What is PBA, or

Pseudobulbar Affect?

PBA is a condition that causes uncontrollable crying and/or laughing that happens suddenly and frequently. It can happen in people with a brain injury or certain neurologic conditions.

A person having a crying episode may cry when they don’t feel sad or when they only feel a little bit sad. Someone having a laughing episode may laugh when they don’t feel amused or when they only feel a little bit amused.

Images of people affected by Pseudobulbar Affect (PBA)
Images of people affected by Pseudobulbar Affect (PBA)

All ambassadors are real patients living with PBA or caregivers for real patients living with PBA.

PBA is more common than you think

While there are almost 2 million people in the US with neurologic conditions or traumatic brain injury who have been diagnosed with PBA, over 7 million people in the US with these primary conditions have symptoms that may suggest PBA.*

Estimated percent of people with common neurologic conditions who have PBA symptoms**

52 %
Traumatic Brain Injury (TBI)
According to a survey of 590 TBI patients (or their caregivers), 52% have symptoms that may be PBA.
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38 %
Stroke
According to a survey of 757 stroke patients (or their caregivers), 38% have symptoms that may suggest PBA.
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46 %
Multiple Sclerosis (MS)
According to a survey of 1215 MS patients (or their caregivers), 46% have symptoms that may suggest PBA.
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29 %
Alzheimer's Disease/Dementia
According to a survey of 1799 Alzheimer's/dementia patients (or their caregivers), 29% have symptoms that may suggest PBA.
45 %
Amyotrophic Lateral Sclerosis (ALS)
According to a survey of 125 ALS patients (or their caregivers), 45% have symptoms that may suggest PBA.
26 %
Parkinson's Disease
According to a survey of 804 Parkinson's patients (or their caregivers), 26% have symptoms that may suggest PBA.

*When considering patients with any of 6 common neurologic conditions associated with PBA, it is estimated that 37%, or an estimated 7.1 million Americans, have symptoms suggestive of PBA as defined by a CNS-LS (Center for Neurologic Study-Lability Scale) score ≥13 and 9.4% of patients, or an estimated 1.8 million Americans, with CNS-LS scores ≥21. The presence of PBA symptoms was defined as a CNS-LS score ≥13 and a more restrictive definition was also evaluated using CNS-LS ≥21. The CNS-LS was validated as a PBA screening tool in ALS and MS populations. A CNS-LS score ≥13 merits further diagnostic assessment.

**Brooks BR et al. PRISM: A Novel Research Tool to assess the Prevalence of Pseudobulbar Affect Symptoms across Neurological Conditions. 2013. PLOS ONE 8(8): e72232.

PBA and Depression

PBA is a condition of emotional expression — crying and/or laughing that's exaggerated or doesn't match how you feel. It's different from depression.

PBA

PBA is neurologic, which means it’s caused by damage to the nervous system.

DEPRESSION

Depression is psychological, which means it affects a person’s mental state.

It's possible to have PBA and depression at the same time, but the two are separate conditions that should be diagnosed and managed separately.

What makes PBA different from depression*

 
PBA
Depression
Primary Condition
You also have a neurologic condition or brain injury
You may or may not have a neurologic condition or brain injury
Signs
You have sudden, frequent crying and/or laughing
You may or may not have crying†
Control
Your crying and/or laughing spells are uncontrollable
You may have control over crying
Mood
Your crying and/or laughing is exaggerated or doesn’t match how you feel
Your crying matches how you feel
Time
Your crying and/or laughing episode lasts seconds to minutes
Crying is part of your depression that can last weeks or months

*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.

†Tearfulness/crying is not a diagnostic hallmark for depression diagnosis.

Wondering if you or someone you love might have symptoms that suggest PBA?

Answer 7 short quiz questions about you or your loved one’s uncontrollable crying and/or laughing episodes.

Take the PBA Quiz
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*PBA Nurse Talk is sponsored by Avanir Pharmaceuticals, Inc., which is committed to supporting those who may be suffering from PBA. This program is offered at no cost to those eligible, does not require health insurance, and does not replace speaking with a healthcare provider – only a healthcare provider can diagnose PBA. PBA Nurse Talk conversations will remain completely confidential. PBA Nurse Talk is only available to people experiencing uncontrollable crying and/or laughing, not their caregivers.

MLR-PBA-US-0761-0822