Objectives
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.
Key Words
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Article info
Publication history
Published online: December 09, 2015
Accepted:
November 3,
2015
Received in revised form:
October 26,
2015
Received:
September 1,
2015
Footnotes
Funding: This study has been supported by Project 81400961 of the National Natural Science Foundation of China.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.003
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
