The neuronal network of laughing in young patients with untreated narcolepsy
Abstract
Objective
To investigate the neuronal correlates of spontaneous laughter in drug-naive pediatric patients with narcolepsy type I (NT1) compared to healthy controls by means of blood oxygen level-dependent (BOLD) MRI.
Methods
Twenty-one children/adolescents with recent onset of NT1 and 21 age- and sex-matched healthy controls were studied with fMRI while viewing funny videos using a naturalistic paradigm. Whole-brain hemodynamic correlates of spontaneous laughter were investigated in each group and compared by use of appropriate second-level general linear model analyses. If recorded, cataplexy events were treated as the effect of no interest at the single-participant level. Correlations analyses between these contrasts and behavioral findings were performed.
Results
Emotion-induced laughter occurred in 16 patients (294 events) and 21 controls (357 events). In controls, laughter-related BOLD increases involved a widespread cortical and subcortical network including the bilateral motor and premotor areas, cingulated cortex, insula, and amygdala. In NT1, laughter induced BOLD signal increments in the motor cortex, right thalamus, and left subthalamic nucleus/zona incerta (STN/ZI). STN/ZI and thalamic changes were significantly higher during fMRI sessions with laughter without cataplexy compared to sessions in which laughter was associated with cataplexy.
Conclusion
Laughter expression in individuals with NT1 involves different brain circuits compared to controls by means of overactivation of cortical and subcortical regions belonging to the volitional control of laughter. The activation of the STN/ZI region observed predominantly in patients with NT1 during laugh episodes without cataplexy suggests that the ZI could act to prevent cataplexy.
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Information & Authors
Information
Published In
Neurology®
Volume 92 • Number 5 • January 29, 2019
Pages: e504-e515
Copyright
© 2019 American Academy of Neurology.
Publication History
Received: April 25, 2018
Accepted: September 28, 2018
Published online: January 11, 2019
Published in issue: January 29, 2019
Disclosure
A. Vaudano reports no disclosures relevant to the manuscript. F. Pizza has received personal compensation as a scientific advisory board member for UCB and Bioproject. F. Talami reports no disclosures relevant to the manuscript. G. Plazzi received research grant support from Fondazione Banca del Monte di Bologna and Bioproject, and personal compensation as a scientific advisory board member for UCB pharma (Europe), Jazz Pharmaceuticals, and Bioproject. S. Meletti received research grant support from the Ministry of Health and the nonprofit organization Foundation “Fondazione Cassa di Risparmio di Modena–FCRM” and has received personal compensation as a scientific advisory board member for UCB and EISAI. Go to Neurology.org/N for full disclosures.
Study Funding
No targeted funding reported.
Authors
Author Contributions
A.E. Vaudano: MRI data acquisition, design and conceptualization of the study, analysis and interpretation of data, statistical analysis, drafting and revising the manuscript. F. Talami: MRI data acquisition, analysis and interpretation of data. F. Pizza and G. Plazzi. clinical data acquisition, design and conceptualization of the study, analysis and interpretation of data, drafting and revising the manuscript. S. Meletti: design and conceptualization of the study, analysis and interpretation of data, drafting and revising the manuscript.
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- Theory of Mind impairment in childhood narcolepsy type 1: a case–control study, Brain Communications, 6, 2, (2024).https://doi.org/10.1093/braincomms/fcae063
- Phenomenology and psychiatric correlates of pseudocataplexy, SLEEP, 47, 11, (2023).https://doi.org/10.1093/sleep/zsad234
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- When laughter arrests speech: fMRI-based evidence, Philosophical Transactions of the Royal Society B: Biological Sciences, 377, 1863, (2022).https://doi.org/10.1098/rstb.2021.0182
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