TY - JOUR
T1 - Pseudobulbar affect prevalence and association with symptoms inmultiple sclerosis
AU - Fitzgerald, Kathryn C.
AU - Salter, Amber
AU - Tyry, Tuula
AU - Fox, Robert J.
AU - Cutter, Gary
AU - Marrie, Ruth Ann
N1 - Funding Information:
NARCOMS is supported in part by the Consortium of Multiple Sclerosis Centers (CMSC) and the Foundation of the CMSC. Performance Scales Questions 9–16, Copyright Registration Number/Date: 233 TXu000743629/1996-04-04; assigned to DeltaQuest Foundation, Inc., effective October 1, 2005. U.S. 234 Copyright law governs terms of use.
Funding Information:
NARCOMS is supported in part by the Consortium of Multiple Sclerosis Centers (CMSC) and The Foundation of the CMSC. This study was supported by a fellowship grant to K.C.F. from the CMSC’s NARCOMS postdoctoral fellowship award.
Funding Information:
has conducted clinical trials for Sanofi-Aventis; and receives research support from CIHR, Research Manitoba, the Waugh Family Chair in Multiple Sclerosis, Multiple Sclerosis Society of Canada, the National Multiple Sclerosis Society, Multiple Sclerosis Scientific Foundation, the Consortium of Multiple Sclerosis Centers, and Crohn’s and Colitis Canada. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Publisher Copyright:
Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background We sought to determine the prevalence of pseudobulbar affect (PBA) in a large MS population and assess its association with disability and symptom severity. Methods North American Research Committee on MS (NARCOMS) registry participants completed the Center for Neurologic Study-Lability Scale (CNS-LS), a validated 7- question self-report measure of PBA. A composite PBA score was derived from the sum of responses to the 7 questions. We categorized individuals as PBA-positive (PBA[+]) if they had a composite score ≥17 without current depression. Participants also reported their demographic characteristics and their clinical characteristics using Patient-Determined Disease Steps and Performance Scales. We compared clinical and disease characteristics for PBA(+) responders with those without PBA using descriptive statistics and multivariable multinomial logistic regression. Results Of the 8,136 responders, 574 (7%) had scores ≥17 on the CNS-LS; however, only 200 (2.5%) individuals had scores ≥17 without comorbid depression, of whom only 22 (11%) reported a diagnosis of PBA. PBA(+) individuals tended to be younger (mean [SD] 53.4 [11.0] vs 57.2 [10.3] years), non-white (13% vs 9%), and have lower socioeconomic status (≤$30,000 annual income: 28% vs 22%). In multivariable models, PBA(+) was associated with increased odds of more severe cognitive impairment (moderate vs mild disability OR: 1.37; 95% CI: 1.01, 1.84). Conclusions Our findings suggest that the prevalence of PBA in MS is low, but similar symptoms may cooccur or overlap with depression, highlighting the importance of concomitant assessment of mood when evaluating potential PBA. PBA may be associated with cognitive impairment in people with MS.
AB - Background We sought to determine the prevalence of pseudobulbar affect (PBA) in a large MS population and assess its association with disability and symptom severity. Methods North American Research Committee on MS (NARCOMS) registry participants completed the Center for Neurologic Study-Lability Scale (CNS-LS), a validated 7- question self-report measure of PBA. A composite PBA score was derived from the sum of responses to the 7 questions. We categorized individuals as PBA-positive (PBA[+]) if they had a composite score ≥17 without current depression. Participants also reported their demographic characteristics and their clinical characteristics using Patient-Determined Disease Steps and Performance Scales. We compared clinical and disease characteristics for PBA(+) responders with those without PBA using descriptive statistics and multivariable multinomial logistic regression. Results Of the 8,136 responders, 574 (7%) had scores ≥17 on the CNS-LS; however, only 200 (2.5%) individuals had scores ≥17 without comorbid depression, of whom only 22 (11%) reported a diagnosis of PBA. PBA(+) individuals tended to be younger (mean [SD] 53.4 [11.0] vs 57.2 [10.3] years), non-white (13% vs 9%), and have lower socioeconomic status (≤$30,000 annual income: 28% vs 22%). In multivariable models, PBA(+) was associated with increased odds of more severe cognitive impairment (moderate vs mild disability OR: 1.37; 95% CI: 1.01, 1.84). Conclusions Our findings suggest that the prevalence of PBA in MS is low, but similar symptoms may cooccur or overlap with depression, highlighting the importance of concomitant assessment of mood when evaluating potential PBA. PBA may be associated with cognitive impairment in people with MS.
UR - http://www.scopus.com/inward/record.url?scp=85060830606&partnerID=8YFLogxK
U2 - 10.1212/CPJ.0000000000000523
DO - 10.1212/CPJ.0000000000000523
M3 - Article
AN - SCOPUS:85060830606
SN - 2163-0402
VL - 8
SP - 472
EP - 481
JO - Neurology: Clinical Practice
JF - Neurology: Clinical Practice
IS - 6
ER -