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Pathologic tearfulness after limbic encephalitis: A novel disorder and its neural basis

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Pathologic tearfulness after limbic encephalitis : A novel disorder and its neural basis. / Argyropoulos, Georgios P.D.; Moore, Lauren; Loane, Clare; Roca-Fernandez, Adriana; Lage-Martinez, Carmen; Gurau, Oana; Irani, Sarosh R.; Zeman, Adam; Butler, Christopher R.

In: Neurology, Vol. 94, No. 12, 24.03.2020, p. e1320-e1335.

Research output: Contribution to journalArticle

Harvard

Argyropoulos, GPD, Moore, L, Loane, C, Roca-Fernandez, A, Lage-Martinez, C, Gurau, O, Irani, SR, Zeman, A & Butler, CR 2020, 'Pathologic tearfulness after limbic encephalitis: A novel disorder and its neural basis', Neurology, vol. 94, no. 12, pp. e1320-e1335. https://doi.org/10.1212/WNL.0000000000008934

APA

Argyropoulos, G. P. D., Moore, L., Loane, C., Roca-Fernandez, A., Lage-Martinez, C., Gurau, O., Irani, S. R., Zeman, A., & Butler, C. R. (2020). Pathologic tearfulness after limbic encephalitis: A novel disorder and its neural basis. Neurology, 94(12), e1320-e1335. https://doi.org/10.1212/WNL.0000000000008934

Vancouver

Argyropoulos GPD, Moore L, Loane C, Roca-Fernandez A, Lage-Martinez C, Gurau O et al. Pathologic tearfulness after limbic encephalitis: A novel disorder and its neural basis. Neurology. 2020 Mar 24;94(12):e1320-e1335. https://doi.org/10.1212/WNL.0000000000008934

Author

Argyropoulos, Georgios P.D. ; Moore, Lauren ; Loane, Clare ; Roca-Fernandez, Adriana ; Lage-Martinez, Carmen ; Gurau, Oana ; Irani, Sarosh R. ; Zeman, Adam ; Butler, Christopher R. / Pathologic tearfulness after limbic encephalitis : A novel disorder and its neural basis. In: Neurology. 2020 ; Vol. 94, No. 12. pp. e1320-e1335.

Bibtex Download

@article{d5cf68f6f1f541b48f5bbb9d5e0a19b2,
title = "Pathologic tearfulness after limbic encephalitis: A novel disorder and its neural basis",
abstract = "OBJECTIVE: We investigated the nature and neural foundations of pathologic tearfulness in a uniquely large cohort of patients who had presented with autoimmune limbic encephalitis (aLE). METHODS: We recruited 38 patients (26 men, 12 women; median age 63.06 years; interquartile range [IQR] 16.06 years) in the postacute phase of aLE who completed questionnaires probing emotion regulation. All patients underwent structural/functional MRI postacutely, along with 67 age- and sex-matched healthy controls (40 men, 27 women; median age 64.70 years; IQR 19.87 years). We investigated correlations of questionnaire scores with demographic, clinical, neuropsychological, and brain imaging data across patients. We also compared patients diagnosed with pathologic tearfulness and those without, along with healthy controls, on gray matter volume, resting-state functional connectivity, and activity. RESULTS: Pathologic tearfulness was reported by 50% of the patients, while no patient reported pathologic laughing. It was not associated with depression, impulsiveness, memory impairment, executive dysfunction in the postacute phase, or amygdalar abnormalities in the acute phase. It correlated with changes in specific emotional brain networks: volume reduction in the right anterior hippocampus, left fusiform gyrus, and cerebellum, abnormal hippocampal resting-state functional connectivity with the posteromedial cortex and right middle frontal gyrus, and abnormal hemodynamic activity in the left fusiform gyrus, right inferior parietal lobule, and ventral pons. CONCLUSIONS: Pathologic tearfulness is common following aLE, is not a manifestation of other neuropsychiatric features, and reflects abnormalities in networks of emotion regulation beyond the acute hippocampal focus. The condition, which may also be present in other neurologic disorders, provides novel insights into the neural basis of affective control and its dysfunction in disease.",
author = "Argyropoulos, {Georgios P.D.} and Lauren Moore and Clare Loane and Adriana Roca-Fernandez and Carmen Lage-Martinez and Oana Gurau and Irani, {Sarosh R.} and Adam Zeman and Butler, {Christopher R.}",
year = "2020",
month = mar,
day = "24",
doi = "10.1212/WNL.0000000000008934",
language = "English",
volume = "94",
pages = "e1320--e1335",
journal = "Neurology",
issn = "0028-3878",
number = "12",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Pathologic tearfulness after limbic encephalitis

T2 - A novel disorder and its neural basis

AU - Argyropoulos, Georgios P.D.

AU - Moore, Lauren

AU - Loane, Clare

AU - Roca-Fernandez, Adriana

AU - Lage-Martinez, Carmen

AU - Gurau, Oana

AU - Irani, Sarosh R.

AU - Zeman, Adam

AU - Butler, Christopher R.

PY - 2020/3/24

Y1 - 2020/3/24

N2 - OBJECTIVE: We investigated the nature and neural foundations of pathologic tearfulness in a uniquely large cohort of patients who had presented with autoimmune limbic encephalitis (aLE). METHODS: We recruited 38 patients (26 men, 12 women; median age 63.06 years; interquartile range [IQR] 16.06 years) in the postacute phase of aLE who completed questionnaires probing emotion regulation. All patients underwent structural/functional MRI postacutely, along with 67 age- and sex-matched healthy controls (40 men, 27 women; median age 64.70 years; IQR 19.87 years). We investigated correlations of questionnaire scores with demographic, clinical, neuropsychological, and brain imaging data across patients. We also compared patients diagnosed with pathologic tearfulness and those without, along with healthy controls, on gray matter volume, resting-state functional connectivity, and activity. RESULTS: Pathologic tearfulness was reported by 50% of the patients, while no patient reported pathologic laughing. It was not associated with depression, impulsiveness, memory impairment, executive dysfunction in the postacute phase, or amygdalar abnormalities in the acute phase. It correlated with changes in specific emotional brain networks: volume reduction in the right anterior hippocampus, left fusiform gyrus, and cerebellum, abnormal hippocampal resting-state functional connectivity with the posteromedial cortex and right middle frontal gyrus, and abnormal hemodynamic activity in the left fusiform gyrus, right inferior parietal lobule, and ventral pons. CONCLUSIONS: Pathologic tearfulness is common following aLE, is not a manifestation of other neuropsychiatric features, and reflects abnormalities in networks of emotion regulation beyond the acute hippocampal focus. The condition, which may also be present in other neurologic disorders, provides novel insights into the neural basis of affective control and its dysfunction in disease.

AB - OBJECTIVE: We investigated the nature and neural foundations of pathologic tearfulness in a uniquely large cohort of patients who had presented with autoimmune limbic encephalitis (aLE). METHODS: We recruited 38 patients (26 men, 12 women; median age 63.06 years; interquartile range [IQR] 16.06 years) in the postacute phase of aLE who completed questionnaires probing emotion regulation. All patients underwent structural/functional MRI postacutely, along with 67 age- and sex-matched healthy controls (40 men, 27 women; median age 64.70 years; IQR 19.87 years). We investigated correlations of questionnaire scores with demographic, clinical, neuropsychological, and brain imaging data across patients. We also compared patients diagnosed with pathologic tearfulness and those without, along with healthy controls, on gray matter volume, resting-state functional connectivity, and activity. RESULTS: Pathologic tearfulness was reported by 50% of the patients, while no patient reported pathologic laughing. It was not associated with depression, impulsiveness, memory impairment, executive dysfunction in the postacute phase, or amygdalar abnormalities in the acute phase. It correlated with changes in specific emotional brain networks: volume reduction in the right anterior hippocampus, left fusiform gyrus, and cerebellum, abnormal hippocampal resting-state functional connectivity with the posteromedial cortex and right middle frontal gyrus, and abnormal hemodynamic activity in the left fusiform gyrus, right inferior parietal lobule, and ventral pons. CONCLUSIONS: Pathologic tearfulness is common following aLE, is not a manifestation of other neuropsychiatric features, and reflects abnormalities in networks of emotion regulation beyond the acute hippocampal focus. The condition, which may also be present in other neurologic disorders, provides novel insights into the neural basis of affective control and its dysfunction in disease.

UR - http://www.scopus.com/inward/record.url?scp=85082342539&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000008934

DO - 10.1212/WNL.0000000000008934

M3 - Article

C2 - 31980582

AN - SCOPUS:85082342539

VL - 94

SP - e1320-e1335

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 12

ER -

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