Abstract
Characterizing Pathological Laughing and Crying in Progressive Supranuclear Palsy (P7-12.005)
Neurology, Vol.106(11_Supplement_1)
06/09/2026
DOI: 10.1212/WNL.0000000000215134
Abstract
Objective
To examine the prevalence and characteristics of pathological laughing and crying in progressive supranuclear palsy (PSP).
Background
Pseudobulbar affect (PBA), or pathological laughing and crying, is a poorly understood clinical phenomenon that lacks standardized diagnostic criteria. Prior studies have suggested that PBA is common in certain neurodegenerative disorders, such as PSP, but large cohort studies on the prevalence and features of PBA in PSP are lacking.
Design/Methods
We conducted a retrospective chart review to evaluate laughing and crying in 210 individuals with PSP who presented to the University of California, San Francisco Memory and Aging Center between 1998 and 2023. Using objective criteria, two raters recorded whether each patient exhibited laughing and crying behaviors that were deemed to be frequent, uncontrollable, or inappropriate. The ratings were then used to classify individuals as having probable or possible PBA. We next compared these classifications with the clinician’s diagnosis of PBA at the time of the evaluation.
Results
The mean age of the patients at the time of the clinical evaluation was 69.2 ± 7.3 years, and the sample consisted of 54% males. Our chart review identified PBA in 53 (25%) of the individuals with PSP: 27 (13%) with probable PBA and 26 (12%) with possible PBA. The clinicians who conducted the evaluations, in contrast, diagnosed PBA in only 30 individuals (14%) in the cohort. There was agreement between the chart review classifications and the clinician ratings of PBA in 21 (78%) of individuals with probable PBA in the chart review and in 7 (27%) of the individuals with possible PBA in the chart review.
Conclusions
Our results suggest that pathological laughing and crying is common in PSP. A better understanding of the clinical phenomenology of PBA will be important for clinicians to evaluate this symptom.
Details
- Title: Subtitle
- Characterizing Pathological Laughing and Crying in Progressive Supranuclear Palsy (P7-12.005)
- Creators
- Kaancan Deniz - University of California, San FranciscoJiwoo Han - University of California, San FranciscoZachary Miller - University of California, San FranciscoMaria Luisa Gorno Tempini - University of California, San FranciscoHoward Rosen - University of California, San FranciscoAdam Boxer - University of California, San FranciscoBruce Miller - University of California, San FranciscoWilliam Seeley - University of California, San FranciscoVirginia Sturm - University of California, San Francisco
- Resource Type
- Abstract
- Publication Details
- Neurology, Vol.106(11_Supplement_1)
- DOI
- 10.1212/WNL.0000000000215134
- ISSN
- 0028-3878
- eISSN
- 1526-632X
- Language
- English
- Date published
- 06/09/2026
- Academic Unit
- Neurology
- Record Identifier
- 9985182277402771
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