Study: 'PBA' Affects 80 Percent of TBI Survivors

Posted on: January 6, 2011

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VIENNA, VA -- A survey released Jan. 6 by the Brain Injury Association of America (BIAA) indicates that approximately 80 percent of survey respondents experience symptoms of an additional neurologic condition called pseudobulbar affect (PBA). PBA is thought to be caused by structural damage in the brain due to injury or disease, and causes involuntary and unpredictable outbursts of laughing or crying, often in socially inappropriate situations. In fall of 2010, BIAA conducted a survey among the organization's constituents, including a range of people living with brain injury and caregivers (n=311). To complete the survey, the respondents were required to score a 13 or greater on the Center for Neurologic Study Lability Scale (CNS-LS), which assesses the presence and severity of PBA symptoms. Data demonstrate that nearly 80 percent (n=248) of the qualified respondents experience PBA episodes, with approximately half (48 percent) indicating that they are affected by PBA on a regular basis. Yet in stark contrast to the prevalence of this condition among respondents with brain injuries, only seven percent are aware of the term pseudobulbar affect. "Many don't understand that a brain injury is only the beginning of an ongoing neurological disease," said Susan H. Connors, president and CEO of the Brain Injury Association of America. "Similarly, pseudobulbar affect is a misunderstood and under-diagnosed, yet separate and treatable medical condition. Recognizing the complexities of these neurologic conditions and how they correlate helps to pave the way for improving quality of life among individuals with a brain injury." Survey results also illustrated the negative effect on quality of life that PBA has on people with brain injury and caregivers. In addition to the frequency of PBA symptoms reported, more than one-third (35 percent) of people with brain injury consider these episodes of involuntary crying and laughing to be extremely or very burdensome. Approximately six in 10 respondents reported that PBA episodes interfere with social activities, including spending time with friends and family. The survey respondents with brain injury reported leaving social functions abruptly to avoid embarrassing themselves and their family members. Some respondents note that their frequent outbursts are misunderstood or misconstrued as offensive and can interfere with work or school. "There are people with brain injury who have PBA that are not being identified and treated," said Dr. Brent Maisel, medical director for the Brain Injury Association of America. "Based on the BIAA survey results and recent progress in treating PBA, I am hopeful that more brain injury patients will begin the necessary dialogue with their doctors to help minimize the burden of this often stressful and disruptive condition." Even though people with brain injury and caregivers report that treatment for PBA is extremely or very important (39 percent), two-thirds remain untreated for the condition (67 percent).  Until recently, there have been no approved treatment options and 79 percent of those who are treated are not satisfied.

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