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In Some Rare Instances, Brain Damage Can Lead to Joke Addiction

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It’s generally a good thing to have a sense of humor. But for some people, joking can become a compulsion.

In two case studies by a pair of UCLA brain researchers recently published in the Journal of Neuropsychiatry and Clinical Neurosciences, the subjects' brain trauma and dementia led to what the scientists describe as “intractable joking.” Called Witzelsucht (German for "joke addiction"), excessive joking is a real neurological disease. Coming up with puns is pathological.

For five years, one man, an anonymous 69-year-old, would wake his wife up in the middle of the night to tell her jokes he’d come up with. When she complained, he wrote them down instead—accumulating 50 pages of puns and poop jokes that he later revealed to the researchers.

Ten years before he visited the lab, this man suffered a brain hemorrhage that changed his behavior. He became compulsive, particularly about recycling. He would dig through dumpsters to try to find recyclables, and hoard napkins from restaurants. Five years after the episode, his compulsion turned toward comedy. In what was later attributed to a stroke, he became so obsessed with making jokes and puns that it began to wear on his relationship with his wife. He laughed incessantly at his own jokes, yet he struggled to find other people’s jokes funny. On a multiple choice test in the lab, he could identify the punch lines of jokes, but didn’t laugh or find them funny. But his own quips—like “How do you cure hunger? Step away from the buffet table!”—he couldn’t stop giggling at.

In the second case studied, a 57-year-old with dementia got fired from his job for his inability to quash his jokester persona. He was let go after he blurted “Who the hell chose this God-awful place?” at work. He “would frequently break out in laughter, almost cackling, at his own comments, opinions, or jokes, many of which were borderline sexual or political in content,” the researchers describe. He disco-danced during one visit to the clinic to meet with the researchers, grabbing the ties of passing physicians and comparing them on another visit. Like the aforementioned pun-lover, though, he didn’t find other people’s jesting amusing. His sense of humor was entirely personal. When he died, the man’s autopsy showed that he had Pick’s disease, a form of dementia, that resulted in severe atrophy of the frontal lobes of his brain.

These men did not die of laughter, and it sounds like their friends and family were excessively patient with them. Still, joke addiction is serious business. Figuring out the brain issues that lead to this compulsive jesting and merriment can help us understand how the brain processes humor—a particularly human behavior psychologists and other researchers still don’t entirely understand. Both the cases above represented patients with frontal lesions from brain trauma and neurodegenerative disease. The frontal regions of the brain, especially on the right side of the brain, seem to play a major role in our ability to see the humor in the world, and get other people’s jokes. People with lesions on the right frontal lobe of their brain still respond to silly puns and slapstick, but can’t appreciate more complicated jokes or those that are new to them (as in, told by someone else). And with the damage to the parts of the brain involved in self-control, these people lose the ability to stop themselves from making that terrible pun.

Next, perhaps researchers will discover the neurological root of Dad Jokes.

[h/t BBC]

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New Patient Test Could Suggest Whether Therapy or Meds Will Work Better for Anxiety
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Like many psychological disorders, there's no one-size-fits-all treatment for patients with anxiety. Some might benefit from taking antidepressants, which boost mood-affecting brain chemicals called neurotransmitters. Others might respond better to therapy, and particularly a form called cognitive behavioral therapy, or CBT.

Figuring out which form of treatment works best often requires months of trial and error. But experts may have developed a quick clinical test to expedite this process, suggests a new study published in the journal Neuropsychopharmacology.

Researchers at the University of Illinois at Chicago have noted that patients with higher levels of anxiety exhibit more electrical activity in their brains when they make a mistake. They call this phenomenon error-related negativity, or ERN, and measure it using electroencephalography (EEG), a test that records the brain's electric signals.

“People with anxiety disorders tend to show an exaggerated neural response to their own mistakes,” the paper’s lead author, UIC psychiatrist Stephanie Gorka, said in a news release. “This is a biological internal alarm that tells you that you've made a mistake and that you should modify your behavior to prevent making the same mistake again. It is useful in helping people adapt, but for those with anxiety, this alarm is much, much louder.”

Gorka and her colleagues wanted to know whether individual differences in ERN could predict treatment outcomes, so they recruited 60 adult volunteers with various types of anxiety disorders. Also involved was a control group of 26 participants with no history of psychological disorders.

Psychiatrists gauged subjects’ baseline ERN levels by having them wear an EEG cap while performing tricky computer tasks. Ultimately, they all made mistakes thanks to the game's challenging nature. Then, randomized subjects with anxiety disorders were instructed to take an SSRI antidepressant every day for three months, or receive weekly cognitive behavioral therapy for the same duration. (Cognitive behavioral therapy is a type of evidence-based talk therapy that forces patients to challenge maladaptive thoughts and develop coping mechanisms to modify their emotions and behavior.)

After three months, the study's patients took the same computer test while wearing EEG caps. Researchers found that those who'd exhibited higher ERN levels at the study's beginning had reduced anxiety levels if they'd been treated with CBT compared to those treated with medication. This might be because the structured form of therapy is all about changing behavior: Those with enhanced ERN might be more receptive to CBT than other patients, as they're already preoccupied with the way they act.

EEG equipment sounds high-tech, but it's relatively cheap and easy to access. Thanks to its availability, UIC psychiatrists think their anxiety test could easily be used in doctors’ offices to measure ERN before determining a course of treatment.

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New Study Shows It's Surprisingly Easy to Make People Have Auditory Hallucinations
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If you’ve ever heard something that wasn't there—an auditory hallucination—you know that the sound seems very, very real. A new study suggests that it's easy to induce auditory hallucinations in people, but it's even easier in people who already claim to hear things that aren't there. The research was published in the journal Science.

Co-author Al Powers is a psychiatric researcher at Yale. Speaking in a study, he said hallucinations “…may arise from an imbalance between our expectations about the environment and the information we get from our senses.”

In other words, he says, "You may perceive what you expect, not what your senses are telling you."

Powers and his colleagues recruited 59 people to help them test that hypothesis. There were four groups of participants: people who heard voices and had been diagnosed with psychosis; people who had been diagnosed with psychosis but didn’t hear voices; people who heard voices but had not been diagnosed with any mental illness (we'll come back to that in a moment); and people who just plain didn't hear voices.

The third group was an unusual one: 15 self-professed psychics. These participants said that they heard voices every day, but unlike people in the first group—those diagnosed with psychosis who heard voices—they weren't bothered by the voices they claimed to hear. In fact, they took them to be communications from supernatural forces or entities.

All the participants then underwent brain scans. While they were in the scanner, the researchers used a combination of sounds and images to trick their brains into producing auditory hallucinations. First, participants were shown a checkerboard and played a sound. Then they were told to listen for the sound. Sometimes it played when the checkerboard appeared. Sometimes it didn't play at all, but the checkerboard showed, which led their brains to expect the sound would be played.

Members of all four groups experienced the hallucinations, hearing noises even in the silence. Their brain scans showed that they really were "hearing" the nonexistent sounds.

Unsurprisingly, the two groups of hallucination-prone people were more susceptible to hearing things. But when they were told that there had in fact been no sound, people with psychosis were less likely to believe it. 

The authors say this difference could potentially help doctors spot, diagnose, and treat psychosis in their patients before it becomes severe.

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