Are you seeing PBA symptoms in your patients with stroke, dementia, or TBI?

Patients with stroke, dementia, or TBI may also be struggling with involuntary episodes of exaggerated crying or laughing—treatable symptoms suggestive of PBA, a common comorbidity in those with underlying neurological conditions.1

Symptoms of PBA are frequent, sudden, uncontrollable crying or laughing outbursts1

In relation to mood, PBA episodes may be incongruent, or commonly, exaggerated1-6

Exaggerated

Excessive or disproportionate in relation to mood1

  • Crying or laughing is consistent with the nature of the stimulus and how the patient feels, but excessive2
  • Episodes are sudden, uncontrollable, and may be stronger or more intense than normal reactions2,7
and/or
Incongruent

Inconsistent with or opposite to a person’s mood1

  • Crying or laughing does not match how the patient feels, and there may be no meaningful stimulus2
  • Episodes may be sudden, uncontrollable, and may be brief (lasting only seconds or minutes)1,2

 

Why don’t you see PBA in your clinic?

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DR FISHER DISCUSSES WHY YOU MAY NOT SEE PBA IN YOUR PRACTICE (0:36)

Consider PBA

Patients or caregivers may report episodes of crying or laughing that they don’t understand. But when asked for details, they may go on to describe the frequent, sudden, uncontrollable outbursts of PBA.1,8

 

PATIENTS MAY DESCRIBE THEIR SYMPTOMS IN DIFFERENT WAYS1,8

Frequent
“I cry more than I used to. The littlest thing sets me off.”

Sudden
“I cry for no good reason. It comes out of the blue.”

Uncontrollable
“It happens in public. I can’t stop it.”

The importance of screening for PBA

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SEE A DISCUSSION ON THE IMPORTANCE OF SCREENING FOR PBA (1:59)

PBA vs depression

PBA is often mischaracterized as depression—and may be comorbid1,9,10

Comorbidity with depression may complicate diagnosis

TO HELP DISTINGUISH PBA FROM DEPRESSION,
IDENTIFY THE CHARACTERISTICS OF CRYINGa,1

Differentiating PBA from depression when crying is present

 

  • In a Harris online poll (N=399), approximately 75% of patients with PBA symptoms (CNS-LS ≥13) showed at least moderate depression symptoms11
  • In PRISM II (N=367), 57.5% of patients with PBA secondary to stroke, dementia, or TBI were diagnosed with comorbid depression12
Study Description
 

PRISM ll was a 90-day, open-label (uncontrolled), US trial in adult patients with dementia, stroke, or TBI. All patients had a clinical diagnosis of PBA and a CNS-LS score ≥13 at baseline. Patients received 1 capsule of NUEDEXTA QD during Week 1 and were titrated to 1 capsule Q12H for Weeks 2 through 12. The primary endpoint was change from baseline in CNS-LS score. Effectiveness population: Dementia: Baseline n=108, Day 30 n=108, Day 90 n=102. Stroke: Baseline n=103, Day 30 n=103, Day 90 n=92. TBI: Baseline n=87, Day 30 n=86, Day 90 n=67. Overall: Baseline n=298, Day 30 n=297, Day 90 n=261.12

aThese are not all the diagnostic features of depression.10 Formal diagnosis of depression or PBA can only be made by a qualified healthcare practitioner.

PBA vs depression

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WATCH NURSE PRACTITIONER, CATHY YAGGI CHARACTERIZE PBA VS DEPRESSION (0:33)