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Suspected Pseudobulbar Affect in Neurodegenerative Disease
Maureen K O'Connor1,2,3,4, Brandon Frank3,4,5, Renée DeCaro5
1Neuropsychology Service, Bedford VA Healthcare System, Bedford, Massachusetts, USA.
International Journal of Geriatric Psychiatry
|October 21, 2024
Summary
Pseudobulbar affect (PBA) in Alzheimer's disease (AD) patients was linked to better memory recall and recognition. Understanding PBA may aid early AD identification and treatment in neurodegenerative diseases.
Area of Science:
- Neuroscience
- Geriatrics
- Psychiatry
Background:
- Pseudobulbar affect (PBA) is characterized by involuntary emotional expression.
- PBA is frequently observed in neurodegenerative diseases, but its association with cognitive function and specific diagnoses like Alzheimer's disease (AD) requires further investigation.
- Early identification of PBA may offer insights into disease progression and treatment.
Purpose of the Study:
- To explore the relationship between suspected PBA, clinical diagnosis, cognitive performance, and mood in older adults evaluated for dementia.
- To determine the prevalence of PBA in patients with Alzheimer's disease and other neurocognitive disorders.
- To compare cognitive test performance between patients with and without suspected PBA.
Main Methods:
- Network modeling was used to analyze associations between neuropsychological tests, rating scales, and the Center for Neurological Study-Lability Scale (CNS-LS) in 311 outpatients.
- Patients with suspected AD (n=133) and other neurocognitive diagnoses (n=178) were included.
- Propensity score matching and Bayesian models were employed to compare cognitive performance between patients with and without suspected PBA (CNS-LS ≥ 13), controlling for covariates.
Main Results:
- The prevalence of suspected PBA was approximately 44.4% in AD and similar in other dementias.
- In network models, higher CNS-LS scores correlated with increased anxiety and improved word list recall.
- AD patients with suspected PBA demonstrated enhanced word list recall and fewer false recognition errors compared to those without PBA.
Conclusions:
- Suspected PBA in AD patients was associated with better memory recall and recognition, suggesting emotional dysregulation might be an early AD indicator.
- These findings highlight the potential of PBA as an early sign in AD, especially when memory decline is less pronounced.
- Further research into PBA prevalence and psychiatric comorbidities in neurodegenerative diseases is crucial for timely diagnosis and intervention.
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