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多发性硬化症患者的假性延髓情绪障碍

PSEUDOBULBAR AFFECT IN MULTIPLE SCLEROSIS PATIENTS.

作者信息

Vidović Viktor, Rovazdi Merisanda Časar, Kraml Oto, Kes Vanja Bašić

出版信息

Acta Clin Croat. 2015 Jun;54(2):159-63.

PMID:26415311
Abstract

The aim of the study was to determine the prevalence of pseudobulbar affect (PBA) in patients with multiple sclerosis (MS) and to analyze the link between PBA and patient age, sex, clinical course of MS, disease duration and degree of disability. The study was conducted on 79 MS patients that underwent inpatient rehabilitation at the Lipik Special Hospital for Medical Rehabilitation in the period from August 15, 2014 to February 15, 2015. PBA is a term used for an emotional disinhibition syndrome characterized by sudden and involuntary episodes of crying or laughing which are not in proportion to the stimulus applied or occur without stimulus. The condition can be present in patients with various neurological disorders, such as amyotrophic lateral sclerosis, Alzheimer's disease, Parkinson's disease, patients having recovered from stroke, or following traumatic brain injury. The estimated prevalence in patients with MS ranges from 10% to 46.2%. As a measuring instrument in the study, we used the Center for Neurologic Study-Lability Scale (CNS-LS), where a sum 17 denoted positive finding. The total number of respondents was 79, of which 33 (41.8%) met the CNS-LS criteria for the diagnosis of PBA. There was no statistically significant correlation between PBA, age and degree of disability, although PBA was more common in women and in patients with a secondary progressive form of the disease. We found that 42.4% of respondents with positive CNS-LS criteria for PBA did not inform their neurologist on the presence of sudden mood changes. The high frequency of PBA and the fact that a significant proportion of patients did not inform the neurologist on their affective disturbances call for an active approach to diagnosis and treatment.

摘要

该研究的目的是确定多发性硬化症(MS)患者中假球麻痹情感障碍(PBA)的患病率,并分析PBA与患者年龄、性别、MS临床病程、疾病持续时间和残疾程度之间的联系。该研究对2014年8月15日至2015年2月15日期间在利皮克医疗康复专科医院接受住院康复治疗的79例MS患者进行。PBA是一个用于描述情感抑制综合征的术语,其特征为突然且不由自主的哭笑发作,这些发作与所施加的刺激不成比例或无刺激时发生。这种情况可出现在各种神经系统疾病患者中,如肌萎缩侧索硬化症、阿尔茨海默病、帕金森病、中风康复患者或创伤性脑损伤后患者。MS患者中PBA的估计患病率为10%至46.2%。在该研究中,我们使用神经学研究易激惹量表(CNS-LS)作为测量工具,总分17分表示阳性结果。受访者总数为79人,其中33人(41.8%)符合CNS-LS诊断PBA的标准。PBA与年龄和残疾程度之间无统计学显著相关性,尽管PBA在女性和继发进展型疾病患者中更为常见。我们发现,CNS-LS标准为PBA阳性的受访者中,42.4%未告知其神经科医生存在突然的情绪变化。PBA的高发生率以及相当一部分患者未告知神经科医生其情感障碍这一事实,要求采取积极的诊断和治疗方法。

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PSEUDOBULBAR AFFECT IN MULTIPLE SCLEROSIS PATIENTS.多发性硬化症患者的假性延髓情绪障碍
Acta Clin Croat. 2015 Jun;54(2):159-63.
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Safety, Tolerability, and Effectiveness of Dextromethorphan/Quinidine for Pseudobulbar Affect Among Study Participants With Traumatic Brain Injury: Results From the PRISM-II Open Label Study.安全性、耐受性和右美沙芬/奎尼丁治疗创伤性脑损伤患者假性延髓情绪的有效性:来自 PRISM-II 开放性研究的结果。
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PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury.PRISM II:一项开放标签研究,旨在评估右美沙芬/奎尼丁对痴呆、中风或创伤性脑损伤患者假性延髓情绪的疗效。
BMC Neurol. 2016 Jun 9;16:89. doi: 10.1186/s12883-016-0609-0.

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Int J MS Care. 2019 May-Jun;21(3):135-142. doi: 10.7224/1537-2073.2018-016.
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Pathological Crying and Laughing in Motor Neuron Disease: Pathobiology, Screening, Intervention.运动神经元病中的病理性哭笑:病理生物学、筛查与干预
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