What is PBA?
PBA (Pseudobulbar Affect) is a medical condition causing sudden, frequent, uncontrollable crying and/or laughing that doesn’t match how you feel. It can happen in people living with a brain injury or certain neurologic conditions including:
- TBI (Traumatic Brain Injury)
- Alzheimer’s Disease/Dementia
- MS (Multiple Sclerosis)
- ALS (Lou Gehrig’s Disease)
- Parkinson’s Disease
Why treat PBA?
We express our emotions to connect with those around us and having PBA may affect that connection. Because PBA episodes are unpredictable and can happen at inappropriate times, including social situations, they can leave you feeling misunderstood and frustrated.
Reducing the number of PBA episodes you experience could help ensure that your crying and/or laughing more often matches how you feel. NUEDEXTA is the only treatment approved by the FDA to treat PBA.
The Center for Neurologic Study-Lability Scale (CNS-LS) was developed by healthcare professionals to identify and measure symptoms suggestive of PBA. It does not diagnose PBA and is not intended to substitute for professional medical assessment and/or advice. Please consult with your doctor.
PBA can affect both men and women. PBA is thought to affect about 2 million people in the US who suffer from certain neurologic conditions or brain injury.†
- Stroke Read more
- Traumatic Brain Injury (TBI) Read more
- Alzheimer's Disease and Dementia Read more
- ALS (Lou Gehrig's Disease) Read more
- Multiple Sclerosis (MS) Read more
- Parkinson's Disease Read more
Because people recovering from a stroke are often concerned with regaining lost function—and preventing another stroke—it may be easy to overlook sudden, frequent, uncontrollable crying and/or laughing symptoms that don’t match how they feel or mistake the symptoms for depression.
For about a quarter of a million people in the US who have suffered a stroke, these laughing and crying episodes may be PBA.
According to a survey of 500 patients who suffered a stroke (or their caregivers), 4.3% may have PBA. Based on this data, nearly 250,000 patients who suffered a stroke in the United States may have PBA.†
Traumatic Brain Injury (TBI)
Some patients living with TBI experience PBA symptoms of frequent, uncontrollable crying and/or laughing very soon after their injury. While for others, these symptoms may not be recognized until some months after their TBI, during the recovery process. Some never experience PBA symptoms at all.
According to studies, 800,000 people in the US, or about 15% of those who have suffered a Traumatic Brain Injury, may have PBA.
According to a survey of 326 patients with TBI (or their caregivers), 15% may have PBA. Based on this data, 800,000 patients with TBI in the United States may have PBA.†
Alzheimer's Disease and Dementia
Alzheimer’s disease and other dementias can make PBA especially hard to spot, since sudden episodes of crying and/or laughing can be mistaken for depression or other personality changes associated with dementia. In addition, people in long-term care settings, like nursing homes, may not have the benefit of a single caretaker who can watch their behavior every day to look for patterns.
About 9.6% of people in the US with Alzheimer's disease or dementia may have PBA—over half a million people.
According to a survey of 499 patients with Alzheimer’s disease (or their caregivers), 9.6% may have PBA. Based on this data, 500,000 people living with Alzheimer's in the United States may also have PBA.†
ALS (Lou Gehrig's Disease)
PBA episodes can occur at any time during the course of ALS and may be mistaken for depression.
At least 27.5% of people with ALS in the US may have PBA.
According to a survey of 40 patients with ALS (or their caregivers), 27.5% patients with ALS in the US may have PBA.†
Multiple Sclerosis (MS)
Because MS may produce a wide variety of symptoms, and require different medications to treat them, people with MS who develop sudden, frequent, uncontrollable crying and/or laughing episodes that don’t match how they feel may not always know what’s causing them. That’s why it’s important for patients to describe these episodes to their doctor – how long they last, how the patient feels while they’re happening, and how they affect the patient.
In the US, 9.8% of people with MS (almost 40,000 people) may have PBA.
According to a survey of 504 patients with MS (or their caregivers), 9.8% may have PBA. Based on this data, 40,000 patients with MS in the United States may have PBA.†
Parkinson’s disease is a progressive condition known for its physical symptoms. While it’s important to make adjustments for physical symptoms, don’t forget to talk to a doctor if you or a loved one also have frequent, uncontrollable crying and/or laughing that doesn’t match how they feel.
Over 35,000 people in the US with Parkinson's disease (3.6%) may have PBA.
According to a survey of 449 patients with Parkinson’s disease (or their caregivers), 3.6% may have PBA. Based on this data, 35,000 patients with Parkinson’s disease in the United States may have PBA.†
†Work SS, Colamonico JA, Bradley WG, Kaye RE. Pseudobulbar affect: an under-recognized and under-treated neurological disorder. Adv Ther. 2011;28:586–601.
PBA is not depression. But because sudden, frequent, uncontrollable episodes of crying are a key feature of PBA, people sometimes mistake PBA for depression. It's important to understand that the two are separate conditions. Some people can have both PBA and depression. Both conditions are treatable and should be diagnosed by your doctor§ and managed separately.
|Underlying Condition||Occurs in people with neurologic conditions such as Stroke, Alzheimer’s disease and Dementia, ALS (Lou Gehrig's Disease), MS (Mutltiple Sclerosis), and Parkinson’s disease, or with brain injury*||May or may not have an underlying neurologic condition|
|Symptoms||Sudden, frequent crying, laughing, or both||May include crying, loss of interest or pleasure, sad mood, appetite changes, or sleeping too much or too little‡|
|Episode Control||Crying and/or laughing episodes are uncontrollable||Crying, if present, may be voluntarily controlled|
|Expressions vs Feelings||Crying and/or laughing are exaggerated or do not match how you feel||Outward expression matches feelings or intent|
|Accompanying Thoughts||Episodes may not be related to a happy or depressed mood||Crying, if present, matches mood|
*This is not a complete list. Other neurologic conditions may be associated with PBA.
§Formal diagnosis of PBA or depression can only be made by a qualified healthcare professional (HCP). These are not all of the diagnostic features of depression or PBA. PBA occurs in the context of a neurologic condition/injury affecting the brain and is not explained by other causes such as medication use.
‡Diagnosis can only be made by a qualified healthcare professional. These are not all the symptoms of depression.
“When I was diagnosed with PBA, I was so relieved I had a name for it—there was a real thing that was affecting me.”
NUEDEXTA is the first and only treatment approved by the FDA to treat PBA.
Prepare yourself and the people close to you to talk about the impact of PBA on your lives. Then, talk to your doctor.