Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/31298
Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Pathologic tearfulness after limbic encephalitis: A novel disorder and its neural basis
Author(s): Argyropoulos, Georgios P D
Moore, Lauren
Loane, Clare
Roca-Fernandez, Adriana
Lage-Martinez, Carmen
Gurau, Oana
Irani, Sarosh R
Zeman, Adam
Butler, Christopher R
Contact Email: georgios.argyropoulos@stir.ac.uk
Keywords: Clinical Neurology
Issue Date: 24-Mar-2020
Date Deposited: 7-Jun-2020
Citation: 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, 94 (12), pp. e1320-e1335. https://doi.org/10.1212/wnl.0000000000008934
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.
DOI Link: 10.1212/wnl.0000000000008934
Rights: This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY - https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Licence URL(s): http://creativecommons.org/licenses/by/4.0/

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