David C Gillespie1, Amy P Cadden2, Rosalind Lees3, Robert M West4, Niall M Broomfield5. 1. Division of Clinical Neurosciences, Western General Hospital, Edinburgh, UK. Electronic address: david.gillespie@nhslothian.scot.nhs.uk. 2. School of Psychology, Trinity College Dublin, Dublin, Ireland. 3. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. 4. Institute of Health Sciences, University of Leeds, Leeds, UK. 5. Department of Clinical Psychology, NHS Greater Glasgow and Clyde, Glasgow, UK.
Abstract
BACKGROUND: Several studies have reported that emotional lability is a common consequence of stroke. However, there is uncertainty about the "true" prevalence of the condition because, across these studies, patients have been recruited at different stages of recovery, from different settings, and using different diagnostic methods. There have been no systematic reviews of the published evidence to ascertain how the prevalence of poststroke pseudobulbar affect (PBA) might vary according to these factors. METHODS: A systematic review and meta-analysis of the published literature were undertaken. RESULTS: A total of 15 studies (n = 3391 participants) met inclusion criteria for the review. Meta-analysis estimated that the prevalence of PBA was 17% (95% confidence interval 12%-24%) acutely (<1 month post stroke), 20% (14%-29%) post acutely (1-6 months post stroke), and 12% (8%-17%) in the medium to longer term (>6 months post stroke). The evidence from the published literature, although limited, is that crying is a more common PBA presentation following stroke than laughter. CONCLUSIONS: PBA is a common condition that affects approximately 1 in 5 stroke survivors at the acute and postacute phases, and 1 in 8 survivors beyond 6 months post stroke. These prevalence data are very important for clinicians and the commissioners of services.
BACKGROUND: Several studies have reported that emotional lability is a common consequence of stroke. However, there is uncertainty about the "true" prevalence of the condition because, across these studies, patients have been recruited at different stages of recovery, from different settings, and using different diagnostic methods. There have been no systematic reviews of the published evidence to ascertain how the prevalence of poststroke pseudobulbar affect (PBA) might vary according to these factors. METHODS: A systematic review and meta-analysis of the published literature were undertaken. RESULTS: A total of 15 studies (n = 3391 participants) met inclusion criteria for the review. Meta-analysis estimated that the prevalence of PBA was 17% (95% confidence interval 12%-24%) acutely (<1 month post stroke), 20% (14%-29%) post acutely (1-6 months post stroke), and 12% (8%-17%) in the medium to longer term (>6 months post stroke). The evidence from the published literature, although limited, is that crying is a more common PBA presentation following stroke than laughter. CONCLUSIONS: PBA is a common condition that affects approximately 1 in 5 stroke survivors at the acute and postacute phases, and 1 in 8 survivors beyond 6 months post stroke. These prevalence data are very important for clinicians and the commissioners of services.
Authors: Niall M Broomfield; Robert West; Allan House; Theresa Munyombwe; Mark Barber; Fergus Gracey; David C Gillespie; Matthew Walters Journal: Clin Rehabil Date: 2020-12-21 Impact factor: 3.477
Authors: Niall M Broomfield; Robert West; Mark Barber; David C Gillespie; Allan House; Matthew Walters Journal: Clin Rehabil Date: 2021-06-17 Impact factor: 3.477