New Study: Inappropriate laughter and crying
Posted 10 April 2010 - 08:35 AM
You should be aware as we have discussed in the past that many PD patients may laugh or cry without feeling happy or sad. This emotional expression problem is quite treatable. If you have this please consult your doctor. He is a new study out this week from Wake Forest.
J Neurol. 2010 Apr 8. [Epub ahead of print]
Pseudobulbar affect: prevalence and quality of life impact in movement disorders.
Strowd RE, Cartwright MS, Okun MS, Haq I, Siddiqui MS.
Department of Neurology, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA, email@example.com.
Pseudobulbar affect (PBA) is an affective disinhibition syndrome characterized by sudden, involuntary outbursts of inappropriate crying or laughing. We have previously reported the prevalence of PBA in movement disorders using an interviewer-administered questionnaire that had not been validated. In the current study, a validated self-administered screening instrument, the Center for Neurologic Study-Lability Scale (CNS-LS), was used to study the prevalence of PBA, its association with mood symptoms, and the quality of life impact. Two hundred sixty-nine patients met inclusion criteria (consent, age > 18 years, formal diagnosis, and completion of the CNS-LS). The CNS-LS was used to assess PBA at a cutoff score of 17 (utilized from multiple sclerosis studies). The Beck Depression Inventory (BDI) scale and Parkinson's disease questionnaire (PDQ-39) were used to assess depressive symptoms and quality of life. Logistic regression analysis was used to predict associations with PBA. PBA was prevalent in 7.1% (n = 19) of movement disorder patients. No significant difference in prevalence was observed by patient diagnosis: 7.1% (12/168) in Parkinson's disease (PD), 11.4% (4/35) in essential tremor, 0% (0/13) in dystonia, 0% (0/16) in psychogenic movement disorders, and 10.7% (3/28) in patients with other movement disorders. Patients with PBA had higher BDI depression scores (p < 0.0001) and lower PDQ-39 emotional well-being subscores (p < 0.0001). Patients taking antidepressant medications had significantly higher rates of PBA (p = 0.0008). The prevalence of PBA symptoms was 7.1% in PD and all movement disorders patients. Patients with PBA tend to have more depressive symptoms and poorer quality of life.
PMID: 20376475 [PubMed - as supplied by publisher]
Michael S. Okun, M.D.
Author of Amazon Kindle, Paperback and Audio of 10 Breakthrough Therapies for Parkinson's Disease
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips
Posted 17 May 2010 - 12:51 AM
Posted 17 May 2010 - 12:56 AM
Posted 25 May 2010 - 03:53 PM
Tremors, stiffness, voice problems can be part of PD. Having said that, he is on a lot of blood pressure medications, he is also on anti anxiety agents/muscle relxants and I am not sure how much of this is a result of the medication side effects and also from his high blood pressure.
The one other area that can throw a kink into this is if he is depressed. Everything can worsen during depression.
So there are lots to sort out. Hopefully, all these will be addressed by his doctor, one at a time.
Best of luck to you!
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