Suspected Pseudobulbar Affect in Neurodegenerative Disease.
Alzheimer's disease
dementia
pseudobulbar affect
Journal
International journal of geriatric psychiatry
ISSN: 1099-1166
Titre abrégé: Int J Geriatr Psychiatry
Pays: England
ID NLM: 8710629
Informations de publication
Date de publication:
Oct 2024
Oct 2024
Historique:
revised:
20
09
2024
received:
12
06
2024
accepted:
14
10
2024
medline:
22
10
2024
pubmed:
22
10
2024
entrez:
21
10
2024
Statut:
ppublish
Résumé
To investigate the association between suspected pseudobulbar affect (PBA), clinical diagnosis, cognitive testing, and self-reported mood in older adults presenting for evaluation of dementia. Patients presenting to an outpatient memory disorders clinic (N = 311). We used traditional and novel network modeling approaches to examine associations between neuropsychological (NP) tests, patient and clinician rating scales, and the Center for Neurological Study-Lability Scale (CNS-LS) among patients with suspected AD (n = 133) and other neurocognitive diagnosis (n = 178). We then examined differences in test performance between patients with and without suspected PBA (CNS-LS cut-off of ≥ 13), while accounting for demographic and psychiatric covariates with propensity score matching. Group differences were assessed with Bayesian models. Prevalence of suspected PBA in AD was slightly less than half (44.4%) and at a similar rate in other dementias (e.g., 46.9% in CVD and 45.5% in LBD). In network models, the CNS-LS was associated with higher anxiety and better word list recall. After accounting for covariates, AD patients with suspected PBA performed better on word list recall β Patients with suspected PBA and AD diagnosis had better memory recall and recognition than those without suspected PBA, suggesting that impaired emotional regulation may be an early sign of AD in patients with less prominent memory decline. Better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification, education, and initiation of treatment.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e70002Subventions
Organisme : NIH HHS
ID : P30AG072978
Pays : United States
Organisme : VA Merit
ID : RX004828-01, VA RR&D
Organisme : VA Merit
ID : CX-002400-01A2, VA CSR&D
Organisme : VA CDA
ID : IK2 CX002065, VA CSR&D
Informations de copyright
© 2024 John Wiley & Sons Ltd.
Références
A. Ahmed and Z. Simmons, “Pseudobulbar Affect: Prevalence and Management,” Therapeutics and Clinical Risk Management (2013): 483–489, https://doi.org/10.2147/tcrm.s53906.
C. Kim, “Review of the Diagnosis and Management of Pseudobulbar Affect,” U.S. Pharmacist 42 (2017): 31–35.
D. B. Arciniegas, E. C. Lauterbach, D. L. Ginsberg, et al., “The Differential Diagnosis of Pseudobulbar Affect (PBA): Distinguishing PBA Among Disorders of Mood and Affect,” supplement, CNS Spectrums 10, no. S5 (2005): 1–16, https://doi.org/10.1017/s1092852900026602.
S. S. Work, J. A. Colamonico, W. G. Bradley, and R. E. Kaye, “Pseudobulbar Affect: An Under‐Recognized and Under‐Treated Neurological Disorder,” Advances in Therapy 28, no. 7 (2011): 586–601, https://doi.org/10.1007/s12325‐011‐0031‐3.
R. R. King and J. P. Reiss, “The Epidemiology and Pathophysiology of Pseudobulbar Affect and Its Association With Neurodegeneration,” Degenerative Neurological and Neuromuscular Disease (2013): 23–31, https://doi.org/10.2147/dnnd.s34160.
W. Turell, A. Roc, E. Pioro, and A. Howson, “Living With the Burden of Pseudobulbar Affect: A Qualitative Analysis of the Effects of Education on Patient Experience,” Journal of Patient Experience 7, no. 6 (2020): 1324–1330, https://doi.org/10.1177/2374373519899597.
B. R. Brooks, D. Crumpacker, J. Fellus, D. Kantor, and R. E. Kaye, “PRISM: A Novel Research Tool to Assess the Prevalence of Pseudobulbar Affect Symptoms Across Neurological Conditions,” PLoS One 8 (2013): e72232, https://doi.org/10.1371/journal.pone.0072232.
J. Colamonico, A. Formella, and W. Bradley, “Pseudobulbar Affect: Burden of Illness in the USA,” Advances in Therapy 29, no. 9 (2012): 775–798, https://doi.org/10.1007/s12325‐012‐0043‐7.
R. E. Strowd, M. S. Cartwright, M. S. Okun, I. Haq, and M. S. Siddiqui, “Pseudobulbar Affect: Prevalence and Quality of Life Impact in Movement Disorders,” Journal of Neurology 257, no. 8 (2010): 1382–1387, https://doi.org/10.1007/s00415‐010‐5550‐3.
B. Brooks, R. Thisted, S. H. Appel, et al., “Treatment of Pseudobulbar Affect in ALS With Dextromethorphan/Quinidine: A Randomized Trial,” Neurology 63, no. 8 (2004): 1364–1370, https://doi.org/10.1212/01.wnl.0000142042.50528.2f.
J. Cummings, “The Role of Neuropsychiatric Symptoms in Research Diagnostic Criteria for Neurodegenerative Diseases,” American Journal of Geriatric Psychiatry 29, no. 4 (2021): 375–383, https://doi.org/10.1016/j.jagp.2020.07.011.
Z. Ismail, E. E. Smith, Y. Geda, et al., “Neuropsychiatric Symptoms as Early Manifestations of Emergent Dementia: Provisional Diagnostic Criteria for Mild Behavioral Impairment,” Alzheimer's and Dementia 12, no. 2 (2016): 195–202, https://doi.org/10.1016/j.jalz.2015.05.017.
J. E. Duda, “History and Prevalence of Involuntary Emotional Expression Disorder,” supplement, CNS Spectrums 12, no. S5 (2007): 6–10, https://doi.org/10.1017/s1092852900025955.
H. S. Wortzel, T. J. Oster, C. A. Anderson, and D. B. Arciniegas, “Pathological Laughing and Crying: Epidemiology, Pathophysiology and Treatment,” CNS Drugs 22, no. 7 (2008): 531–545, https://doi.org/10.2165/00023210‐200822070‐00001.
A. Miller, H. Pratt, and R. B. Schiffer, “Pseudobulbar Affect: The Spectrum of Clinical Presentations, Etiologies and Treatments,” Expert Review of Neurotherapeutics 11, no. 7 (2011): 1077–1088, https://doi.org/10.1586/ern.11.68.
S. Moore, L. Gresham, M. Bromberg, E. J. Kasarkis, and R. A. Smith, “A Self Report Measure of Affective Lability,” Journal of Neurology, Neurosurgery & Psychiatry 63, no. 1 (1997): 89–93, https://doi.org/10.1136/jnnp.63.1.89.
R. A. Smith, J. E. Berg, L. E. Pope, J. D. Callahan, D. Wynn, and R. A. Thisted, “Validation of the CNS Emotional Lability Scale for Pseudobulbar Affect (Pathological Laughing and Crying) in Multiple Sclerosis Patients,” Multiple Sclerosis Journal 10, no. 6 (2004): 679–685, https://doi.org/10.1191/1352458504ms1106oa.
W. L. Buntine, “Operations for Learning With Graphical Models,” Journal of Artificial Intelligence Research 2 (1994): 159–225, https://doi.org/10.1613/jair.62.
S. Epskamp, D. Borsboom, and E. I. Fried, “Estimating Psychological Networks and Their Accuracy: A Tutorial Paper,” Behavior Research Methods 50, no. 1 (2018): 195–212, https://doi.org/10.3758/s13428‐017‐0862‐1.
E. J. Emond and D. W. Mason, “A New Rank Correlation Coefficient With Application to the Consensus Ranking Problem,” Journal of Multi‐Criteria Decision Analysis 11, no. 1 (2002): 17–28, https://doi.org/10.1002/mcda.313.
L. R. Tucker and C. Lewis, “A Reliability Coefficient for Maximum Likelihood Factor Analysis,” Psychometrika 38 (1973): 1–10, https://doi.org/10.1007/bf02291170.
P. M. Bentler, “Comparative Fit Indexes in Structural Models,” Psychological Bulletin 107, no. 2 (1990): 238–246, https://doi.org/10.1037/0033‐2909.107.2.238.
W. Browne and R. Cudeck, “Alternative Ways of Assessing Model Fit,” Sociological Methods & Research 21, no. 2 (1993): 230–258, https://doi.org/10.1177/0049124192021002005.
J. Chen and Z. Chen, “Extended Bayesian Information Criteria for Model Selection With Large Model Spaces,” Biometrika 95, no. 3 (2008): 759–771, https://doi.org/10.1093/biomet/asn034.
P. C. Austin, “An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies,” Multivariate Behavioral Research 46, no. 3 (2011): 399–424, https://doi.org/10.1080/00273171.2011.568786.
A. E. Raftery, “Bayesian Model Selection in Social Research,” Sociological Methodology 25 (1995): 111–163, https://doi.org/10.2307/271063.
L. Phuong, S. Garg, J. E. Duda, M. B. Stern, and D. Weintraub, “Involuntary Emotional Expression Disorder (IEED) in Parkinson's Disease,” Parkinsonism & Related Disorders 15, no. 7 (2009): 511–515, https://doi.org/10.1016/j.parkreldis.2009.01.001.
J. R. Fonda, J. L. Rudolph, R. E. McGlinchey, et al., “Identification of Pseudobulbar Affect Symptoms in Veterans With Possible Traumatic Brain Injury,” Journal of Rehabilitation Research and Development 52, no. 7 (2015): 839–850, https://doi.org/10.1682/jrrd.2014.08.0191.
Pseudobulbar Affect (PBA) Self‐Advocacy Toolkit (2022), https://www.biausa.org/wp‐content/uploads/PBA‐Self‐Advocacy‐Toolkit‐1.pdf.
R. S. Doody, S. D’amico, A. J. Cutler, et al., “An Open‐Label Study to Assess Safety, Tolerability, and Effectiveness of Dextromethorphan/Quinidine for Pseudobulbar Affect in Dementia: PRISM II Results,” CNS Spectrums 21, no. 6 (2016): 450–459, https://doi.org/10.1017/s1092852915000620.
K. Foley, R. T. Konetzka, A. Bunin, and C. Yonan, “Prevalence of Pseudobulbar Affect Symptoms and Clinical Correlates in Nursing Home Residents,” International Journal of Geriatric Psychiatry 31, no. 7 (2016): 694–701, https://doi.org/10.1002/gps.4374.
W. S. Eikelboom, E. van den Berg, E. H. Singleton, et al., “Neuropsychiatric and Cognitive Symptoms Across the Alzheimer Disease Clinical Spectrum: Cross‐Sectional and Longitudinal Associations,” Neurology 97, no. 13 (2021): e1276–e1287, https://doi.org/10.1212/wnl.0000000000012598.
M. C. Masters, J. C. Morris, and C. M. Roe, “‘Noncognitive’ Symptoms of Early Alzheimer Disease: A Longitudinal Analysis,” Neurology 84, no. 6 (2015): 617–622, https://doi.org/10.1212/wnl.0000000000001238.
L. C. Banning, I. H. Ramakers, S. Köhler, et al., “The Association Between Biomarkers and Neuropsychiatric Symptoms Across the Alzheimer's Disease Spectrum,” American Journal of Geriatric Psychiatry 28, no. 7 (2020): 735–744, https://doi.org/10.1016/j.jagp.2020.01.012.
M. Defrancesco, J. Marksteiner, G. Kemmler, et al., “Specific Neuropsychiatric Symptoms Are Associated With Faster Progression in Alzheimer’s Disease: Results of the Prospective Dementia Registry (PRODEM‐Austria),” Journal of Alzheimer's Disease 73, no. 1 (2020): 125–133, https://doi.org/10.3233/jad‐190662.
K. P. Ng, H. Chiew, P. Rosa‐Neto, N. Kandiah, Z. Ismail, and S. Gauthier, “Associations of AT (N) Biomarkers With Neuropsychiatric Symptoms in Preclinical Alzheimer’s Disease and Cognitively Unimpaired Individuals,” Translational Neurodegeneration 10 (2021): 1–14, https://doi.org/10.1186/s40035‐021‐00236‐3.
G. M. McKhann, D. S. Knopman, H. Chertkow, et al., “The Diagnosis of Dementia Due to Alzheimer’s Disease: Recommendations From the National Institute on Aging‐Alzheimer’s Association Workgroups on Diagnostic Guidelines for Alzheimer's Disease,” Alzheimer's and Dementia 7, no. 3 (2011): 263–269, https://doi.org/10.1016/j.jalz.2011.03.005.
P. B. Rosenberg, M. M. Mielke, B. S. Appleby, E. S. Oh, Y. E. Geda, and C. G. Lyketsos, “The Association of Neuropsychiatric Symptoms in MCI With Incident Dementia and Alzheimer Disease,” American Journal of Geriatric Psychiatry 21, no. 7 (2013): 685–695, https://doi.org/10.1016/j.jagp.2013.01.006.
M. Peters, P. Rosenberg, M. Steinberg, et al., “Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study,” American Journal of Geriatric Psychiatry 21, no. 11 (2013): 1116–1124, https://doi.org/10.1016/j.jagp.2013.01.049.
C. R. Jack Jr., D. A. Bennett, K. Blennow, et al., “NIA‐AA Research Framework: Toward a Biological Definition of Alzheimer's Disease,” Alzheimer's and Dementia 14, no. 4 (2018): 535–562, https://doi.org/10.1016/j.jalz.2018.02.018.