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PubMed2004

Some neurological aspects of laughter.

This brief survey of laughter attempts an analysis of its neurological mechanisms, evolution, role in social behaviour and its clinicopathological importance. The mechanisms of laughter, its physiological consequences and its demonstration by sound spectrography are considered. Something resembling laughter occurs in certain primates, and possibly rodents, though there are important differences. The evolution of laughter in a social context is appraised. Pathological laughter arises rarely, usually caused by diseases of the frontal or temporal lobes, and in hypothalamic hamartomata in children.

Animals↗
PubMed1996

Videoendoscopic analysis of laryngeal function during laughter.

Although commonly encountered in all human cultures, laughter remains poorly understood. In order to examine laryngeal function during laughter, telescopic and fiberscopic videolaryngoscopy was performed on five subjects, who laughed in the different vowels, at various frequencies, and in several voice qualities. During laughter, the vocal folds were found consistently to undergo rhythmic abduction and adduction. At the end of these specific phonation tasks, all subjects were able to gain voluntary control of paramedian vocal fold positioning. This study defined laryngeal function during laughter. These results have important clinical implications. Voluntary vocal fold positioning has important applications in speech therapy for dysphonias, such as vocal fold nodules, in which the primary cause is vocal fold hyperadduction. Patients suffering from these hyperadductive dysphonias may be able to utilize laughter to correct them.

Adult↗
PubMed1991

Normal and pathologic laughter in children.

Laughter is a partly involuntary act involving complex pathways in the central nervous system. Laughter normally has positive effects on emotions; however, pathologic laughter is not related to emotion and occurs independent of a stimulus in the environment. This paper outlines normal laughter and the etiology of pathologic laughter, considering both congenital and acquired causes.

Child↗
PubMed1985

[Imotivated laughter: report of 3 cases].

The authors present three cases where the involuntary, imotivated laughter was a distinct finding. The first patient was a 29-year-old engineer, who had had several bursts of neurologic deficits, either sensitive or motor, which recovered almost completely and was diagnosed as suffering from multiple sclerosis. During and after one of the episodes he presented involuntary laughter and has been like this since then, albeit in much less extension. The second patient was a 35-year-old housewife, who presented several episodes of brain infarction in both hemispheres which were considered as being the result of arteritis. No specific collagen disease was found. The CAT scan showed several hypodense areas in both hemispheres. The third patient was a 52-year-old man of Japanese ancestry who presented three years ago a sudden ischemic stroke with difficulty in the speech and left sided weakness, followed by bursts of imotivated laughter, which persisted since then. Subsequently he had another stroke. He is hypertensive and diabetic. The authors searched the literature for the different causes of involuntary laughter. The occurrence in multiple sclerosis, although reported by several authors is by no means a common finding. In the literature available no case of cerebral arteritis with involuntary laughter could be found. The pathophysiology of this rare symptom was discussed.

Adult↗
PubMed2004

A chuckle a day keeps the doctor away: therapeutic humor and laughter.

There are several beneficial efforts attributed to humor and laughter, including improved immune function, increased pain tolerance, and decreased stress response. Humor therapy, laughter therapy, laughter meditation,and laughter clubs all have unique implications as group programs and as self-management techniques. For practitioners to implement credible programs and effectively teach self-management techniques, further empirical research on the physical, psychosocial, debonafide, and the placebo effects of humor and laughter needs to be conducted.

Health Status↗
PubMed2002

[The effect of public self-consciousness on forced laughter].

The purpose of this study was to investigate the effect of public self-consciousness on forced laughter. Participants (N = 409) were asked to imagine a group of either friends or acquaintances, and then to indicate how often he or she exhibited forced laughter toward the group members. They also completed Self-Consciousness Scale (Fenigstein, Scheier, & Buss, 1975). Results indicated that persons with high public self-consciousness reported more frequent expressions of all types of forced laughter--expression control, intimacy maintenance, action control, and affect manipulation--than those who were low, regardless of interpersonal intimacy level. Besides public self-consciousness, both gender and intimate feeling toward group members influenced frequency of forced laughter. Implications for the nature of public self-consciousness and forced laughter were discussed.

Adult↗
PubMedDate not supplied

The effect of mirthful laughter on stress and natural killer cell activity.

CONTEXT: A recent survey of rural Midwestern cancer patients revealed that humor was one of the most frequently used complementary therapies. Psychoneuroimmunology research suggests that, in addition to its established psychological benefits, humor may have physiological effects on immune functioning. OBJECTIVE: To determine the effect of laughter on self-reported stress and natural killer cell activity. DESIGN: Randomized, pre-post test with comparison group. SETTING: Indiana State University Sycamore Nursing Center, which is a nurse-managed community health clinic in a mid-sized, Midwestern city. PARTICIPANTS: 33 healthy adult women. INTERVENTION: Experimental subjects viewed a humorous video while subjects in the distraction control group viewed a tourism video. MAIN OUTCOME MEASURES: Self-reported stress and arousal (Stress Arousal Check List), mirthful laughter (Humor Response Scale), and immune function (chromium release natural killer [NK] cell cytotoxicity assay). RESULTS: Stress decreased for subjects in the humor group, compared with those in the distraction group (U32 = 215.5; P = .004). Amount of mirthful laughter correlated with postintervention stress measures for persons in the humor group (r16 = -.655; P = .004). Subjects who scored greater than 25 on the humor response scale had increased immune function postintervention (t16 = 2.52 P = .037) and compared with the remaining participants (t32 = 32.1; P = .04). Humor response scale scores correlated with changes in NK cell activity (r16 = .744; P = 001). CONCLUSION: Laughter may reduce stress and improve NK cell activity. As low NK cell activity is linked to decreased disease resistance and increased morbidity in persons with cancer and HIV disease, laughter may be a useful cognitive-behavioral intervention.

Adult↗
PubMedDate not supplied

Effects of mirthful laughter on growth hormone, IGF-1 and substance P in patients with rheumatoid arthritis.

OBJECTIVE: Growth hormone (GH) plays an ancillary role in the regulation of immune function. GH has been shown to be associated with joint symptoms such as pain and swelling. On the other hand, mirthful laughter has favorable effects on the neuroendocrine-immune system. We evaluated the levels of serum GH, insulin-like growth factor-1 (IGF-1) in RA patients and evaluated the effect of mirthful laughter on GH and IGF-1. METHODS: We compared with the levels of serum GH, IGF-1 and substance P (SP) in patients with RA and healthy subjects (control group) before and after exposure to "Rakugo", a traditional Japanese comical story that induces mirthful laughter. RESULTS: The basal level of serum GH in the RA group was significantly higher than in the control group. After experiencing mirthful laughter, the level of serum GH in the RA group significantly decreased, approaching that in the control group. The serum IGF-1 level was lower in the RA group than in the control group. There was no significant difference in the level of serum SP between the RA group and the control group. CONCLUSION: The basal level of serum GH in the RA group was significantly higher than in the control group, and the level of serum GH significantly decreased after experiencing mirthful laughter These results suggest that the homeostasis of GH in patients with RA is disturbed, and the increased serum GH levels in RA patients may be associated with their stress condition.

Adult↗
PubMed2003

Mirth-triggered asthma: is laughter really the best medicine?

Mirthful emotions such as laughter and excitement are unrecognized but perhaps important triggers of asthma. Our study aimed to explore the prevalence, mechanisms, and associations of mirth-triggered asthma (MTA) in children. Our MTA prevalence questionnaire was given to 285 children who presented to the Emergency Department of Sydney Children's Hospital (SCH) with an acute episode of asthma. Our MTA profile questionnaire study was a cross-sectional study of 541 children with asthma. The parents completed a questionnaire regarding their child's asthma. In our laughter diary study, diary cards were given to the parents of 21 children with asthma. The diary required details regarding the mirthful stimulus, symptoms of asthma, and recording of peak expiratory flow (PEF) measurements. Of the selected cohort, 31.9% had mirth-triggered asthma. In the cross-sectional study, mirth-triggered asthma was more common: with increasing age (P = 0.02); in those who in the last 3 months had taken more doses of salbutamol (P = 0.005), and who had more wheeze, nocturnal symptoms, and early morning symptoms (P < 0.0005); and in those who reported exercise-induced asthma (P < 0.0005). Laughter was more commonly reported as a trigger than excitement; cough was the most prominent symptom; and symptoms mostly occurred within 2 min of the mirthful stimulus. In the laughter diary study, 59 of 130 recorded events described symptoms of asthma. Mirth while watching a film led to PEF of 73% of baseline, compared with 81% for mirth with exertional play, and 95% for mirth with nonexertional play (P = 0.01). Mirth-triggered asthma is common, and is an indicator of suboptimal asthma control.

Adolescent↗
PubMed1979

Epileptic laughter: electroclinical and cinefilm report of a case.

A woman, aged 30, experienced attacks of pathological laughter which began during the first months of life; they meet the qualifying criteria of epileptic laughter. Several attacks were recorded by polygraphy and cinefilm. The attack begins with a feeling of unreality associated with a forced, involuntary smile progressing to full laughter. The patient tried to mask the laughter which was not accompanied by euphoria but was followed by loss of consciousness and automatisms. Only during the latter phase of the previously normal EEG did an ictal discharge appear over the right hemisphere. On the basis of the electroclinical pattern and of a review of the literature, the seizure is tentatively explained in terms of a progressive ictal involvement of temporodiencephalic structures.

Adult↗
PubMed2005

Distinct fMRI responses to laughter, speech, and sounds along the human peri-sylvian cortex.

In this event-related fMRI study, 12 right-handed volunteers heard human laughter, sentential speech, and nonvocal sounds in which global temporal and harmonic information were varied whilst they were performing a simple auditory target detection. This study aimed to delineate distinct peri-auditory regions which preferentially respond to laughter, speech, and nonvocal sounds. Results show that all three types of stimuli evoked blood-oxygen-level-dependent responses along the left and right peri-sylvian cortex. However, we observed differences in regional strength and lateralization in that (i) hearing human laughter preferentially involves auditory and somatosensory fields primarily in the right hemisphere, (ii) hearing spoken sentences activates left anterior and posterior lateral temporal regions, (iii) hearing nonvocal sounds recruits bilateral areas in the medial portion of Heschl's gyrus and at the medial wall of the posterior Sylvian Fissure (planum parietale and parietal operculum). Generally, the data imply a differential regional sensitivity of peri-sylvian areas to different auditory stimuli with the left hemisphere responding more strongly to speech and with the right hemisphere being more amenable to nonspeech stimuli. Interestingly, passive perception of human laughter activates brain regions which control motor (larynx) functions. This observation may speak to the issue of a dense intertwining of expressive and receptive mechanisms in the auditory domain. Furthermore, the present study provides evidence for a functional role of inferior parietal areas in auditory processing. Finally, a post hoc conjunction analysis meant to reveal the neural substrates of human vocal timbre demonstrates a particular preference of left and right lateral parts of the superior temporal lobes for stimuli which are made up of human voices relative to nonvocal sounds.

Acoustic Stimulation↗
PubMed2003

Postictal laughter following absence status epilepticus.

Acute pathologic neurologic laughter has been described as an ictal phenomenon in epilepsy, as a result of electrical brain stimulation to the cortex and to deep brain structures, in brain tumors, and in stroke. We report what is, to our knowledge, the first report of a case of postictal pathologic laughter. Previously diagnosed with medically refractory complex partial seizures, our patient was admitted to the hospital with phenytoin toxicity. During video-EEG monitoring she experienced multiple brief absence seizures as well as a prolonged episode of absence status epilepticus. Immediately following cessation of the seizure she began to laugh. Her laughter was mirthful and infectious. This lasted several minutes and was followed immediately by several minutes of crying and then a return to normal. We propose that diffuse cortical inhibition led to release of subcortical structures involved in emotional expression. Possible neural substrates of laughter are discussed.

Adult↗
PubMed2006

Laughter and the mesial and lateral premotor cortex.

We report the induction of laughter and smiling by cortical electrical stimulation of the frontal lobe of two patients: an 18-month-old boy with a left frontal cortical lesion extending to the vertex and the central gyrus, and a 35-year-old woman with a lesion in the right supplementary sensorimotor area (SSMA). The subjects underwent presurgical epilepsy evaluation with subdural grid electrodes to determine surgical candidacy. Stimulation of the prefrontal area reproducibly induced laughter. The adult patient reported absence of emotional content. Slowing of speech occurred under stimulation of electrodes in the upper and posterior vicinity. In this patient laughter was elicited in the anterior part of the SSMA. In the child, this response was induced by stimulation of the lateral prefrontal cortex near the midline. We conclude that the anterior portion of the SSMA/lateral premotor cortex is involved in generating the motor pattern of laughter.

Adult↗
PubMed1995

Humour and laughter therapy.

There is much anecdotal 'evidence' from nurses and patients to support humour and laughter as therapy. However, there is little research to support specific humour or laughter interventions as beneficial in the short or long term in the clinical environment. Humour and laughter remain potentially exciting and innovative tools for nursing therapy. They have a number of effects which could prove beneficial for many different nursing and medical diagnoses and appear to have the additional advantage of being adaptable to most situations. More clinical evaluation of humour and laughter therapy is required before its appropriate use can be defined.

Holistic Nursing↗
PubMed2004

Humor and laughter in palliative care: an ethnographic investigation.

OBJECTIVE: Humor and laughter are present in most of human interaction. Interactions in health care settings are no exception. Palliative care practitioners know from experience that humor and laughter are common in palliative care despite the seriousness of the care context. Research establishing the significance of humor in care of the dying is limited. METHODS: Clinical ethnography conducted in a 30-bed inpatient palliative care unit served as the means of exploring the functions of humor in care of the dying. Clinical ethnography is intended for examination of the human experience of illness or of caregiving in an interpersonal context (Kleinman, 1992). The method emphasizes the subjective experience and the realm of communication and interaction for both patients and caregivers. Data were collected through participant observation, informal interviews with patients and families, and semistructured interviews with members of the health care team. RESULTS: Humor and laughter were widespread and important in the research setting. An overall attitude of good humor prevailed. Within that atmosphere, humor served myriad functions. Functions were identified in three overarching themes; building relationships, contending with circumstances, and expressing sensibility. Humor among patients, families, and staff most commonly served to build therapeutic relationships, relieve tension, and protect dignity and a sense of worth. Humor was particularly significant in maintaining collegial relationships, managing stressful situations, and maintaining a sense of perspective. SIGNIFICANCE OF RESULTS: Findings established the significance of humor and laughter as humanizing dimensions of care of the dying and contributes to the volume of research supporting evidence-based practice.

Humans↗
PubMed1975

Personal evaluations, laughter, and affective judgments.

Fifty-six subjects read positive or negative evaluations of their personality made by a bogus same-sex peer and then rated their immediate feelings. A second group of 22 subjects rated their feelings after reading the evaluations of a third person. It was found that personal evaluations evoked more spontaneous laughter than did the evaluation of a third person (p less than .001). Inclusion of the factor of laughter in the experimental design disclosed that subjects who laughed felt more pleasant than those who did not laugh (p less than .008) and that laughter was associated with affective state only in the negative evaluation condition (p less than .003).. Also, positive evaluations made the subjects feel good, and negative ones made them feel bad (p less than .001). Results seemed to suggest that extreme affective arousal engenders laughter which, in turn, alters the judgments of one's affective state.

Adolescent↗
PubMed1996

The effects of audience laughter on men's and women's responses to humor.

Forty participants (20 men and 20 women) listened individually to a recording of a radio comedy show under one of two conditions: an experimental condition, with audience laughter present, or a control condition, with laughter absent. While the participants were listening to the tape, their spontaneous responses were covertly videotaped so that the frequency of laughter and smiling could be measured. After listening to the program, the participants rated the material for funniness and enjoyment. Those participants who listened with laughter present gave significantly higher ratings of the funniness and enjoyability of the recording. Moreover, they laughed and smiled more in the experimental condition, although the score for the difference in smiling failed to reach significance. In contrast with some published studies, no differences between men and women were found--a result that is attributed to the greater ecological validity of the context and to the stimuli used in the present study.

Adult↗
PubMed2004

Laughter-associated asthma.

This study was conducted to assess the prevalence of laughter-induced asthma, and to study any associations with asthma-related triggers and measures of disease activity, using a questionnaire-based survey of asthma subjects in both the community and on presentation to hospital. A total of 105 subjects participated, and 44 (41.9%) reported laughter-associated asthma. Exercise and laughter were strongly associated as triggers (p < 0.006), as well as molds and grass pollen (p = 0.03). It seems to be associated with poor asthma control as well, since hospital admissions are also more frequent in this group (p = 0.043). Laughter-induced asthma is strongly associated with exercise as a trigger; the mechanism remains uncertain, but better understanding of this problem may assist in controlling difficult asthma.

Adult↗