Posted by: Thixia | March 3, 2008

A quantitative MRI study in multiple sclerosis.

Neuroanatomy of pseudobulbar affect : A quantitative MRI study in multiple sclerosis.

Pseudobulbar affect (PBA) is defined as episodes of involuntary crying, laughing, or both in the absence of a matching subjective mood state. This neuropsychiatric syndrome can be found in a number of neurological disorders including multiple sclerosis (MS).

The aim of this study was to identify neuroanatomical correlates of PBA in multiple sclerosis (MS) using a case-control 1.5T MRI study. MS patients with (n = 14) and without (n = 14) PBA were matched on demographic, disease course, and disability variables. Comorbid (1) psychiatric disorders including depressive and anxiety disorders were absent.

Hypo- and hyperintense lesion volumes plus measurements of atrophy were obtained and localized anatomically according to parcellated brain regions. Between-group statistical comparisons were undertaken with alpha set at 0.01 for the primary analysis.

Discrete differences in lesion volume were noted in six regions:

Brainstem hypointense lesions, bilateral inferior parietal and medial inferior frontal hyperintense lesions, and right medial superior frontal hyperintense lesions were all significantly higher in the PBA group.

A logistic regression model identified four of these variables (brainstem hypointense, left inferior parietal hyperintense, and left and right medial inferior frontal hyperintense lesion volumes) that accounted for 70% of the variance when it came to explaining the presence of PBA.


MS patients with PBA have a distinct distribution of brain lesions when compared to a matched MS sample without PBA. The lesion data support a widely-dispersed neural network involving frontal, parietal, and brainstem regions in the pathophysiology of PBA.

(1) Coexisting or concomitant with an unrelated pathological or disease process

Ghaffar O, Chamelian L, Feinstein A.

Neuropsychiatry Division,
Dept. of Psychiatry,
Sunnybrook Health Sciences Centre,
University of Toronto,
FG08-2075 Bayview Avenue,
Toronto, ON
M4N 3M5,

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