Some Vets With Brain Injury Can't Control Laughing or Tears

This is a laughing matter — but a medical situation that’s the farthest thing from funny for afflicted ex-troops.

In a survey of more than 700 veterans who showed signs of traumatic brain injury, 60 percent said they struggle with a little-known, neurological condition that causes them to lapse into uncontrolled fits of laughter or crying, according to a U.S. Department of Veterans Affairs survey released Wednesday.

Called pseudobulbar affect (PBA), the condition occurs in some 2 million Americans who have had strokes, brain injuries or been diagnosed with Parkinson’s or Alzheimer’s diseases.

But the surprisingly high portion of veterans who revealed they, too, experience unwanted bouts of giggles or tears may mean that hundreds of thousands of Iraq and Afghanistan veterans are grappling with the stigmatizing malady, said a VA brain expert.

“That’s probably very accurate,” said Regina McGlinchey, director of the VA’s Translational Research Center for Traumatic Brain Injury and Stress Disorders, based in Boston. She will present the findings Friday at the Tenth World Congress on Brain Injury, in San Francisco.

More than 2 million U.S. troops served in the two wars. Between 12 and 23 percent of those men and women sustained TBIs, the VA estimates.

“The data suggests over half of these people are having symptoms of PBA. And it really exacerbates their problem with reintegration (into society) and may facilitate greater isolation,” McGlinchey said. “These are veterans and service members who are very proud, very confident, and they’re not going to be out in social situations and not be in control of their emotions. That’s one thing I am extremely concerned about.”

Crying jags seem slightly more common than laughing spells. Some people endure both. The frequency and length of the outbursts vary among individuals, McGlinchey said.

The VA study was sponsored by Avanir Pharmaceuticals, Inc., which markets Nuedexta, a drug specifically approved to treat PBA.

There are no known triggers for the emotional eruptions, which often run opposite to what a person is feeling internally, McGlinchey said.

“That’s one of the most fascinating but also debilitating aspects of PBA because, really, what you’re looking at is a disassociation between someone’s emotional experience in the moment and what their emotional expression is,” she said. “These acts of laughing or crying are completely uncontrollable. They can just happen.”