Clinical Features and Related Factors of Poststroke Pathological Laughing and Crying: A Case-Control Study

详细信息    查看全文

• 作者：Geying Wang ; MD¹ ; ^* ; Fei Teng ; PhD ; MD¹ ; ^* ; Yuhui Chen ; MD^* ; Yuanhua Liu ; MD^* ; Yancheng Li ; MD^* ; Li Cai ; MD^&dagger ; ; Xu Zhang ; MD^&Dagger ; ; Zhiyu Nie ; MD^* ; Lingjing Jin ; MD^* ; ^{lingjingjin@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pathological laughing and crying ; stroke ; anger proneness ; mild cognitive impairment ; pseudobulbar palsy
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：25
• 期：3
• 页码：556-564
• 全文大小：973 K

文摘

The purpose of this study was to analyze clinical features and related factors of poststroke pathological laughing and crying (PSPLC) and to differentiate PSPLC patients with and without pseudobulbar signs.

Methods

We performed a case–control study in which 56 patients with PSPLC were matched to 56 control stroke patients by age and gender. The pathological laughing and crying scale was used to identify patients with PSPLC. Characteristics of PSPLC outbursts, presence of pseudobulbar signs and autonomic symptoms, lesion locations, and different clinical data were analyzed. Mild cognitive impairment (MCI) was evaluated by the Montreal Cognitive Assessment. Poststroke anger proneness (PSAP) was evaluated by comparison of the patients' premorbid states.

Results

Significantly more patients in the PSPLC group showed MCI, PSAP, and pseudobulbar signs than those in the control group. Most patients with PSPLC showed bilateral multiple lesions and the pons (especially the bilateral paramedian basal and basal–tegmental areas) stood out as the most important lesion location. Logistic regression analysis showed that pontine lesion, MCI, and PSAP were independently related to PSPLC; however, the presence of pseudobulbar signs was not related. PSPLC patients with pseudobulbar signs showed more recurrent strokes in the previous 2 years, more severe neurological deficits, as well as higher severity of PSPLC. In addition, more patients in the group with pseudobulbar signs showed concomitant autonomic symptoms.

Conclusions

PSPLC, MCI, and PSAP could be manifestations of a more general disorder, in which pontine lesion plays an important role. PSPLC patients with pseudobulbar signs and those without show different features.