{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:38:53Z","timestamp":1740166733653,"version":"3.37.3"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Emotional lability (EL), the uncontrollable and unmotivated expression of emotion, is a rare and distressing symptom of brainstem compression. In published case reports, EL from an extra-axial posterior fossa tumor was alleviated by tumor resection. The primary aim herein was to radiographically establish the degree of compression from mass lesions onto brainstem structures. Secondarily, we compared changes in patient-reported quality of life (QOL) pre- and postoperatively.<\/jats:p><jats:p>\n          Methods\u2003A retrospective review of posterior fossa tumors treated between 2002 and 2018 at Vancouver General Hospital revealed 11 patients with confirmed EL. Each case was matched to three controls. A lateral brainstem compression scale characterized mass effect at the level of the medulla, pons, and midbrain in preoperative axial T2-weighted fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) scans. Compression and clinical variables were compared between patient groups. Short Form-36 version 1 health surveys were retrospectively obtained from patient charts to compare pre- versus postoperative changes in survey scores between EL and control patients.<\/jats:p><jats:p>\n          Results\u2003EL symptoms ceased postoperatively for all EL patients. EL tumors exert greater compression onto the pons (p\u2009=\u20090.03) and EL patients more commonly have cerebellar findings preoperatively (p\u2009=\u20090.003). Patients with EL-causing tumors experienced greater improvement postoperatively in \u201cHealth Change\u201d (p\u2009=\u20090.05), which was maintained over time.<\/jats:p><jats:p>\n          Conclusion\u2003Findings suggest that compression onto the pons inhibits control over involuntary, stereotyped expression of emotion. This adds to evidence that EL may be attributed to cerebellum deafferentation from cortical and limbic structures through the basis pontis, leading to impaired modulation of emotional response. QOL results augment benefits of offering patients EL-alleviating tumor resection surgery.<\/jats:p>","DOI":"10.1055\/a-2028-6373","type":"journal-article","created":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T23:28:42Z","timestamp":1675553322000},"page":"189-201","source":"Crossref","is-referenced-by-count":0,"title":["Emotional Lability as a Symptom of Extra-axial Posterior Fossa Tumors: a Case\u2013Control Review of Neuroanatomy and Patient-Reported Quality of Life"],"prefix":"10.1055","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-9323","authenticated-orcid":false,"given":"Swetha","family":"Prakash","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of British Columbia Faculty of Medicine, Vancouver, Canada"},{"name":"University of Alberta Faculty of Medicine, Edmonton, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Gooderham","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of British Columbia Faculty of Medicine, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryojo","family":"Akagami","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of British Columbia Faculty of Medicine, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/B978-0-444-53485-9.00015-5","article-title":"Extra-axial brain tumors","volume":"135","author":"O Rapalino","year":"2016","journal-title":"Handb Clin Neurol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1098\/rstb.2009.0064","article-title":"Brainstem: neural networks vital for life","volume":"364","author":"J G Nicholls","year":"2009","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"volume-title":"Chiari I Malformation & Syringomyelia","year":"2018","author":"A Ringer","key":"ref3"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1093\/brain\/124.9.1708","article-title":"Pathological laughter and crying: a link to the cerebellum","volume":"124","author":"J Parvizi","year":"2001","journal-title":"Brain"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1146\/annurev.neuro.23.1.155","article-title":"Emotion circuits in the brain","volume":"23","author":"J E LeDoux","year":"2000","journal-title":"Annu Rev Neurosci"},{"issue":"02","key":"ref6","first-page":"162","article-title":"Trigeminal schwannoma associated with pathological laughter and crying","volume":"49","author":"M J Virani","year":"2001","journal-title":"Neurol India"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/S1474-4422(05)00970-1","article-title":"Treatment of emotional lability in ALS","volume":"4","author":"V Meininger","year":"2005","journal-title":"Lancet Neurol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s00415-008-0685-1","article-title":"Neuroanatomy of pseudobulbar affect : a quantitative MRI study in multiple sclerosis","volume":"255","author":"O Ghaffar","year":"2008","journal-title":"J Neurol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.psc.2013.12.001","article-title":"Emotional and behavioral dyscontrol after traumatic brain injury","volume":"37","author":"D B Arciniegas","year":"2014","journal-title":"Psychiatr Clin North Am"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1136\/bmj.298.6679.991","article-title":"Emotionalism after stroke","volume":"298","author":"A House","year":"1989","journal-title":"BMJ"},{"key":"ref11","first-page":"275","volume-title":"Extra-axial brain tumors","author":"O Rapalino","year":"2016"},{"issue":"04","key":"ref12","first-page":"187","article-title":"Petroclival meningioma presenting with pathological laughter: report of a case and review of the literature","volume":"12","author":"T-J Cheng","year":"2003","journal-title":"Acta Neurol Taiwan"},{"issue":"10","key":"ref13","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2176\/nmc.41.505","article-title":"Pathological laughter as a presenting symptom of petroclival meningioma\u2013case report","volume":"41","author":"D Muzumdar","year":"2001","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1055\/s-2002-31568-1","article-title":"Pseudobulbar palsy caused by a large petroclival meningioma: report of two cases","volume":"12","author":"W E McCormick","year":"2002","journal-title":"Skull Base"},{"issue":"06","key":"ref15","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.3171\/jns.1966.24.6.1024","article-title":"Pathological laughing and crying associated with a tumor ventral to the pons. 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