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PubMed1995

Humor as a cognitive technique for increasing pain tolerance.

Substantial research has demonstrated that cognitive psychological techniques including distraction can increase pain tolerance. In recent years, there also have been claims that humor and laughter possess unique characteristics for coping with pain and stress. Theoretically, explanations include the release of endorphins, the lowering of tension, as well as the distraction that results from humor. The question is whether humor is more effective than simple distraction. For this purpose humor was contrasted with a repulsive stimulus and a neutral stimulus controlled for interest level, that would also have distraction capabilities but not the unique aspects of humor. Pain tolerance was tested using cold pressor stimulation. Four groups (20 subjects in each) were tested. Three groups were shown a film: (1) a humorous film, (2) a repulsive film, (3) a neutral film. Group 4 was not shown any film. Results indicated that both the humor and repulsive groups showed a significant increase in pain tolerance as compared to the other groups. The repulsive group yielded the largest increase in pain tolerance although not different from the humor group. Except for sex differences, pain ratings did not show any group effects. Discussion focused on the type of distraction that would be meaningful for increasing pain tolerance and on the place of humor in pain control.

Adolescent↗
PubMedDate not supplied

Electroclinical diagnosis of Angelman syndrome: a study of 7 cases.

The authors describe 7 new cases of Angelman syndrome (AS: 3 males and 4 females) diagnosed on the basis of clinical features (dysmorphic facial features, severe mental retardation with absent speech, peculiar jerky movements, ataxic gait and paroxysms of inappropriate laughter) and neurophysiological findings. Failure to detect deletion of the long arm of chromosome 15 or the absence of epileptic seizure were not considered sufficient to exclude a diagnosis of AS. Feeding problems, developmental delay and early signs of ataxia, especially tremor on handling objects and unstable posture when seated, proved effective as clinical markers for early diagnosis of AS. The EEG patterns characteristic of AS were found within the first 2 years of life (under 18 months in the majority of cases). The authors conclude that AS should be included in differential diagnosis in a child aged under 12 months having cryptogenic psychomotor retardation with prevalent language compromise. Repeat EEG recordings are needed to check for the typical trace, and cytogenetic investigations are mandatory.

Angelman Syndrome↗
PubMedDate not supplied

Precocious puberty in a case with probable Angelman syndrome.

The authors report a 9-year-old girl with mid-facial hypoplasia, maxillary hypoplasia, prognathia, microbrachycephaly, mouth opening and protruding tongue. She also had psychomotor retardation such as mental retardation and speech delay. Frequent laughter fits and seizure disorder was also noted. Although the high resolution chromosome study failed to demonstrate any deletion of chromosome 15q, the clinical picture was compatible with Angelman syndrome. Breast development at the age of six and rapid progression of bone age was noted at follow up. After a series of examinations, the diagnosis of gonadotropin-dependent precocious puberty was made. MRI of brain revealed an intermediate cyst in the pituitary gland and slightly enlarged pineal gland. However, serum alpha-fetoprotein and beta-HCG were undetectable and the size of the pineal gland remained the same at the 1-year follow-up. She was treated with long-acting GnRH analogue and valproic acid. The combination of precocious puberty and Angelman syndrome has not been reported before and such association needs further experience for clarification.

Angelman Syndrome↗
PubMed2005

[Angelman syndrome and intracranial aneurysm: fortuitous association or commune genetic predisposition?].

Although the pathogenesis of cerebral aneurysms has been studied intensively, it is yet poorly understood. However, a genetic predisposition to this pathology has been often suspected. We describe a patient with both intracranial aneurysm and Angelman syndrome. Angelman syndrome is characterized by severe mental retardation, inappropriate laughter, absent speech, dysmorphic facial features and seizures. It is due to genetic abnormalities of chromosome 15. Cerebral aneurysms are sometimes associated with inherited diseases like autosomal dominant polycystic kidney disease. Moreover several candidate genes have been analysed, to search for genetic variants which might be associated with the occurrence of intracranial aneurysms. Our question is: is the association described in our observation fortuitous or do these diseases share a same genetic predisposition? Our observation also supports the hypothesis of a genetic participation in the genesis of cerebral aneurysms.

Angelman Syndrome↗
PubMed2004

Thelarche variant in a girl with Angelman syndrome.

A case of Angelman syndrome (AS) with thelarche variant in a 4.5-year-old girl is presented. Clinical suspicion of AS was raised at the age of 15 months when she presented with mental retardation and epilepsy, absence of speech, ataxic gait with jerky movements, hyperactivity and paroxysmal episodes of laughter. Moreover, she had facial dysmorphic features such as microbrachycephaly, mid-facial hypoplasia, macrostomia and prominent mandible. Dinucleotide repeat polymorphism (DNRP) analysis, identified absence of maternal alleles at D15S543, D15S113 and GABRB3 loci, findings consistent with AS. Studies on CYP19 locus (outside the 15q11-13 region) revealed the presence of two different alleles, thus excluding the possibility of paternal isodisomy of chromosome 15 in this patient. Breast development at the age of 4.5 years, accompanied by accelerated growth velocity and bone age suggested the diagnosis of variant thelarche. This is the second case of AS with sexual precocity reported and whether this combination is a coincidence or not remains to be clarified.

Alleles↗
PubMed2006

The biology and evolution of music: a comparative perspective.

Studies of the biology of music (as of language) are highly interdisciplinary and demand the integration of diverse strands of evidence. In this paper, I present a comparative perspective on the biology and evolution of music, stressing the value of comparisons both with human language, and with those animal communication systems traditionally termed "song". A comparison of the "design features" of music with those of language reveals substantial overlap, along with some important differences. Most of these differences appear to stem from semantic, rather than structural, factors, suggesting a shared formal core of music and language. I next review various animal communication systems that appear related to human music, either by analogy (bird and whale "song") or potential homology (great ape bimanual drumming). A crucial comparative distinction is between learned, complex signals (like language, music and birdsong) and unlearned signals (like laughter, ape calls, or bird calls). While human vocalizations clearly build upon an acoustic and emotional foundation shared with other primates and mammals, vocal learning has evolved independently in our species since our divergence with chimpanzees. The convergent evolution of vocal learning in other species offers a powerful window into psychological and neural constraints influencing the evolution of complex signaling systems (including both song and speech), while ape drumming presents a fascinating potential homology with human instrumental music. I next discuss the archeological data relevant to music evolution, concluding on the basis of prehistoric bone flutes that instrumental music is at least 40,000 years old, and perhaps much older. I end with a brief review of adaptive functions proposed for music, concluding that no one selective force (e.g., sexual selection) is adequate to explaining all aspects of human music. I suggest that questions about the past function of music are unlikely to be answered definitively and are thus a poor choice as a research focus for biomusicology. In contrast, a comparative approach to music promises rich dividends for our future understanding of the biology and evolution of music.

Animal Communication↗
PubMed2006

Continuity of temperament from infancy to middle childhood.

Continuity of temperament from 6 months (the IBQ) to 5.5 years (the CBQ) was explored in Finnish children (n=231) within the theoretical framework deviced by Rothbart. Activity level, smiling and laughter, distress to limitations and fear showed significant differential homotypic and heterotypic continuity, while soothability and duration of orienting showed significant differential heterotypic continuity. On the level of latent superconstructs, infant positive and negative affectivity accounted for 4.6, 22.3, and 6.0% of the variance in childhood extraversion, effortful control and negative affectivity, respectively. Infant and childhood temperament clustered into profile types named "resilient", "undercontrolled", and "overcontrolled" mirroring ipsative continuity. These findings give empirical credence to Rothbart's theory by replicating and extending previous findings in significant ways.

Child, Preschool↗
PubMed2005

Could personality traits modify the response to uncorrected high hyperopia?

PURPOSE: We aimed to measure temperament and investigate personality in children with high hyperopia considering that these could modify the individual response to uncorrected high hyperopia. METHODS: Fifteen children (age range, 5 to 12 years) with orthotropia and ametropic amblyopia in the presence of uncorrected high hyperopia were identified (group 1). Among the children with refractive accommodative esotropia, 15 children (age range, 5 to 12 years) were enrolled to form group 2. We measured the temperament by using the Children's Behavior Questionnaire (CBQ) Short Form. The Children's Apperception Test (CAT-H) was also administered to all subjects. RESULTS: Regarding the temperament scales measured by CBQ, themes of discomfort, fear, and shyness were more dominant in group 2; high-intensity pleasure and smiling-laughter were dominant in group 1. However the difference was statistically significant only for fear scale (P = 0.045). CAT-H results revealed that aggression toward the parents was the most commonly encountered behavioral pattern in both groups. The children in group 1 were more likely to express passive-aggressive behavioral pattern. Obstinacy and anal period characteristics dominate in the children in group 2. Themes of narcissistic injury was more frequently expressed by these children. CONCLUSION: The temperament scales and personality traits could play a role in the modification of the individual response to uncorrected high hyperopia. This finding deserves more research in a larger study group.

Child↗
PubMed2006

Emotion with tears decreases allergic responses to latex in atopic eczema patients with latex allergy.

OBJECTIVE: Allergic responses are enhanced by stress, whereas they are reduced by laughter in atopic eczema patients. Emotion with tears decreases plasma IL-6 levels in patients with rheumatoid arthritis. Thus, the effect of emotion with tears on allergic responses in patients with atopic eczema was studied. METHODS: Sixty patients with atopic eczema having latex allergy viewed both the weather information video and the heart-warming movie, Kramer vs. Kramer. Just before and immediately after viewing each video, allergic responses to latex were measured. RESULTS: Viewing the weather information video did not cause emotion with tears in any patients, and it failed to modulate allergic responses. In contrast, viewing Kramer vs. Kramer caused emotion with tears in 44 of 60 patients, and it reduced allergic skin wheal responses to latex and latex-specific IgE production in them. CONCLUSION: Emotion with tears reduced allergic responses, and it may be useful in the treatment of allergic diseases.

Adult↗
PubMed2005

Music, memory, and Alzheimer's disease: is music recognition spared in dementia, and how can it be assessed?

Despite intriguing and suggestive clinical observations, no formal research has assessed the possible sparing of musical recognition and memory in Alzheimer's dementia (AD). A case study is presented of an 84-year old woman with severe cognitive impairment implicating AD, but for whom music recognition and memory, according to her caregivers, appeared to be spared. The hypotheses addressed were, first, that memory for familiar music may be spared in dementia, and second, that musical recognition and memory may be reliably assessed with existing tests if behavioral observation is employed to overcome the problem of verbal or written communication. Our hypotheses were stimulated by the patient EN, for whom diagnosis of AD became probable in 2000. With severe problems in memory, language, and cognition, she now has a mini-mental status score of 8 (out of 30) and is unable to understand or recall standard instructions. In order to assess her music recognition abilities, three tests from the previous literature were adapted for behavioral observation. Two tests involved the discrimination of familiar melodies from unfamiliar melodies. The third involved the detection of distortions ("wrong" notes) in familiar melodies and discrimination of distorted melodies from melodies correctly reproduced. Test melodies were presented to EN on a CD player and her responses were observed by two test administrators. EN responded to familiar melodies by singing along, usually with the words, and often continuing to sing after the stimulus had stopped. She never responded to the unfamiliar melodies. She responded to distorted melodies with facial expressions - surprise, laughter, a frown, or an exclamation, "Oh, dear!"; she never responded in this way to the undistorted melodies. Allowing these responses as indicators of detection, the results for EN were in the normal or near normal range of scores for elderly controls. As well, lyrics to familiar melodies, spoken in a conversational voice without rhythmic or pitch clues, often prompted EN to sing the tune that correctly accompanied the lyrics. EN's results provide encouraging support for our hypotheses that sparing of musical memory may be a feature of some forms of dementia and that it may be reliably and quantitatively assessed through behavioral observation. The contrast between EN's response to music and her mini-mental status is dramatic. The article concludes with several considerations why music may be preserved in dementia and suggestions to guide future research.

Aged↗
PubMed2005

The dynamic range of biologic functions and variation of many environmental cues may be declining in the modern age: implications for diseases and therapeutics.

We hypothesize that declining dynamic range and variation of environmental cues may contribute to health dysfunctions, and that judicious expansion of biologic dynamic ranges may be beneficial. Three disparate examples involving the endocrine, autonomic, and musculoskeletal systems are discussed. Daytime sheltering, optical shading, and nighttime use of artificial light may reduce circadian luminal variation. The resulting melatonin alterations may contribute to systemic dysfunctions. Loss of temporal variation of other hormones may contribute to biologic dysfunctions, especially those involving the hypothalamic-pituitary axis. Reduced variation of physical exertion, environmental stressors, and thermal gradients that characterize modern lifestyles may reduce the autonomic dynamic range resulting in lowered heart rate variability and a myriad of systemic dysfunctions. The health benefits of activities such as exercise, meditation, acupuncture, coitus, and laughter may operate through increasing autonomic variability. Reduced physical exertion also accounts for declining dynamic range of musculoskeletal function. The resulting muscle atrophy, fat infiltration, and sarcomere shortening may not only have deleterious local effects, but may also be involved in systemic metabolic dysfunctions such as insulin resistance. The extent to which our endogenous systems rely on environmental variation for self-tuning and the impact that under-utilization of compensatory mechanisms has on biologic function are not well understood. Modern therapeutic approaches generally result in reversion to the mean of physiologic functions and may buffer against variation. For example, beta-blockers are given to reduce adrenergic excess, insulin to treat insulin insufficiency, serotonin-reuptake inhibitors for depression, and refractive lenses for myopia. By undermining the demand for native compensatory functions, such therapeutic strategies may actually impair future ability to respond to biologic disequilibria. Generalizing from these observations, we anticipate benefits of therapeutic and lifestyle approaches that expand, rather than reduce, the dynamic range of many biologic experiences.

Animals↗
PubMed2005

Central nervous system control of the laryngeal muscles in humans.

Laryngeal muscle control may vary for different functions such as: voice for speech communication, emotional expression during laughter and cry, breathing, swallowing, and cough. This review discusses the control of the human laryngeal muscles for some of these different functions. Sensori-motor aspects of laryngeal control have been studied by eliciting various laryngeal reflexes. The role of audition in learning and monitoring ongoing voice production for speech is well known; while the role of somatosensory feedback is less well understood. Reflexive control systems involving central pattern generators may contribute to swallowing, breathing and cough with greater cortical control during volitional tasks such as voice production for speech. Volitional control is much less well understood for each of these functions and likely involves the integration of cortical and subcortical circuits. The new frontier is the study of the central control of the laryngeal musculature for voice, swallowing and breathing and how volitional and reflexive control systems may interact in humans.

Brain↗
PubMed1997

Angelman's syndrome: clinical and electroencephalographic findings.

Angelman's syndrome is a rare genetic disorder characterized by developmental delay, craniofacial abnormalities, ataxia, paroxysmal laughter, and seizures. The diagnosis is suspected in infants who have the characteristic clinical features and electroencephalographic (EEG) abnormalities and is confirmed by the genetic identification of a maternally derived 15q11-13 deletion. We report on 3 patients with genetically confirmed Angelman's syndrome who had the characteristic clinical and EEG features. The EEGs demonstrated high-amplitude 2- to 3-Hz delta activity, with intermittent spike-and-slow-wave discharges maximal in the occipital region in 2 patients and generalized sharp-and-slow-wave discharges, occipital spikes, and electrographic status epilepticus during slow-wave sleep in the other patient. The findings of generalized high-amplitude delta slowing and occipital spike-and-wave discharges, facilitated by eye closure, in children with developmental delay and seizures suggest the diagnosis of Angelman's syndrome and should lead to genetic testing.

Angelman Syndrome↗
PubMed2001

The role of age at asthma diagnosis in the development of triggers of asthma episodes.

This study examined the relationship of age at asthma diagnosis to the subsequent impacts of 12 common asthma triggers, which we classified as either mainly physically based or strongly psychosocially mediated. The physically based triggers were air pollution, cigarette smoke, high humidity, high/low environmental temperature, allergy problems, respiratory infection, physical activity, and nighttime hours; the psychosocially mediated triggers were stress or worry, anger, excitement, and laughter. Data were collected with questionnaires from families with asthmatic children (n=115), 2 to 20 years of age, as part of a larger study of biological and psychosocial factors in asthma and other illnesses. Using parents' reports, we classified the children as early-diagnosed (before age 2) or later-diagnosed (at or after 2) for asthma and compared these groups, separated by gender, in 2 x 2 multivariate analyses. The impacts of all four psychosocially mediated triggers on asthma attacks were significantly greater for the later-diagnosed children than the early-diagnosed children. No age of diagnosis differences were found for any of the physically based triggers, and no gender or interaction effects were found for either type of trigger.

Age Factors↗
PubMed1999

Effects of obstetrician gender on communication and patient satisfaction.

OBJECTIVE: To describe patient-obstetrician communication during the first prenatal visit and its relationship to physician gender and patient satisfaction. METHODS: The first prenatal visit of 87 women with 21 obstetricians (11 male and ten female) was audiotaped and analyzed using the Roter Interaction Analysis System. Patient satisfaction was measured by postvisit questionnaire. RESULTS: Communication during first prenatal visits was largely biomedical, with little psychosocial or social discussion. Male physicians conducted longer visits than females (26 minutes versus 21.9 minutes, P < .05) and engaged in more facilitative communication (ie, making sure they were understood and providing direction and orientation) and explicit statements of concern and partnership (z > 1.96, P < .05). Female physicians devoted more communication to agreements, disagreements, and laughter than males (z > 1.96, P < .05). Satisfaction with physicians' emotional responsiveness and informational partnership was related to female physician gender and a variety of task-focused and affective communication variables. CONCLUSION: Communication and satisfaction between women and obstetricians during initial prenatal visits is related to physician gender and patient satisfaction. Male physicians conducted longer visits but women were more satisfied with female physicians.

Adult↗
PubMedDate not supplied

Humor: a nursing intervention for the elderly.

Researchers should investigate humor's value and impact on quality of life of elders. Humorous interventions should be studied and compared in elders. The effects of endorphin release during laughter is another aspect of humor to be studied. Certainly humor is not the answer to all the discomforts encountered by older adults, but the positive effects on some cannot be disputed. Humor as a noninvasive modality and an adjunct to patient care can be of benefit not only to the patient and family, but also to the professional nurse who encounters the discomforts of the patient on a daily basis. Humor can aid in viewing the pleasures and pains of the world with new perspectives.

Aged↗
PubMed1998

The effects of emotional behaviour on components of the respiratory cycle.

The present study was designed to examine affect-related respiratory responses during film scenes, reaction time (RT) and cold pressor (CP) tasks. In addition, I investigated whether affect-related respiratory responses could be characterised by a number of underlying dimensions, such as positive versus negative affect and active versus passive coping. Respiratory output was indexed by a detailed analyses of various volumetric and timing components of the breathing cycle. There were fundamental differences in respiratory responses to different types of affective and cognitively demanding tasks. The emotionally loaded film stimuli showed clear effects on respiration whenever the films elicited amusement and disgust. That is, amusement (laughter) induced a decrease in inspiratory time and tidal volume, whereas disgust could be linked to a prolongation of inspiratory pauses (breath-holding). Relative to a pretask baseline, RT performance elicited a relatively fast, shallow and regular breathing pattern. The pattern of breathing in response to CP was in stark contrast to the RT task, in that a substantial increase in tidal volume, minute ventilation, mean inspiratory flow and breathing irregularity was accompanied by no change in total cycle duration. The implications of these results are discussed with regard to specificity and dimensional models. It is suggested that specificity models might apply to phasic respiratory activity such as breath-holding in disgust and pain. On the other hand, breathing irregularity and expiratory pause duration appears to correspond to emotion dimensions (positive versus negative affect) that cut across the boundaries of emotion categories. Lastly, there were the respiratory patterns that could be more readily interpreted in terms of a task-involvement or active versus passive coping attitude.

Adolescent↗
PubMed2002

Gelastic seizures and low-grade hypothalamic astrocytoma: a case report.

The typical, well recognized childhood epilepsy syndrome caused by hypothalamic hamartoma is characterized by early-onset, stereotyped attacks of uncontrollable laughter, frequent refractory seizures with progressive cognitive deterioration and severe behavioral problems. Here, we report a 17-year-old patient with gelastic phenomenon started in the neonatal period, later on associated with drug resistant polymorphic seizures, intellectual deficit and behavioral disorders, who improved by partial resection of an expected hypothalamic hamartoma that, in turn, resulted to be a hypothalamic low-grade astrocytoma.

Adolescent↗