Pathological laughter and crying - A link to cerebellum

被引:282
作者
Parvizi, J [1 ]
Anderson, SW [1 ]
Martin, CO [1 ]
Damasio, H [1 ]
Damasio, AR [1 ]
机构
[1] Univ Iowa, Coll Med, Dept Neurol, Div Cognit Neurosci, Iowa City, IA 52242 USA
关键词
emotion; pathological laughter and crying; cerebellum; pons; cortico-ponto-cerebellar pathways;
D O I
10.1093/brain/124.9.1708
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Patients with pathological laughter and crying (PLC) are subject to relatively uncontrollable episodes of laughter, crying or both. The episodes occur either without an apparent triggering stimulus or following a stimulus that would not have led the subject to laugh or cry prior to the onset of the condition. PLC is a disorder of emotional expression rather than a primary disturbance of feelings, and is thus distinct from mood disorders in which laughter and crying are associated with feelings of happiness or sadness. The traditional and currently accepted view is that PLC is due to the damage of pathways that arise in the motor areas of the cerebral cortex and descend to the brainstem to inhibit a putative centre for laughter and crying. In that view, the lesions 'disinhibit' or 'release' the laughter and crying centre. The neuroanatomical findings in a recently studied patient with PLC, along with new knowledge on the neurobiology of emotion and feeling, gave us an opportunity to revisit the traditional view and propose an alternative. Here we suggest that the critical PLC lesions occur in the cerebro-pontocerebellar pathways and that, as a consequence, the cerebellar structures that automatically adjust the execution of laughter or crying to the cognitive and situational context of a potential stimulus, operate on the basis of incomplete information about that context, resulting in inadequate and even chaotic behaviour.
引用
收藏
页码:1708 / 1719
页数:12
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