Facts about PBA

What is PBA?

Though you may have never heard of PseudoBulbar Affect (PBA), you're not alone. Nearly two million Americans with certain neurologic conditions or brain injuries are estimated to suffer from these frequent uncontrollable outbursts of crying or laughing. PBA doesn’t discriminate. It can affect men and women, old and young. Conditions or injuries that can lead to PBA include:

  • Traumatic brain injury (TBI)
  • Alzheimer’s disease or other dementias
  • Stroke or TIA’s
  • Multiple sclerosis (MS)
  • Parkinson’s disease
  • ALS (Amyotrophic Lateral Sclerosis)/Lou Gehrig's Disease

The Science of PBA

PseudoBulbar Affect (PBA) symptoms are frequent, uncontrollable outbursts of crying or laughing in people with certain neurologic conditions or brain injuries. PBA is not a new condition. In fact, it was first described in medical literature over 130 years ago by Charles Darwin.

PBA can occur when certain neurologic diseases or brain injuries damage the areas in the brain that control normal expression of emotion. This damage can disrupt brain signaling, causing a ‘short circuit’ and triggering involuntary episodes of crying or laughing.

Emotions That Don’t Match

PBA episodes can be described in two key ways:

PBA outbursts can be inappropriate
The crying or laughing episodes are inappropriate to the situation in which they occur. Sometimes these are spontaneous crying or laughing eruptions that don’t reflect the way a person is actually feeling.

PBA outbursts can be exaggerated
Another characteristic of PBA episodes is that though the crying or laughing may be appropriate for a given situation, they’re exaggerated – they’re more intense or last longer than the situation calls for.

PBA is Neurologic

One of the jobs of the brain is to figure out how we feel in the moment. That information is then sent down to the brainstem, also known as the “bulb.” The brainstem then sends signals to the face and other parts of the body that show emotion.

PBA is believed to be the result of a disruption of these signals. When people have certain neurologic conditions or brain injuries, it can cause damage in the brain tissue that creates a disconnection between the parts of the brain that express emotion and those that control emotion. The result is the frequent outbursts of involuntary crying or laughing known as pseudobulbar affect. If you break the term down literally, “pseudo” means false, “bulbar” refers to the brainstem and “affect,” describes how the body shows mood or emotion.

PBA is Different from Depression

PBA is not depression though it is frequently mistaken for it. Many patients, however, may have both conditions. If you have PBA and depression, it’s important that each condition be diagnosed and treated separately. Generally speaking, depression is an ongoing and continuous state of sadness or hopelessness that can last over weeks or months, whereas PBA episodes are relatively brief, spontaneous episodes of crying and/or laughing that may not truly reflect what a person is feeling inside. 

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