosis, Parkinson disease, traumatic brain injury, brain tumors, etc.

• #1 Pseudobulbar Affect: Understanding the Neurological Condition Behind Uncontrollable Laughter and Crying | KCC

  https://kentuckycounselingcenter.com/pseudobulbar-affect/

  Pseudobulbar Affect (PBA) may not be a household term, but its a crucial concept to understandespecially if you or a loved one has a history of neurological conditions. […] The National Stroke Association defines pseudobulbar affect as uncontrollable crying or laughing that does not align with an individuals actual emotional state. […] PBA is often attributed to damage or lesions in the brains frontal lobe, which is involved in emotional regulation. […] The release hypothesis suggests that when the normal inhibitory pathways between the frontal lobe and the brainstem (where laughter and crying are generated) are damaged, uncontrolled emotional expressions occur. […] Some researchers propose that the mechanism regulating emotional expressionoften referred to as an internal gateis disrupted.

• #1 Pseudobulbar Affect | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-319-56484-5_24

  Pseudobulbar affect is a syndrome occurring in patients with bilateral upper motor neuron disease and characterized by inappropriate laughter or crying that is at variance with the felt emotion or is greatly exaggerated compared to the emotional stimulus. […] Pseudobular affect is disabling and can be treated effectively with medications.

• #1 Pseudobulbar Affect in Alzheimer’s DiseaseEnvelope icon

  https://alzheimersnewstoday.com/pseudobulbar-affect-alzheimers-disease/

  Pseudobulbar affect (PBA) is a condition that causes sudden and uncontrollable bursts of emotion, such as laughing or crying, that may not reflect how a person is actually feeling. […] Patients who have neurological conditions such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, traumatic brain injury, and strokes are all at risk of developing PBA. PBA is a distinct clinical condition, and not part of the underlying neurological disease. […] PBA develops when a neurological disease or brain injury disrupts this connection. […] Neurotransmitters — chemical messengers that allow nerve cells to communicate — such as serotonin, dopamine, and glutamate, also may play a role in PBA. […] The deficiency of this neurotransmitter is thought to contribute to dysfunction that leads to PBA. […] Although little is known about the role of dopamine in PBA, there is some evidence supporting the role of this signaling molecule in triggering inappropriate outbursts. […] Excessive levels of glutamate in certain brain circuits are also thought to contribute to outbursts.

• #1 Pseudobulbar Affect | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117649/all/Pseudobulbar_Affect

  Pseudobulbar affect (PBA) is a neuropsychiatric disorder consisting of brief emotional outbursts thought to be caused by disruption of corticobulbar or cortico-subcortical-thalamo-cerebellar circuitry. […] Disruption of emotional motor pathway consisting of cortico-pontine-cerebellar circuitry is hypothesized to be at the root of PBA. […] PBA is believed to result from dysfunction anywhere along this circuit from cortex through basis pontis to cerebellum, disrupting coordination of mood and behavioral output and causing disinhibition of emotional motor expression. […] Disruption of glutamate and serotonin systems are thought to be central to PBA.

• #1 Pseudobulbar affect (pathological laughing and crying) | MS Trust

  https://mstrust.org.uk/a-z/pseudobulbar-affect-pathological-laughing-and-crying

  The neurotransmitters thought to be involved in PBA are serotonin, dopamine, glutamate and noradrenaline (also known as norepinephrine). These neurotransmitters are also involved with depression and manic episodes, and as indicated previously pseudobulbar affect can sometimes be mistaken for depression.

• #1 PseudoBulbar Affect in Parkinson’s DiseaseShare to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on facebookFollow us on linkedincaret icon

  https://parkinsonsdisease.net/living-with-pd/pseudobulbar-affect-pba

  PseudoBulbar Affect (PBA) is a condition that can occur in people with a variety of neurological conditions, including Parkinson’s disease (PD). PBA is characterized by sudden, uncontrollable outbursts of crying or laughing, and it is believed to develop when the underlying neurological disease affects areas of the brain related to emotion. […] In people with PD, PBA may occur as levodopa medication is wearing off. PBA may also be triggered by deep brain stimulation (DBS), a surgical technique in which a device is implanted in the person to deliver electrical pulses to the brain to decrease motor symptoms of PD. […] Besides PD, other neurological conditions that are associated with PBA include traumatic brain injury, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Alzheimer’s disease, stroke, and brain tumors.

• #1 When Tears Keep Falling: A Case Report of Pseudobulbar Affect

  https://www.psychiatrist.com/pcc/when-tears-keep-falling-case-report-pseudobulbar-affect/

  Pseudobulbar affect (PBA) is a disorder of affect regulation or of emotional expression. The phenomenon was described as early as 1872 by Charles Darwin. Since 1969, 3 groups of diagnostic criteria have been described: those of Poeck (1969), Cummings et al (2006), and Miller et al (2011). Clinically, PBA is characterized by paroxistic sudden episodes of exaggerated and uncontrolled emotional expression, usually of laughter or weeping, not necessarily congruent with the patients mood, feelings, or situational context. […] PBA mainly occurs in patients with neurologic disorders. It has also been reported in patients with secondary brain lesions of other etiologies, such as brain tumor, aneurysm, or herpetic encephalitis. The most commonly associated disorders are Alzheimers disease, lateral amiotrophic sclerosis, multiple sclerosis, Parkinsons disease, stroke, brain trauma, and brain tumor. The exact prevalence of PBA is unknown, and it is reported as being largely underdiagnosed. In stroke patients, PBA is a common disorder, affecting about 1 in 5 survivors in both acute and post-acute phases and 1 in 8 survivors beyond 6 months post-stroke.

• #1 How Is Pseudobulbar Affect Linked to Multiple Sclerosis (MS)?Share to Facebookprint pageBookmark for latercommentcaret iconcaret iconmore actionsmore actionsmore actionsmore actionsmore actionsFollow us on facebookFollow us on instagramFollow us on facebo

  https://multiplesclerosis.net/clinical/pseudobulbar-affect

  Many people with multiple sclerosis (MS) experience pseudobulbar affect (PBA). PBA develops because of an underlying neurological condition, such as MS. […] We do not yet know what causes PBA. A part of the brain, called the cerebellum, helps monitor emotional responses. Damage to nerve pathways to the cerebellum may cause a loss of control over emotional expression. […] Several neurological conditions can cause this damage. This is why PBA is linked to neurological conditions, including: MS, Traumatic brain injury, Amyotrophic lateral sclerosis (ALS), Alzheimer’s, Parkinson’s, and Wilson’s diseases, Stroke, Brain tumors, Epilepsy.

• #1 We Interviewed a Doctor About PBA, the Neurological Disorder That Causes Uncontrollable Crying

  https://www.vice.com/en/article/pba-is-the-neurological-disorder-that-causes-uncontrollable-episodes-of-crying/

  PBA can be triggered by something happy that makes you cry, something sad that makes you laugh, or it can come out of nowhere. […] Patients talk to me about the fact that they feel sad inside but feel like they’re crying too often for no reason. […] Treatments for PBA are very effective, so you’ll know in a couple weeks whether PBA was a component of your problems if the crying goes away. […] Historically, people used to use antidepressants because crying is generally more common than laughter, and if someone has been crying, you would want to err on the side of caution that it might be depression. […] Now, most doctors use Nuedexta, which is made up of dextromethorphan that is also the active ingredient in Robitussin-DM and other cough syrups. […] Traumatic Brain Injury seems to be at the top of the list. […] I think for some people the condition doesn’t seem real because it doesn’t make sense to them. […] Charles Darwin described this condition over 130 years ago, so it’s not a new thing; there’s plenty of high quality research out there.

• #1 Pseudobulbar Affect Common After Brain Injury, Often Undiagnosed | The Becker Law FirmVisit our FacebookVisit our InstagramVisit our TwitterVisit our LinkedInVisit our YouTube channelprintchevron-leftchevron-rightchevron-downphonefacebookenvelopelinkedinx

  https://www.beckerjustice.com/blog/2011/june/pseudobulbar-affect-common-after-brain-injury-of/

  Individuals who have suffered a traumatic brain injury commonly experience surprising difficulties, different from those initially encountered, months and years after the injury occurs. Pseudobulbar affect, a condition that causes unexpected crying or laughter, often at odd or inappropriate times, is one type of problem that happens to many TBI sufferers. […] Pseudobulbar affect (also known as PBA) is a secondary condition, meaning it is caused by something else other than the actual TBI. It is associated with structural changes to the brain, which can result from injury, stroke, Alzheimer’s disease, multiple sclerosis (MS), and other ailments. […] The increased attention on PBA and the high number of TBI patients who suffer from the condition will hopefully lead to greater testing and diagnosis of this condition in the future.

• #1 Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02525-3

  Pseudobulbar affect is a very distressing and underdiagnosed neuropsychiatric disorder that causes contextually inappropriate episodes of laughing and crying and general emotional incontinence. […] Although many proposed etiologies exist, the most widely accepted theory espouses the disruption of a corticopontinecerebellar circuit that governs the modulation of emotional response. […] PBA is nearly always produced secondary to neurological trauma such as stroke, brain tumor, or progressive neurodegenerative disease such as amyotrophic lateral sclerosis (ALS). […] Although many proposed etiologies exist, PBA is thought to relate to the release of brainstem emotional control centers from regulation by the frontal lobes. […] The success in our patients case speaks to the efficacy of DM/Q for the treatment of PBA in acutely affected patients, but it also raises questions regarding the pathophysiological gate control model of PBA, which posits the cerebellum as the apparatus responsible for unconscious modulation of emotional expression, scaling it appropriately and producing an emotionally congruent response according to the contextual information transmitted via descending pathways from the sensory cortex through the frontal and temporal cortices.

• #1 What Is Pseudobulbar Affect?

  https://www.brainandlife.org/articles/what-is-pseudobulbar-affect

  Pseudobulbar affect (PBA) a condition that causes excessive and uncontrollable crying or laughing unrelated to either sadness or happiness can occur with many neurologic conditions, including Alzheimer’s disease and dementia, amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, stroke, and traumatic brain injury. […] People may develop PBA when parts of the brain and brain stem that control movement have been damaged on both sides of their brains. The underlying mechanism isn’t completely understood, but it may be that circuits that involve the cerebellum disrupt the coordination of emotion. Researchers continue to explore causes and treatment. To date, they don’t know why some people experience PBA and others do not. […] The condition is not related to medication or other psychiatric or neurologic disorders.

• #1 Pseudobulbar Affect: Symptoms, Treatments, and Outlook

  https://resources.healthgrades.com/right-care/mental-health-and-behavior/pseudobulbar-affect

  Pseudobulbar affect is classified as a neurological impairment, not a mental illness. It may be mistaken for depression, but there are some key differences. […] The severity of PBA may get better or worse over time, depending on the underlying cause and how well medications can manage the episodes. People with progressive conditions like Alzheimer’s may find that their PBA symptoms worsen over time. […] There is currently no known way to fix PBA permanently. However, medications like antidepressants or Nuedexta may relieve your symptoms. […] PBA is generally characterized by brief episodes of laughter, crying, or both that a person cannot control. It often occurs alongside ALS, Alzheimer’s disease, and stroke.

• #1 We Interviewed a Doctor About PBA, the Neurological Disorder That Causes Uncontrollable Crying

  https://www.vice.com/en/article/pba-is-the-neurological-disorder-that-causes-uncontrollable-episodes-of-crying/

  PBA is a mismatch between what you’re feeling on the inside and what you are showing on the outside, so if the two don’t line up we have a problem, said Fellus. […] However, Fellus believes that PBA is mainly caused by the harm of various neural circuits in the brain stem that are responsible for the brain’s emotional expressions. […] According to the Brain Injury Association of America, it’s estimated over one million people deal with PBA in North America alone. […] PBA expresses itself differently in every person. […] If it’s acquired during the early stages of a stroke or brain trauma, you generally get better and it could disappear completely in a couple of months to two years. […] For other neurological disorders like Parkinson’s, Alzheimer’s, and Multiple Sclerosis, it usually worsens over time until your brain has no more connections left to even create a smile.

• #1 Pseudobulbar affect – Wikipedia

  https://en.wikipedia.org/wiki/Pseudobulbar_affect

  PBA is a consequence of another neurologic disorder or brain injury. […] The specific pathophysiology involved in this frequently debilitating condition is still under investigation; the primary pathogenic mechanisms of PBA remain controversial. […] PBA is a condition that occurs secondary to neurological disease or brain injury, and is thought to result from disruptions of neural networks that control the generation and regulation of motor output of emotions. […] It is hypothesized that these primary neurologic injuries and diseases affect chemical signaling in the brain, which in turn disrupts the neurologic pathways that control emotional expression.

• #1 Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02525-3

  Our patient had experienced two devastating neurological traumas, both in anatomical areas that have been implicated in the corticopontinecerebellar circuit thought to be responsible for PBA. […] Further research is required in order to provide a more complete pathological picture of this complex neurological disease.

• #1 Impact of PBA: Patients may be suffering in silence

  https://www.nuedextahcp.com/impact-of-pba

  PBA occurs secondary to a variety of otherwise unrelated neurologic conditions, and is characterized by involuntary, sudden, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state. PBA is a specific condition, distinct from other types of emotional lability that may occur in patients with neurologic disease or injury. […] PBA can strike anytime, anywhere. Because episodes are uncontrollable, patients may not be able to stop crying and/or laughing in inappropriate settings. […] Since crying is common in depression, patients may attribute their PBA crying symptoms to their depression. They may not bring up these symptoms because they don’t realize that PBA is a separate condition. […] Laughing and crying are normal displays of emotion, but in patients with PBA, they can be exaggerated or incongruent with their underlying mood. So patients may not realize that what they’re experiencing is part of a real neurologic condition.

• #1 About PBA | Nuedexta

  https://www.nuedexta.com/about-pba

  PBA is a medical condition that causes crying and/or laughing that is sudden, frequent, uncontrollable and is exaggerated or doesn’t match how you feel. […] PBA may be caused by neurological damage related to your neurologic condition or brain injury but is a separate and treatable condition. […] The uncontrollable crying and/or laughing episodes of PBA may be a result of brain damage caused by neurologic conditions or brain injuries. […] Damage to the cerebellum, from a neurological condition or brain injury, may lead to miscommunication with the cerebral cortex. This miscommunication is thought to result in PBA episodes. […] PBA is distinct and different from other types of emotional changes caused by neurologic disease or injury.

• #1 6 Pseudobulbar Affect Symptoms: Intense Emotions and More

  https://www.healthline.com/health/neurological-health/pba-signs

  People who have a brain injury or neurological disease can also develop pseudobulbar affect (PBA), which causes sudden, uncontrollable, and exaggerated emotional outbursts. […] The shifts are due to a problem with the part of the brain that normally regulates emotional responses to situations. […] PBA is not dangerous, but it can be disruptive to your loved ones life. […] For this reason, and because PBA can overlap with or mimic depression, its important to have your loved one contact a doctor. […] A few medications are available to treat PBA. They include a drug called dextromethorphan/quinidine (Nuedexta) and antidepressants. […] Nuedexta is the only medication that the Food and Drug Administration (FDA) has approved to treat PBA. But antidepressants may be prescribed off-label. […] Nuedexta and antidepressants do not cure PBA, but they can reduce the intensity and frequency of emotional outbursts.

• #1 Pseudobulbar Affect: Causes, PBA Quiz, and Management | PBAInfo

  https://www.pbainfo.org/

  Pseudobulbar Affect (PBA) is a medical condition causing sudden, frequent, uncontrollable crying and/or laughing that doesnt match how you feel inside. It can happen in people with a brain injury or certain neurologic conditions. […] PBA is sometimes mistaken for or attributed to depression, but the 2 are separate conditions with their own symptoms. […] Neurologists, psychiatrists, internists, neuropsychiatrists, and physiatrists are types of healthcare providers who may be able to help identify symptoms and properly diagnose PBA.

• #1 Pseudobulbar Affect (PBA) – Brain Injury Association of America

  http://biausa.org/brain-injury/about-brain-injury/psuedobulbar-affect-information

  PBA episodes, which often involve uncontrollable laughter or involuntary crying, are unpredictable. They can occur any time and last several seconds or minutes. […] People who experience PBA (and their caregivers and those around them) may feel frustrated, embarrassed, worried, or confused. Untreated, PBA may negatively affect everything from relationships and social situations to work and quality of life. Treatment can help. […] Symptoms can range from mildly disturbing to seizure-like episodes.

• #1 Pseudobulbar Affect: Symptoms, Treatments, and Outlook

  https://resources.healthgrades.com/right-care/mental-health-and-behavior/pseudobulbar-affect

  Pseudobulbar affect (PBA) refers to brief, uncontrollable episodes of laughing, crying, or both. PBA is associated with various neurological conditions, such as traumatic brain injury, Alzheimer’s disease, and stroke. […] The ASA states that PBA occurs when there is a disconnect between the frontal lobe, brain stem, and cerebellum. […] PBA is associated with various neurological conditions, such as: stroke, traumatic brain injury (TBI), Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis, brain tumors. […] PBA can have adverse effects on quality of life. It may be disruptive to your daily activities and increase stress. However, following your doctor’s treatment plan as closely as possible may help manage the condition and increase your ability to maintain your typical routine.

• #2 Pseudobulbar affect – Wikipedia

  https://en.wikipedia.org/wiki/Pseudobulbar_affect

  PBA is a consequence of another neurologic disorder or brain injury. […] The specific pathophysiology involved in this frequently debilitating condition is still under investigation; the primary pathogenic mechanisms of PBA remain controversial. […] PBA is a condition that occurs secondary to neurological disease or brain injury, and is thought to result from disruptions of neural networks that control the generation and regulation of motor output of emotions. […] It is hypothesized that these primary neurologic injuries and diseases affect chemical signaling in the brain, which in turn disrupts the neurologic pathways that control emotional expression.

• #2 What is the Pseudobulbar Affect? | Neuropsychology Program | Barrow Neurological InstituteSecond Opinion IconSecond Opinion IconGroup 12

  https://www.barrowneuro.org/condition/pseudobulbar-affect/

  Pseudobulbar affect (PBA) describes a disorder that causes a person to experience uncontrollable episodes of crying, laughing, or other emotional displays that are out of context in their social interactions. […] Typically, pseudobulbar affect occurs secondary to other neurological conditions. […] Pseudobulbar affect typically occurs secondary to a neurological injury or disease, such as: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumors, Dementia, Multiple sclerosis, Stroke, Parkinson’s disease, Traumatic brain injury (TBI). […] But again, pseudobulbar usually does not develop unless a pre-existing neurological disorder or injury is present. […] Pseudobulbar affect may also occur in people who suffer a physiological disorder such as Graves disease, hyperthyroidism, or hypothyroidism.

• #2 Pseudobulbar Affect (PBA) | American Stroke Association

  https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects/pseudobulbar-affect

  When the parts of the brain that control emotions are injures, pseudobulbar affect (PBA) occurs. This neurological condition is also known as emotional lability, reflex crying or involuntary emotional expression disorder, among others. […] PBA occurs as a result of several neurological diseases, such as: Stroke, Amyotrophic lateral sclerosis (ALS), Parkinson’s, Traumatic brain injury, Multiple sclerosis, Dementia. […] The cause is a neurological disconnect between the brain’s nerve connections or chemistry that interferes with accurate emotional expression. […] Ongoing research into stroke, traumatic brain injury, multiple sclerosis, Alzheimer’s disease and ALS continues to increase our knowledge about PBA.

• #2 When Tears Keep Falling: A Case Report of Pseudobulbar Affect

  https://www.psychiatrist.com/pcc/when-tears-keep-falling-case-report-pseudobulbar-affect/

  Pseudobulbar affect (PBA) is a disorder of affect regulation or of emotional expression. The phenomenon was described as early as 1872 by Charles Darwin. Since 1969, 3 groups of diagnostic criteria have been described: those of Poeck (1969), Cummings et al (2006), and Miller et al (2011). Clinically, PBA is characterized by paroxistic sudden episodes of exaggerated and uncontrolled emotional expression, usually of laughter or weeping, not necessarily congruent with the patients mood, feelings, or situational context. […] PBA mainly occurs in patients with neurologic disorders. It has also been reported in patients with secondary brain lesions of other etiologies, such as brain tumor, aneurysm, or herpetic encephalitis. The most commonly associated disorders are Alzheimers disease, lateral amiotrophic sclerosis, multiple sclerosis, Parkinsons disease, stroke, brain trauma, and brain tumor. The exact prevalence of PBA is unknown, and it is reported as being largely underdiagnosed. In stroke patients, PBA is a common disorder, affecting about 1 in 5 survivors in both acute and post-acute phases and 1 in 8 survivors beyond 6 months post-stroke.

• #2 Pseudobulbar affect (PBA) | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/pseudobulbar-affect-pba

  Research has shown that neurotransmitters such as serotonin, glutamate, dopamine, and norepinephrine may play a role in the development of PBA. […] PBA has been linked to traumatic brain injury (TBI), with many patients developing the condition following a blow to the head. It has also been associated with neurological diseases such as Alzheimer’s disease, multiple sclerosis (MS), stroke, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). […] PBA has also been reported as a symptom of certain thyroid disorders and diseases such as Graves disease.

• #2 Introduction to Pseudobulbar Affect: Setting the Stage for Recognition and Familiarity With This Challenging Disorder

  https://www.ajmc.com/view/introduction-to-pseudobulbar-affect-setting-the-stage-for-recognition-and-familiarity-with-this-challenging-disorder

  Pseudobulbar affect (PBA) is thought to center around preexisting neurological conditions, which include Parkinson disease, multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer disease, traumatic brain injury, and stroke. […] The causes of PBA are complex, but it is believed to result from the alteration of neuronal pathways, primarily in the frontal lobe of the brain, which control emotions. […] PBA is associated with brain injury or a neurological disease or disorder that alters normal neuronal control and affect likely linked to frontal lobe function and other areas of the brain, such as the brainstem and cerebellum. […] The pathways related to PBA are multifaceted and thought to result from disruptions of neural networks that control the generation and regulation of motor output of emotions.

• #2 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  PBA occurs secondary to many neurological disease states. The most common diseases associated with PBA are Alzheimers disease (AD), ALS, multiple sclerosis (MS), Parkinsons disease (PD), stroke, and traumatic brain injury (TBI). The exact cause of PBA is unknown, but it is thought to be related to nerve impulse disruption from the cerebellum to the limbic and paralimbic systems. Dysregulation and disinhibition in the frontal cortex are also thought to be part of the process underlying PBA. The release hypothesis, gate control theory, and dysfunction of neurotransmitters theory are among the proposed mechanisms of PBA. […] The release hypothesis explains the disruption of cortical inhibition in the upper brainstem center, leading to a release of lower bulbar nuclei affecting responses to laughing and crying. A revised theory behind the release hypothesis suggests that cerebellar structures involved in laughing and crying are operating on incomplete information because of the lesions affecting this part of the brain.

• #2 Enhancing Approaches to the Identification and Management of Pseudobulbar Affect

  https://www.psychiatrist.com/jcp/enhancing-approaches-identification-management-pseudobulbar/

  Pseudobulbar affect (PBA) is a socially debilitating condition that primarily affects people with neurologic diseases, such as Alzheimers disease or multiple sclerosis. […] While its exact etiology is unknown, PBA likely results from disruptions in the brain structures and/or neurotransmitters that regulate emotions. […] The exact causes of PBA are unclear, although it is believed to be related to disruption of neural networks involving the limbic and paralimbic systems modulated by the cerebellum. […] Studies of the etiology of PBA in patients with MS suggest that the disorder is due to disinhibition of the gate control mechanisms that normally hold emotional expressions in check. […] Disruption of cortico-limbic-subcortico-thalamic-pontocerebellar pathways that control human emotion is suggested in each of the previous theories. […] This suggests that interventions targeting these modulators may offer a possible avenue for treatment.

• #2 Pseudobulbar affect (pathological laughing and crying) | MS Trust

  https://mstrust.org.uk/a-z/pseudobulbar-affect-pathological-laughing-and-crying

  The neurotransmitters thought to be involved in PBA are serotonin, dopamine, glutamate and noradrenaline (also known as norepinephrine). These neurotransmitters are also involved with depression and manic episodes, and as indicated previously pseudobulbar affect can sometimes be mistaken for depression.

• #2 What Is Pseudobulbar Affect? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/pseudobulbar-affect/

  Dysfunction of Neurotransmitters Theory According to this theory, the neurotransmitters serotonin, dopamine, glutamate, and sigma-1 are disrupted in various brain pathways and cause the emotional expressions to be altered. […] Although PBA is associated with brain injury and different pre-existing neurological conditions, experts arent certain why some individuals develop it and others dont; there isnt a way to prevent or reduce the risk of developing pseudobulbar affect.

• #2 Pseudobulbar Affect | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117649/all/Pseudobulbar_Affect

  Pseudobulbar affect (PBA) is a neuropsychiatric disorder consisting of brief emotional outbursts thought to be caused by disruption of corticobulbar or cortico-subcortical-thalamo-cerebellar circuitry. […] Disruption of emotional motor pathway consisting of cortico-pontine-cerebellar circuitry is hypothesized to be at the root of PBA. […] PBA is believed to result from dysfunction anywhere along this circuit from cortex through basis pontis to cerebellum, disrupting coordination of mood and behavioral output and causing disinhibition of emotional motor expression. […] Disruption of glutamate and serotonin systems are thought to be central to PBA.

• #2 Pseudobulbar Affect (PBA) | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) is a problem in the brain that causes you to laugh or cry for no reason. […] Brain damage from a stroke, brain tumour, or head trauma can lead to PBA. PBA can also happen along with such conditions as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, ALS, and dementia. […] Normally, the „feel” and „express” parts of your brain work together. But with PBA, the expressive part of your brain can trigger behaviour on its own.

• #2 About PBA | Nuedexta

  https://www.nuedexta.com/about-pba

  PBA is a medical condition that causes crying and/or laughing that is sudden, frequent, uncontrollable and is exaggerated or doesn’t match how you feel. […] PBA may be caused by neurological damage related to your neurologic condition or brain injury but is a separate and treatable condition. […] The uncontrollable crying and/or laughing episodes of PBA may be a result of brain damage caused by neurologic conditions or brain injuries. […] Damage to the cerebellum, from a neurological condition or brain injury, may lead to miscommunication with the cerebral cortex. This miscommunication is thought to result in PBA episodes. […] PBA is distinct and different from other types of emotional changes caused by neurologic disease or injury.

• #2 Pseudobulbar Affect: Causes, PBA Quiz, and Management | PBAInfo

  https://www.pbainfo.org/

  Pseudobulbar Affect (PBA) is a medical condition causing sudden, frequent, uncontrollable crying and/or laughing that doesnt match how you feel inside. It can happen in people with a brain injury or certain neurologic conditions. […] PBA is sometimes mistaken for or attributed to depression, but the 2 are separate conditions with their own symptoms. […] Neurologists, psychiatrists, internists, neuropsychiatrists, and physiatrists are types of healthcare providers who may be able to help identify symptoms and properly diagnose PBA.

• #2 What Is Pseudobulbar Affect?

  https://www.brainandlife.org/articles/what-is-pseudobulbar-affect

  Pseudobulbar affect (PBA) a condition that causes excessive and uncontrollable crying or laughing unrelated to either sadness or happiness can occur with many neurologic conditions, including Alzheimer’s disease and dementia, amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, stroke, and traumatic brain injury. […] People may develop PBA when parts of the brain and brain stem that control movement have been damaged on both sides of their brains. The underlying mechanism isn’t completely understood, but it may be that circuits that involve the cerebellum disrupt the coordination of emotion. Researchers continue to explore causes and treatment. To date, they don’t know why some people experience PBA and others do not. […] The condition is not related to medication or other psychiatric or neurologic disorders.

• #2 Treatment of pseudobulbar affect (PBA) in a patient with a history of traumatic brain injury, partial brain resection, and brainstem stroke: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02525-3

  Our patient had experienced two devastating neurological traumas, both in anatomical areas that have been implicated in the corticopontinecerebellar circuit thought to be responsible for PBA. […] Further research is required in order to provide a more complete pathological picture of this complex neurological disease.

• #2 The epidemiology and pathophysiology of pseudobulbar affect and its association with neurodegeneration

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6065587/

  Pseudobulbar affect is a disorder resulting from neurologic damage manifesting as sudden, stereotyped affective outbursts that are not reflective of internal emotion. […] The disorder appears to result from a disruption of the cortico-limbic-subcortical-thalamic-pontocerebellar network involved in emotional expression and regulation with resulting disruptions of neurotransmitter systems. […] The pathophysiology of PBA is likely varied and best conceptualized as a focal or diffuse disruption in the complex neurocircuitry or neurochemistry involved in the inhibition of emotional expression. […] One of the original hypotheses about PBA came from Wilson, who proposed that there was disruption of the cortical inhibition to an upper brainstem center followed by release of lower bulbar nuclei that coordinate the motor responses associated with laughing and crying.

• #2 Pseudobulbar Affect (PBA): Symptoms, Causes, & Treatment

  https://www.webmd.com/brain/pseudobulbar-affect

  Pseudobulbar affect (PBA) is a nervous system disorder that can make you laugh, cry, or become angry without being able to control when it happens. […] Scientists believe that PBA may result from damage to the prefrontal cortex, the area of your brain that helps control emotions. Damage to other parts of the brain, as well as changes in brain chemicals linked to depression and hyper moods (mania), could also play a role. […] An injury or disease that affects your brain can lead to PBA. Other brain conditions commonly linked to PBA include: Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Brain tumor, Dementia, Multiple sclerosis (MS), Parkinson’s disease, Traumatic brain injury. […] PBA can happen if you’ve had a brain injury or live with a neurological condition such as a stroke. Research shows that more than one-third of people who’ve had a stroke have symptoms that suggest PBA.

• #2 Pseudobulbar Affect Illustrated & Explained Using Medical Animation

  https://www.scientificanimations.com/medical-animation-pseudobulbar-affect-symptoms-causes-treatment/uncategorized/

  Pseudobulbar affect or PBA is a medical condition in which the patient has emotional outbursts of laughing or crying without any kind of triggering. […] This happens when part of the cerebellum is damaged by lesions or nerve issues. […] PBA appears in people with neurological condition or injuries such as ALS or Amyotrophic lateral sclerosis, MS or Multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, Traumatic brain injury, ADHD or Attention deficit hyperactivity disorder, Grave’s disease. […] As per medical resources, it is assumed that PBA is associated with the injuries in the neurological pathways, which are responsible for the effect and regulation of external expression of emotion. […] People who have a history of stroke are more prone to getting affected by PBA.

• #2 Pseudobulbar affect (PBA) | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/pseudobulbar-affect-pba

  Pseudobulbar affect (PBA) is believed to result from damage to brain regions that regulate emotional responses, such as the prefrontal cortex and cerebellum, and is often linked to traumatic brain injuries, neurological diseases (like Alzheimer’s and multiple sclerosis), and certain thyroid disorders. […] Experts do not fully understand the cause of PBA. Reigning theories hold that PBA may result from damage to parts of the brain that cause disruptions to the neural network, so identifying one specific region as the culprit is not often possible. Research points to damage to the prefrontal cortex region of the brain as a likely precursor to the disorder. […] Damage to the cerebellum, another brain region involved in the management and monitoring of emotions, is also a suspected cause of PBA.

• #2 Pseudobulbar Affect Versus Depression: Issues in Diagnosis and Treatment

  https://www.psychiatrictimes.com/view/pseudobulbar-affect-versus-depression-issues-diagnosis-and-treatment

  Research also suggests that abnormal glutaminergic and serotonergic neurotransmission may contribute to PBA. However, numerous other neurotransmitters may also be involved given their impact on emotion, such as dopamine, norepinephrine, and acetylcholine. The exact etiology of PBA is unknown, but research supports a dysfunction of neural circuits and neurotransmitters that modulate the motor expression of emotion.

• #2

  https://www.geron.org/News-Events/GSA-News/Press-Room/Press-Releases/pseudobulbar-affect-an-often-overlooked-condition

  Pseudobulbar affect (PBA) is characterized by bouts of uncontrolled crying or laughing that are disproportionate or inappropriate to the social context and are not associated with depression or anxiety. […] PBA typically occurs in patients who have a brain injury or neurologic disorder, such as amyotrophic lateral sclerosis (ALS), extrapyramidal and cerebellar disorders (e.g., Parkinsons disease), multiple sclerosis (MS), traumatic brain injury, Alzheimers disease and other dementias, stroke, and brain tumors. The exact cause is unknown, but it appears that the disease or injury disrupts the neural networks and neurotransmitters that are responsible for expression of emotion, especially in the cerebellum. […] Although PBA is common in many neurologic conditions, it is often underrecognized and undertreated.

• #2 Pseudobulbar affect | MedLink Neurology

  https://www.medlink.com/articles/pseudobulbar-affect

  Pathophysiologically, pathological laughing and crying involves white matter degeneration, which can impair voluntary control over emotional expressions. […] Emotional incontinence manifested as episodes of crying and laughter are frequent in patients with small lenticulocapsular stroke. […] A case of severe pathologic crying has been described after a limited left anterior choroidal artery territory infarction. […] Furthermore, a case pseudobulbar affect was reported in an elderly woman with small vessel ischemic disease and alcohol abuse disorder. […] In cases of unilateral lesions, the left-sided lesions are more often associated with crying and the right-sided lesions with laughter. […] In the circuitry involved in pathologic laughter and crying, ventral pons appears to be a crucial location, but further investigations are needed to determine how lesions in the basis pontis affect the activity of the cerebellum and the brainstem.

• #2 About PBA | PBAinfo

  https://www.pbainfo.org/about-pba

  PBA is a condition that causes uncontrollable crying and/or laughing that happens suddenly and frequently. It can happen in people with a brain injury or certain neurologic conditions. […] PBA is neurologic, which means its caused by damage to the nervous system. […] PBA occurs in the context of a neurologic condition/injury affecting the brain and is not explained by other causes such as medication use.

• #2 Review of the Diagnosis and Management of Pseudobulbar Affect

  https://www.uspharmacist.com/article/review-of-the-diagnosis-and-management-of-pseudobulbar-affect

  The gate control theory proposes inhibition of the mechanism regulating emotional expression. MS and related neurological damage are thought to be involved in disrupting activity in the cortical structures related to sensory, motor, and emotional processes, along with overactive motor cortical areas. […] In the dysfunctional neurotransmitters theory, serotonin, dopamine, glutamate, and sigma-1 are disrupted in various brain pathways, leading to alterations in emotional expression. Therefore, medications that modulate these neurotransmitters may play a role in providing therapeutic benefit.

• #2 6 Pseudobulbar Affect Symptoms: Intense Emotions and More

  https://www.healthline.com/health/neurological-health/pba-signs

  People who have a brain injury or neurological disease can also develop pseudobulbar affect (PBA), which causes sudden, uncontrollable, and exaggerated emotional outbursts. […] The shifts are due to a problem with the part of the brain that normally regulates emotional responses to situations. […] PBA is not dangerous, but it can be disruptive to your loved ones life. […] For this reason, and because PBA can overlap with or mimic depression, its important to have your loved one contact a doctor. […] A few medications are available to treat PBA. They include a drug called dextromethorphan/quinidine (Nuedexta) and antidepressants. […] Nuedexta is the only medication that the Food and Drug Administration (FDA) has approved to treat PBA. But antidepressants may be prescribed off-label. […] Nuedexta and antidepressants do not cure PBA, but they can reduce the intensity and frequency of emotional outbursts.

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