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Background: We here report two cases of stimulation induced pathological laughter PL under thalamic deep brain stimulation DBS for essential tremor and interpret the effects based on a modified neuroanatomy of positive affect display PAD.
We speculate that a co-stimulation of parts of this fiber structure might lead to a non-volitional modulation of PAD resulting in PL. We integrate these results with literature concerning PAD and the neuroanatomy of smiling and laughing.
A conceptual revised neuroanatomy of PAD is described. PAD is evolution driven, hard wired to the brain and realized over previously described branches of the motorMFB. This limiter in our cases is bilaterally disturbed through DBS. The here described anatomy adds to a previously described framework of neuroanatomy of laughter and humor. Presentation of positive affect — smiling and laughing — is important for interindividual signaling between primates.
Both, smile and laughter have important functions in human social context and the amount of facial activity during smiling — especially presentation of Duchenne smiles — is interpreted as the degree of trustworthiness, cooperation, openness, and sociability Parkinson, ; Mehu et al.