Laughter-Induced Seizures: A Rare Type of Reflex Epilepsy.

This research explores the rare occurrence of laughter-induced seizures, a form of reflex epilepsy documented in only one previous case in the literature. The patient, free from prior medical or neuropsychiatric history, exhibited seizures triggered solely by laughter. Electroencephalography and neuroimaging revealed normal results. Despite declining medical therapy, lifestyle modifications enabled seizure management. The study emphasizes the dearth of data on laughter-induced seizures, prompting the consideration of multimodal strategies for treatment. Further research is imperative to unveil the precise pathophysiology and establish standardized therapeutic approaches for this uncommon epileptic manifestation.

Hearing laughter: a prescription for anxiety relief.

Anxiety can have adverse effects on cognition such as impairing test performance or restricting working memory. One way of reducing anxiety is through humor, and the present research investigated if the perception of laughter, which is often seen as a reaction to humor, could impact self-reported anxiety. Participants completed the STAI battery containing subscales for both state and trait anxiety before and after one of three manipulations: a laughter sounds rating task, a neutral sounds rating task, or a working memory span task. Results showed that perceiving laughter decreased both state and trait anxiety, taking a working memory test increased state anxiety, and perceiving neutral sounds had no effect on either type of anxiety. These findings are interpreted as evidence that the positive emotions induced by hearing laughter help to regulate anxiety by undoing arousal, even when negative emotions are not present.

Mapping the differential impact of spontaneous and conversational laughter on brain and mind: an fMRI study in autism.

Spontaneous and conversational laughter are important socio-emotional communicative signals. Neuroimaging findings suggest that non-autistic people engage in mentalizing to understand the meaning behind conversational laughter. Autistic people may thus face specific challenges in processing conversational laughter, due to their mentalizing difficulties. Using fMRI, we explored neural differences during implicit processing of these two types of laughter. Autistic and non-autistic adults passively listened to funny words, followed by spontaneous laughter, conversational laughter, or noise-vocoded vocalizations. Behaviourally, words plus spontaneous laughter were rated as funnier than words plus conversational laughter, and the groups did not differ. However, neuroimaging results showed that non-autistic adults exhibited greater medial prefrontal cortex activation while listening to words plus conversational laughter, than words plus genuine laughter, while autistic adults showed no difference in medial prefrontal cortex activity between these two laughter types. Our findings suggest a crucial role for the medial prefrontal cortex in understanding socio-emotionally ambiguous laughter via mentalizing. Our study also highlights the possibility that autistic people may face challenges in understanding the essence of the laughter we frequently encounter in everyday life, especially in processing conversational laughter that carries complex meaning and social ambiguity, potentially leading to social vulnerability. Therefore, we advocate for clearer communication with autistic people.

Laughter in everyday life: an event-based experience sampling method study using wrist-worn wearables.

Laughter is a universal, nonverbal vocal expression of broad significance for humans. Interestingly, rather little is known about how often we laugh and how laughter is associated with our personality. In a large, event-based, experience sampling method study (N = 52; k = 9,261 assessments) using wrist-worn wearables and a physical analogue scale, we analyzed belly laughs and fit of laughter events in participants' everyday life for 4 weeks. Additionally, we assessed associations with laughter frequency such as personality, happiness, life satisfaction, gelotophobia (i.e., fear of being laughed at), and cheerfulness. Validating our new measurement approach (i.e., wearables, physical analogue scale), laughter events elicited higher happiness ratings compared to reference assessments, as expected. On average, participants reported 2.5 belly laughs per day and on every fourth day a fit of laughter. As expected, participants who were happier and more satisfied with their life laughed more frequently than unhappier, unsatisfied participants. Women and younger participants laughed significantly more than men and older participants. Regarding personality, laughter frequency was positively associated with openness and conscientiousness. No significant association was found for gelotophobia, and results for cheerfulness and related concepts were mixed. By using state-of-the-art statistical methods (i.e., recurrent event regression) for the event-based, multi-level data on laughter, we could replicate past results on laughing.

Efficacy and Safety of Laughter Yoga in Cancer Patients: A Scoping Review of Randomized Controlled Trials.

The use of laughter yoga as a complementary and alternative medicine (CAM) strategy has recently gained interest as a potential supportive intervention for cancer patients. In this review, we aimed to assess the impact of laughter yoga on the quality of life of cancer patients, with a focus on evidence from randomized controlled trials (RCTs). Our analysis indicates that laughter yoga can significantly improve the quality of life of cancer patients by improving emotional and physical functioning and reducing symptoms of depression and stress. These findings suggest that laughter yoga is a promising CAM practice for enhancing cancer patients' psychological and physical health. Future research should aim to extend these studies to more extensive and more diverse populations to validate and expand upon these findings.

Intraoperative changes in large-scale thalamic circuitry following laser ablation of hypothalamic hamartomas.

BACKGROUND AND OBJECTIVES: Gelastic seizures due to hypothalamic hamartomas (HH) are challenging to treat, in part due to an incomplete understanding of seizure propagation pathways. Although magnetic resonance imaging-guided laser interstitial thermal therapy (MRgLITT) is a promising intervention to disconnect HH from ictal propagation networks, the optimal site of ablation to achieve seizure freedom is not known. In this study, we investigated intraoperative post-ablation changes in resting-state functional connectivity to identify large-scale networks associated with successful disconnection of HH. METHODS: Children who underwent MRgLITT for HH at two institutions were consecutively recruited and followed for a minimum of one year. Seizure freedom was defined as Engel score of 1A at the last available follow-up. Immediate pre- and post- ablation resting-state functional MRI scans were acquired while maintaining a constant depth of general anesthetic. Multivariable generalized linear models were used to identify intraoperative changes in large-scale connectivity associated with seizure outcomes. RESULTS: Twelve patients underwent MRgLITT for HH, five of whom were seizure-free at their last follow-up. Intraprocedural changes in thalamocortical circuitry involving the anterior cingulate cortex were associated with seizure-freedom. Children who were seizure-free demonstrated an increase and decrease in connectivity to the pregenual and dorsal anterior cingulate cortices, respectively. In addition, children who became seizure-free demonstrated increased thalamic connectivity to the periaqueductal gray immediately following MRgLITT. DISCUSSION: Successful disconnection of HH is associated with intraoperative, large-scale changes in thalamocortical connectivity. These changes provide novel insights into the large-scale basis of gelastic seizures and may represent intraoperative biomarkers of treatment success.

Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator.

Aim: To investigate the potential effectiveness of "medical clowns" on preoperative, intraoperative, and postoperative anxiety of children undergoing various dental treatments and also its effect on the operator's stress levels in a dental setup. Materials and methods: A total of 170 pediatric patients, aged 4-8 years, indicated for preventive therapy, extractions, restorative, and endodontics were included and divided into two groups [group I-audiovisual (A-V) aids; group II-medical clowns], group of 85 patients each after recording Modified yale preoperative scale. Both pre- and postoperatively, Frankl's behavior score was recorded for each patient. During treatment, the face, legs, activity, cry, consolability (FLACC) pain scale, and dental operator's stress level were recorded. Results: Intervention of medical clowns positively influenced children during dental treatment by increasing their pain threshold. The majority of children showed positive Frankl rating scales after dental treatment. Also, the operator's stress was significantly reduced, which led to enhanced treatment outcomes. Conclusion: Humor yields the power of healing, distracts pediatric patients, reduces their anxiety, and alleviates their pain, conferring the patients with a sense of laughter, creativity, and care.Therefore, medical clowns in pediatric dentistry can prove to be serviceable and valuable as a nonpharmacological approach to behavior management. How to cite this article: Aggarwal P, Mathur S, Chopra R. Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator. Int J Clin Pediatr Dent 2024;17(1):59-66.

Evolution of laughter from play.

In this hypothesis, I discuss how laughter from physical play could have evolved to being induced via visual or even verbal stimuli, and serves as a signal to highlight incongruity that could potentially pose a threat to survival. I suggest how laughter's induction could have negated the need for physical contact in play, evolving from its use in tickling, to tickle-misses, and to taunting, and I discuss how the application of deep learning neural networks trained on images of spectra of a variety of laughter types from a variety of individuals or even species, could be used to determine such evolutionary pathways via the use of latent space exploration.

Impact of Laughter Yoga on Test Anxiety and Education Stress of 8th Grade Students: An Experimental Study.

Objective: In an exam-based education system, it is of utmost importance to identify levels of test anxiety and educational stress that directly affect success, and to reduce anxiety. A study was conducted to examine the effects of laughter yoga on test anxiety and educational stress in 8th grade students in Turkey. Methods: A cluster sampling, parallel-group randomized controlled trial with pre-test/post-test design studied 64 students (32 in the intervention group and 32 in the control group). The intervention group received laughter yoga sessions twice a week for 6 weeks. The control group received no intervention. Data were collected by a demographic questionnaire, the Westside Test Anxiety Scale, and the Educational Stress Scale. Results: After laughter yoga, the intervention group showed a significant decrease in test anxiety (d = 0.859; p < 0.005) and educational stress scores (d = 0.52875; p < 0.001) compared to the control group. Conclusion: Laughter yoga was associated with decreased test anxiety and educational stress. Laughter yoga activities in schools are recommended to decrease educational stress and test anxiety of students.

The Effects of Laughter Yoga on Happiness and Stress in Nursing Students Going into Clinical Practice for the First Time.

Background: There are numerous difficulties that nursing students must overcome in the nursing practice environment. This circumstance mainly impacts the happiness and stress levels of nursing students who lack clinical practice. Aim: In this study aimed to examine the effect of laughter yoga (LY) on nursing students' happiness and stress levels attending to clinical practice for the first-time. Method: In this randomized controlled trial, a totally 50 nursing students were included from a nursing school in Turkey. Data were collected between December 2022-January 2023 via The Happiness Scale and the Perceived Stress Scale for Nursing Students. A total of eight LY lessons for 4 weeks were practiced to the laughter group (LG). Result: The Happiness Scale's means were compared between the groups before and after the intervention, and the results revealed a significant increase (p < 0.05). There was not a significant difference in the stress scale scores between both the groups following LG and clinical practice (t: -1.780; p = 0.081). However, the stress scores of the LG decreased significantly after the LY sessions were completed (b: 3.595; p = 0.001). Conclusion: LY can be an effective method to be used to help increase happiness and reduce the stress of nursing students for first-time entering clinical practice.

Development of a novel tool to investigate human laughter behaviour and experience.

We present a questionnaire exploring everyday laughter experience. We developed a 30-item questionnaire in English and collected data on an English-speaking sample (N = 823). Based on Principal Component Analysis (PCA), we identified four dimensions which accounted for variations in people's experiences of laughter: laughter frequency ('Frequency'), social usage of laughter ('Usage'), understanding of other people's laughter ('Understanding'), and feelings towards laughter ('Liking'). Reliability and validity of the LPPQ were assessed. To explore potential similarities and differences based on culture and language, we collected data with Mandarin Chinese-speaking population (N = 574). A PCA suggested the extraction of the same four dimensions, with some item differences between English and Chinese versions. The Laughter Production and Perception Questionnaire (LPPQ) will advance research into the experience of human laughter, which has a potentially crucial role in everyday life.

Mini-review: Wild laughs: Ontogenesis and phylogenesis of humour.

This mini-review discusses the existing evidence on various forms of humour and humour-like behaviour in non-human animals, combining ontogenetic and phylogenetic perspectives. The first section describes humour-like behaviours, from the simplest to the most complex form (from laughing, tickling, joking, and chasing to ToM humour). In the second section, we propose the SPeCies (Social, Physiological, and Cognitive) Perspective, which frames the various types of humour based on Social motivation, Physiological state, and Cognitive skills. Finally, in the third section, we discuss future directions for further development.

Association between laughter, frailty, and depression in rheumatoid arthritis patients.

OBJECTIVE: This study aimed to determine whether there are associations between laughter, disease activity, frailty, and depression in rheumatoid arthritis (RA) patients. METHODS: A total of 240 patients were included in this prospective cohort study on frailty in RA patients between March 2021 and June 2022. Patients were divided into the following four groups according to the frequency of laughter: "almost every day," "1-5 days per week," "1-3 days per month," and "never or almost never." Patient characteristics were compared among the four groups by analysis of variance. Factors associated with laughter were identified by multivariable logistic analysis. RESULTS: The mean 28-joint Disease Activity Score using CRP was 1.91, with 70.7% of patients in remission and 12.6% in low disease activity. For the "almost every day" (42.5% of patients), "1-5 days per week" (40.0%), "1-3 days per month" (11.3%), and "never or almost never" (6.3%) groups, scores of the Kihon Checklist (KCL) for assessing frailty status were 3.5, 4.6, 7.3, and 8.1 (p < .001), respectively, and scores of the Beck Depression Inventory (BDI-II) were 8.4, 10.7, 15.1, and 16.5 (p < .001), respectively. Multivariable analysis revealed that KCL (OR: 0.81, 95% CI: 0.73-0.90) and BDI-II (OR: 0.91, 95% CI: 0.86-0.95) scores were independently associated with the frequency of laughter. CONCLUSION: Frailty and depression were associated with laughter in RA patients with controlled disease activity. Interventions aimed at not only disease activity control but also frailty prevention may lead to a life filled with laughter.

A structured laughter yoga therapy program on patients with chemotherapy-induced nausea and vomiting: A randomized clinical trial.

Objetive: Chemotherapy is a prevalent cancer treatment, often accompanied by debilitating side effects such as nausea and vomiting. This study explores the potential effectiveness of laughter yoga, a combination of exercise and voluntary laughter, in alleviating chemotherapy-induced nausea and vomiting. Methods: This two-group randomized clinical trial was conducted on 69 cancer patients undergoing chemotherapy at the Reza Chemotherapy and Oncology Center, Mashhad, Iran, in 2018. Patients were randomly divided into intervention and control groups. Both groups received routine self-care training, with the addition of four 20-min to 30-min laughter yoga sessions held immediately before one of their chemotherapy appointments for the intervention group only. Nausea and vomiting were assessed using the Morrow Assessment of Nausea and Emesis questionnaire at two stages, before and after the intervention. Data were analyzed with Chi-square, Independent-t, Mann-Whitney, Wilcoxon, and McNemar tests using Statistical Package for the Social Sciences (SPSS). Results: The mean age of patients in the intervention group was 49.0 ± 9.6 years, while in the control group, it was 45.2 ± 12.6 years. The intragroup comparison showed a statistically significant decrease in the severity and duration of nausea in the intervention group and a statistically significant increase in the severity and duration of nausea in the control group from pre-test to post-test (P < 0.05). The intergroup comparison showed no statistically significant difference between the two groups in terms of vomiting conditions. Conclusions: Laughter yoga demonstrates promise in improving chemotherapy-induced nausea, suggesting its potential recommendation for managing this distressing side effect. Further research is warranted to explore its broader application in cancer care. Trial registration: This study (No. IRCT20180429039463N1) was registered in the Iranian Registry of Clinical Trials on 21/08/2018.

Frequency of laughter and work engagement among Japanese employees: a cross-sectional study during COVID-19.

Laughter is associated with better health and occurs most frequently during casual conversations. However, the COVID-19 pandemic has impaired social interactions, which may have reduced the frequency of laughter and led to poor well-being among workers. This study investigated the relationship between laughter frequency and work engagement among Japanese employees during the pandemic. We conducted a web-based survey among Japanese employees (20-59 yr) via an internet survey company in December 2021; 1,058 valid data were analysed. Of the respondents, 65.1% laughed at least once a week, but the frequency was much lower than that reported in previous studies conducted before the pandemic. Additionally, those who laughed at least once a week had significantly higher work engagement scores than those who laughed less than once a month. Although employees reduced their frequency of laughter during the pandemic, a certain frequency of laughter may be important for maintaining their work engagement.

Mind-Body Therapies in the Management of Otolaryngologic Disease: A State-of-the-Art Review of Randomized Controlled Trials.

OBJECTIVE: To review and assess the peer-reviewed literature on the utility of mind-body therapy (MBT) as an adjunct treatment in the management of otolaryngologic disease. DATA SOURCES: PubMed, Embase, and Cochrane. REVIEW METHODS: Randomized control trials (RCTs) of MBTs in the management of otolaryngologic disease from 2002 to 2022 were identified and included according to predefined criteria. Interventions requiring expensive equipment were excluded because the goal of MBT is to be cost-conscious. All studies were subjected to a two-stage blinded screening, extraction, and appraisal process. The outcomes of the intervention and control groups were compared. CONCLUSION: RCTs of MBTs, including breathing exercises (4), aromatherapy (2), biofeedback (2), meditation, (2), and yoga (2), have been studied in several otolaryngologic conditions, including septoplasty/rhinoplasty (3), head and neck cancer (2), facial palsy (2), and tinnitus (2). Most studies were of moderate risk of bias on appraisal, and each MBT studied was found to significantly reduce subjective and objective distress associated with the otolaryngologic condition in question. IMPLICATIONS FOR PRACTICE: Despite a paucity of strong evidence supporting the universal use of MBTs, our review suggests that MBTs are cost-effective and easily deployable complementary tools in the management of otolaryngologic disease. Future large, methodologically rigorous RCTs are needed to address the limitations of the included studies, such as improper blinding and inappropriate statistical analysis. As MBTs are studied further, a case for their current use can be made because of their low cost and minimal risk to patients.

Effects of Laughter Therapy on Improving Negative Emotions Associated with Cancer: A Systematic Review and Meta-Analysis.

INTRODUCTION: With aging and growth of the population, the risk of cancer incidence and mortality is rapidly increasing. However, psychosocial treatment has been seriously neglected in many healthcare settings. Laughter therapy is a therapeutic program to improve emotional wellbeing and health which has been applied as a complementary treatment. We aim to explore effects of laughter therapy for patients with cancer on their negative emotions such as depression, anxiety, stress, pain, and fatigue. METHODS: We searched the Cochrane Library, Embase, PubMed, Scopus, Web of Science, WANFANG data, Weipu (VIP), Chinese National Knowledge Infrastructure (CNKI) and independently rated the risk of bias in every article using the Cochrane Collaboration's Risk of Bias Assessment Tool. Review Manager and STATA software were used to pool the individually included studies. RESULTS: Seven studies were found eligible to be included in the present review. Overall, study quality was relatively high. Our findings suggest that laughter therapy might have a positive effect on improving emotional response in cancer patients. Arguably, laughter therapy, whether humor or laughter, has a positive effect on anxiety, stress, pain feeling, fatigue, and depression in cancer patients. CONCLUSIONS: Laughter therapy is a convenient, multi-modality, flexible-duration therapy to improve negative emotions in cancer patients, regardless of their gender, age, and type of cancer.

'Should we laugh?' Acoustic features of (in)voluntary laughters in spontaneous conversations.

Laughter is one of the most common non-verbal features; however, contrary to the previous assumptions, it may also act as signals of bonding, affection, emotional regulation agreement or empathy (Scott et al. Trends Cogn Sci 18:618-620, 2014). Although previous research agrees that laughter does not form a uniform group in many respects, different types of laughter have been defined differently by individual research. Due to the various definitions of laughter, as well as their different methodologies, the results of the previous examinations were often contradictory. The analysed laughs were often recorded in controlled, artificial situations; however, less is known about laughs from social conversations. Thus, the aim of the present study is to examine the acoustic realisation, as well as the automatic classification of laughter that appear in human interactions according to whether listeners consider them to be voluntary or involuntary. The study consists of three parts using a multi-method approach. Firstly, in the perception task, participants had to decide whether the given laughter seemed to be rather involuntary or voluntary. In the second part of the experiment, those sound samples of laughter were analysed that were considered to be voluntary or involuntary by at least 66.6% of listeners. In the third part, all the sound samples were grouped into the two categories by an automatic classifier. The results showed that listeners were able to distinguish laughter extracted from spontaneous conversation into two different types, as well as the distinction was possible on the basis of the automatic classification. In addition, there were significant differences in acoustic parameters between the two groups of laughter. The results of the research showed that, although the distinction between voluntary and involuntary laughter categories appears based on the analysis of everyday, spontaneous conversations in terms of the perception and acoustic features, there is often an overlap in the acoustic features of voluntary and involuntary laughter. The results will enrich our previous knowledge of laughter and help to describe and explore the diversity of non-verbal vocalisations.

The Effects of Laughter Yoga on Perceived Stress, Positive Psychological Capital, and Exercise Capacity in Lung Cancer Chemotherapy Patients: A Pilot Randomized Trial.

BACKGROUND: Lung cancer is the malignant tumor with the highest morbidity and mortality rate in China. Although chemotherapy is effective in improving clinical symptoms, it causes a variety of acute and chronic side effects, seriously aggravating the psychological stress of patients. Laughter Yoga as a new type of aerobic exercise can effectively reduce stress levels and increase positive mood in patients. This study aimed to examine the effects of laughter yoga on perceived stress, positive psychological capital, and exercise capacity in lung cancer patients. METHODS: This study was a randomized, single-blind, parallel-group trial. The study enrolled 84 lung cancer chemotherapy patients from a general hospital in central China. These patients were randomly allocated to control and intervention groups (n = 42 per group) after baseline assessments. Patients in the control group received routine care and those in the intervention group received laughter yoga intervention. Perceived stress, positive psychological capital, and exercise capacity were assessed at baseline, immediately post-intervention. RESULTS: During the implementation of the study, there were 2 dropouts in each of the intervention and control groups. Ultimately, 80 patients in the control and intervention groups completed the trial. Patients who received laughter yoga intervention had significantly higher scores in positive psychological capital (P < .01, Cohen's d = 0.692) and exercise capacity (P < .01, Cohen's d = 0.659). Discernible differences were also observed in perceived stress (P < .01, Cohen's d = 1.087) between the 2 groups. CONCLUSIONS: The results of this study suggest that laughter yoga is an effective way and may produce beneficial effects on perceived stress, positive psychological capital and exercise capacity.

[Beneficios de la terapia de la risa en los niveles de depresión en niños diagnosticados con cáncer: estudio de caso.] / Benefits of laughing therapy on depression levels in children diagnosed with cancer: a case study.

OBJECTIVE: Pediatric cancer emotionally affects infants causing depression which must be intervened in a timely manner as an essential part of the treatment. Therefore, the present study sought to identify the benefits of laughter therapy on the levels of depression in children diagnosed with cancer in a foundation in Cali, Colombia. METHODS: The sample consisted of six children undergoing cancer treatment, aged between eight and twelve years. The Children's Depression Inventory (CDI) and three laughter therapy workshops were applied. A descriptive analysis was performed, with measures of central tendency for quantitative variables and absolute and relative frequencies for categorical variables. RESULTS: The results indicated that 83% of the children presented an emotional problem due to the disease; favorable changes were evidenced in the depression scores after the laughter therapy interventions. CONCLUSIONS: It is concluded that laughter therapy is an effective non-pharmacological treatment when combined with workshops aimed at strengthening the expression of emotions, self-esteem and life project, which not only improves the health of children, but also prevents and reduces the appearance of emotional disorders.

OBJETIVO: El cáncer pediátrico afecta emocionalmente a los infantes causando depresión, la cual se debe intervenir oportunamente como parte fundamental del tratamiento. Por lo tanto, el presente estudio buscó identificar los beneficios de la terapia de la risa en los niveles de depresión en niños y niñas diagnosticados con cáncer de una fundación de Cali, Colombia. METODOS: La muestra estuvo conformada por seis niños en tratamiento oncológico, con edades entre los ocho y doce años. Se aplicó el Inventario de Depresión Infantil (CDI) y tres talleres de risoterapia. Se realizo un análisis descriptivo, para las variables cuantitativas se realizaron medidas de tendencia central y para las categóricas se reportaron frecuencias absolutas y relativas. RESULTADOS: Los resultados indicaron que el 83% de los niños presentaron un problema emocional debido a la enfermedad; se evidenciaron cambios favorables en los puntajes de depresión posterior a las intervenciones de la terapia de la risa. CONCLUSIONES: Se concluye que la terapia de la risa es un tratamiento no farmacológico eficaz al combinarse con talleres orientados a fortalecer la expresión de las emociones, autoestima y proyecto de vida, que no solo permite mejorar la salud de los infantes, sino que previne y reduce la aparición de trastornos emocionales.