Wednesday, 27 January 2016

Do you have Emotional Incontinence

Hanna J, Feinstein A, Morrow SA.The association of pathological laughing and crying and cognitive impairment in multiple sclerosis.
J Neurol Sci. 2016 Feb 15;361:200-3.

BACKGROUND:Pathological laughing and crying (PLC) is common in multiple sclerosis (MS), defined as emotional expression that is exaggerated/incongruent with underlying mood. In other neurological disorders, PLC is associated with cognitive impairment (CI). Few studies have examined this relationship in MS.
OBJECTIVE:To determine the association between PLC and CI in an MS population.
METHODS:Retrospective chart review study of 153 MS subjects assessed in an outpatient clinic for CI. Data was collected on the minimal assessment of cognitive function in MS (MACFIMS), the Center for neurological study-lability scale (CNS-LS), a screening measure for PLC symptoms and the hospital anxiety and depression scale (HADS). Analyses of covariance compared performance on the MACFIMS between PLC (CNS-LS score≥17, HADS-D≤7) and non-PLC groups.
RESULTS:MS subjects positive for PLC on the CNS-LS but without depression had lower scores on the controlled oral word association test, a measure of verbal fluency, and the California verbal learning test - 2 immediate recall score, a verbal memory measure.
CONCLUSIONS:This study demonstrates a connection between CI, specifically verbal fluency and verbal learning, and PLC in MS subjects. 


I was an MS Life in Manchester with ProfG when we were doing "Meet the Scientitis" this chap came up to talk to us. He was one of those people who had not looked into their condition and so did not know much about MS. He said that he used to uncontrollably cry alot and ProfG said that he had "emotional incontinence" and that there were treatments that may help with the problem and so if you do have this then speak to your MS care team. This study suggests that there appears to be a link between uncontrollable laughing and crying with cognitive issues and suggests there may be lesions in the pathways controlling these emotions.

10 comments:

  1. I had this in the years leading up to diagnosis and post diagnosis but it is at the bottom of my list of concerns with MS so have never mentioned it to my neuro.

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  2. Many of my external orifices are incontinent possibly due my MS.

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  3. I always ask my family to observe if I'm have cognitive and/or emotional changes, because sometimes "who is out" observe the best changes than those who are facing problems.

    I attended some groups in social networks about MS and I could tell that some were already well clear cognitive difficulties, reading comprehension difficulties, emotional difficulties, etc. ...

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  4. Only when I read MS related research studies.:-)

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  5. MD and treatment with certain antidepressants such as fluoxetine and other drug Dextromethorphan/quinidine can help in this issue of Emotional Incontinence?

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  6. Back when I was 17 years of age, I spent a whole year with "emotional incontinence". I mentioned this to a couple of neurologists on my path to diagnosis, and they just blew it off, saying I was just a flighty teenager.

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  7. Is this not known as pseudobulbar affect?

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  8. Do you think courses or teaching such as coping strategies to enable people to cope better in life whether practical, social or emotional and examining negative thinking could help?

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  9. I have difficulty managing my crying or laughing response. This feels like a reflex and as such does not seem to respond to any mindful techniques I try.

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    Replies
    1. I also have experienced this over the years and only learned it could be related to MS a few months ago. Fascinating!

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