Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology

The spectrum of neuropsychiatric phenomena observed in amyotrophic lateral sclerosis (ALS) is wide and not fully understood. Disorders of laughter and crying stand among the most common manifestations. The aim of this study is to report the results of an educational consensus organized by the Brazil...

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Main Authors: Francisco de Assis Aquino Gondim, Wladimir Bocca Vieira de Rezende Pinto, Marco Antônio Troccoli Chieia, Carolina da Cunha Correia, Francisco Marcos Bezerra Cunha, Mário Emílio Teixeira Dourado Jr, Marcondes Cavalcante França Júnior, Wilson Marques Júnior, Acary Souza Bulle Oliveira, Cleonisio Leite Rodrigues, Delson José da Silva, Elza Dias-Tosta
Format: Article
Language:English
Published: Thieme Revinter Publicações 2023-08-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1771176
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author Francisco de Assis Aquino Gondim
Wladimir Bocca Vieira de Rezende Pinto
Marco Antônio Troccoli Chieia
Carolina da Cunha Correia
Francisco Marcos Bezerra Cunha
Mário Emílio Teixeira Dourado Jr
Marcondes Cavalcante França Júnior
Wilson Marques Júnior
Acary Souza Bulle Oliveira
Cleonisio Leite Rodrigues
Delson José da Silva
Elza Dias-Tosta
author_facet Francisco de Assis Aquino Gondim
Wladimir Bocca Vieira de Rezende Pinto
Marco Antônio Troccoli Chieia
Carolina da Cunha Correia
Francisco Marcos Bezerra Cunha
Mário Emílio Teixeira Dourado Jr
Marcondes Cavalcante França Júnior
Wilson Marques Júnior
Acary Souza Bulle Oliveira
Cleonisio Leite Rodrigues
Delson José da Silva
Elza Dias-Tosta
author_sort Francisco de Assis Aquino Gondim
collection DOAJ
description The spectrum of neuropsychiatric phenomena observed in amyotrophic lateral sclerosis (ALS) is wide and not fully understood. Disorders of laughter and crying stand among the most common manifestations. The aim of this study is to report the results of an educational consensus organized by the Brazilian Academy of Neurology to evaluate the definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in ALS patients. Twelve members of the Brazilian Academy of Neurology - considered to be experts in the field - were recruited to answer 12 questions about the subject. After exchanging revisions, a first draft was prepared. A face-to-face meeting was held in Fortaleza, Brazil on 9.23.22 to discuss it. The revised version was subsequently emailed to all members of the ALS Scientific Department from the Brazilian Academy of Neurology and the final revised version submitted for publication. The prevalence of pseudobulbar affect/pathological laughter and crying (PBA/PLC) in ALS patients from 15 combined studies and 3906 patients was 27.4% (N = 1070), ranging from 11.4% to 71%. Bulbar onset is a risk factor but there are limited studies evaluating the differences in prevalence among the different motor neuron diseases subtypes, including patients with and without frontotemporal dementia. Antidepressants and a combination of dextromethorphan and quinidine (not available in Brazil) are possible therapeutic options. This group of panelists acknowledge the multiple gaps in the current literature and reinforces the need for further studies.
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spelling doaj-art-70f2d0adf5444da089fc3fc57b5930c62025-08-20T02:06:47ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria0004-282X1678-42272023-08-01810876477510.1055/s-0043-1771176Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of NeurologyFrancisco de Assis Aquino Gondim0https://orcid.org/0000-0002-8957-5796Wladimir Bocca Vieira de Rezende Pinto1https://orcid.org/0000-0002-0150-525XMarco Antônio Troccoli Chieia2https://orcid.org/0000-0002-6034-4847Carolina da Cunha Correia3https://orcid.org/0000-0002-2211-3036Francisco Marcos Bezerra Cunha4https://orcid.org/0000-0002-9842-6573Mário Emílio Teixeira Dourado Jr5https://orcid.org/0000-0002-9462-2294Marcondes Cavalcante França Júnior6https://orcid.org/0000-0003-0898-2419Wilson Marques Júnior7https://orcid.org/0000-0002-4589-2749Acary Souza Bulle Oliveira8https://orcid.org/0000-0002-6986-4937Cleonisio Leite Rodrigues9https://orcid.org/0000-0003-0063-8971Delson José da Silva10https://orcid.org/0000-0002-1558-6943Elza Dias-Tosta11https://orcid.org/0000-0003-3082-3334Universidade Federal do Ceará, Departamento de Clínica Médica, Núcleo de Desenvolvimento e Pesquisa de Medicamentos, Fortaleza CE, Brazil.Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia/Ebserh, Setor de Investigações nas Doenças Neuromusculares, São Paulo SP, Brazil.Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia/Ebserh, Setor de Investigações nas Doenças Neuromusculares, São Paulo SP, Brazil.Universidade de Pernambuco, Recife PE, Brazil.Universidade Federal do Cariri, Barbalha CE, Brazil.Universidade Federal do Rio Grande do Norte, Departamento de Medicina Integrada, Natal RN, Brazil.Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brazil.Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências, Ribeirão Preto SP, Brazil.Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia/Ebserh, Setor de Investigações nas Doenças Neuromusculares, São Paulo SP, Brazil.Hospital Geral de Fortaleza, Divisão de Neurologia, Fortaleza CE, Brazil.Universidade Federal de Goiás, Hospital das Clínicas, Unidade de Neurologia e Neurocirurgia/Ebserh, Goiânia GO, Brazil.Comissão de Ética da Academia Brasileira de Neurologia, São Paulo SP, Brazil.The spectrum of neuropsychiatric phenomena observed in amyotrophic lateral sclerosis (ALS) is wide and not fully understood. Disorders of laughter and crying stand among the most common manifestations. The aim of this study is to report the results of an educational consensus organized by the Brazilian Academy of Neurology to evaluate the definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in ALS patients. Twelve members of the Brazilian Academy of Neurology - considered to be experts in the field - were recruited to answer 12 questions about the subject. After exchanging revisions, a first draft was prepared. A face-to-face meeting was held in Fortaleza, Brazil on 9.23.22 to discuss it. The revised version was subsequently emailed to all members of the ALS Scientific Department from the Brazilian Academy of Neurology and the final revised version submitted for publication. The prevalence of pseudobulbar affect/pathological laughter and crying (PBA/PLC) in ALS patients from 15 combined studies and 3906 patients was 27.4% (N = 1070), ranging from 11.4% to 71%. Bulbar onset is a risk factor but there are limited studies evaluating the differences in prevalence among the different motor neuron diseases subtypes, including patients with and without frontotemporal dementia. Antidepressants and a combination of dextromethorphan and quinidine (not available in Brazil) are possible therapeutic options. This group of panelists acknowledge the multiple gaps in the current literature and reinforces the need for further studies.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1771176Amyotrophic Lateral SclerosisEmotional IncontinencePathological Laughter and CryingPseudobulbar AffectAffective SymptomsEmotional RegulationAffectesclerose lateral amiotróficaincontinência emocionaldesordens do riso e do choroafeto pseudobulbardistúrbios do afetoregulação emocionalafeto
spellingShingle Francisco de Assis Aquino Gondim
Wladimir Bocca Vieira de Rezende Pinto
Marco Antônio Troccoli Chieia
Carolina da Cunha Correia
Francisco Marcos Bezerra Cunha
Mário Emílio Teixeira Dourado Jr
Marcondes Cavalcante França Júnior
Wilson Marques Júnior
Acary Souza Bulle Oliveira
Cleonisio Leite Rodrigues
Delson José da Silva
Elza Dias-Tosta
Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology
Arquivos de Neuro-Psiquiatria
Amyotrophic Lateral Sclerosis
Emotional Incontinence
Pathological Laughter and Crying
Pseudobulbar Affect
Affective Symptoms
Emotional Regulation
Affect
esclerose lateral amiotrófica
incontinência emocional
desordens do riso e do choro
afeto pseudobulbar
distúrbios do afeto
regulação emocional
afeto
title Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology
title_full Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology
title_fullStr Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology
title_full_unstemmed Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology
title_short Definitions, phenomenology, diagnosis, and management of the disorders of laughter and crying in amyotrophic lateral sclerosis (ALS): Consensus from ALS and Motor Neuron Disease Scientific Department of the Brazilian Academy of Neurology
title_sort definitions phenomenology diagnosis and management of the disorders of laughter and crying in amyotrophic lateral sclerosis als consensus from als and motor neuron disease scientific department of the brazilian academy of neurology
topic Amyotrophic Lateral Sclerosis
Emotional Incontinence
Pathological Laughter and Crying
Pseudobulbar Affect
Affective Symptoms
Emotional Regulation
Affect
esclerose lateral amiotrófica
incontinência emocional
desordens do riso e do choro
afeto pseudobulbar
distúrbios do afeto
regulação emocional
afeto
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1771176
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