Evidence map›Paper›PMID 31980582›Full record

ArticleNeurology2020

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

Georgios P D Argyropoulos, Lauren Moore, Clare Loane, Adriana Roca-Fernandez, Carmen Lage-Martinez, Oana Gurau, Sarosh R Irani, Adam Zeman, Christopher R Butler

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Diencephalic integrity explains aspects of hippocampal amnesia.Cerebral cortex (New York, N.Y. : 1991) · 2026
    Article
  3. Article
  4. Psychiatric features in NMDAR and LGI1 antibody-associated autoimmune encephalitis.European archives of psychiatry and clinical neuroscience · 2024
    Article
  5. Review
  6. Article
  7. Article
  8. Neuropsychological Performance in Autoimmune Limbic Encephalitis: Evidence from an Immunotherapy-Naïve Cohort.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2022
    Article
  9. Review
  10. Observational
  11. Article
  12. Neuropsychiatric Disorders Due to Limbic Encephalitis: Immunologic Aspect.International journal of molecular sciences · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Georgios P D ArgyropoulosFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago. georgios.argyropoulos@ndcn.ox.ac.uk.ORCID 0000-0001-8267-6861
Lauren MooreFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.
Clare LoaneFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.
Adriana Roca-FernandezFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.
Carmen Lage-MartinezFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.
Oana GurauFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.
Sarosh R IraniFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.ORCID 0000-0002-7667-9748
Adam ZemanFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.ORCID 0000-0003-4875-658X
Christopher R ButlerFrom the Memory Research Group (G.P.D.A., L.M., C.L., A.R.-F., C.L.-M., O.G., C.R.B.) and Autoimmune Neurology Group (S.R.I.), Nuffield Department of Clinical Neurosciences, University of Oxford; Department of Psychology (L.M.), University of Bath; Maurice Wohl Clinical Neuroscience Institute, Basic and Clinical Neuroscience Department (C.L.), King's College London, UK; Valdecilla Biomedical Research Institute (C.L.-M.), University Hospital Marqués de Valdecilla, Santander, Spain; Medical School (A.Z.), University of Exeter, UK; Department of Brain Sciences (C.R.B.) Imperial College London, UK; and Departamento de Neurología (C.R.B.), Pontificia Universidad Católica de Chile, Santiago.ORCID 0000-0002-7502-9284
King's College London · GB

Funding

Department of HealthMedical Research Council MR/K010395/1Wellcome Trust 104079/Z/14/Z
6 · The paper itself

Abstract

objectiveWe investigated the nature and neural foundations of pathologic tearfulness in a uniquely large cohort of patients who had presented with autoimmune limbic encephalitis (aLE).

methodsWe 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.

resultsPathologic 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.

conclusionsPathologic 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.

Indexed as

AgedAutoimmune DiseasesBrainCryingEmotional RegulationFemaleHumansLimbic EncephalitisMagnetic Resonance ImagingMaleMiddle Aged

Identifiers

PMID31980582
PMCPMC7274928
OpenAlexW2987889158

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.