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.

Autistic adults perceive and experience laughter differently to non-autistic adults.

Human interaction is immersed in laughter; though genuine and posed laughter are acoustically distinct, they are both crucial socio-emotional signals. In this novel study, autistic and non-autistic adults explicitly rated the affective properties of genuine and posed laughter. Additionally, we explored whether their self-reported everyday experiences with laughter differ. Both groups could differentiate between these two types of laughter. However, autistic adults rated posed laughter as more authentic and emotionally arousing than non-autistic adults, perceiving it to be similar to genuine laughter. Autistic adults reported laughing less, deriving less enjoyment from laughter, and experiencing difficulty in understanding the social meaning of other people's laughter compared to non-autistic people. Despite these differences, autistic adults reported using laughter socially as often as non-autistic adults, leveraging it to mediate social contexts. Our findings suggest that autistic adults show subtle differences in their perception of laughter, which may be associated with their struggles in comprehending the social meaning of laughter, as well as their diminished frequency and enjoyment of laughter in everyday scenarios. By combining experimental evidence with first-person experiences, this study suggests that autistic adults likely employ different strategies to understand laughter in everyday contexts, potentially leaving them socially vulnerable in communication.

Can critical care transport be safely reduced in children intubated during emergency management of status epilepticus in the United Kingdom: a national audit with case-control analysis.

OBJECTIVE: This study describes the baseline clinical characteristics, predictors of successful extubation at referring hospitals and short-term outcomes of children intubated for status epilepticus and referred to United Kingdom (UK) paediatric critical care transport teams (PCCTs). DESIGN: Multicentre audit with case-control analysis, conducted between 1 September 2018 and 1 September 2020. SETTING: This study involved 10 UK PCCTs. PATIENTS: Children over 1 month of age intubated during emergency management for status epilepticus (SE), referred to UK PCCTs. Patients with trauma, requiring time-critical neurosurgical intervention or those with a tracheostomy were excluded. INTERVENTIONS: No interventions were implemented. MEASUREMENTS AND MAIN RESULTS: Out of the 1622 referrals for SE, 1136 (70%) were intubated at referral. The median age was 3 years (IQR 1.25-6.54 years). Among the intubated children, 396 (34.8%) were extubated locally by the referring team, with 19 (4.8%) requiring reintubation. Therefore, the overall rate of successful extubation was 33% (377/1136). There was significant variation between PCCTs, with local extubation rates ranging from 2% to 74%. Multivariable analyses showed region/PCCT, contributing diagnosis, acute changes on CT, preceding encephalopathy and type of continuous sedation (midazolam) used postintubation were significantly associated with transfer to a critical care unit. CONCLUSION: This study highlights wide regional variation in early extubation practices. Regions with high successful extubation rates have established extubation guidelines from PCCTs. Successful extubation represents critical care transports that have been avoided.

Inhibiting orofacial mimicry affects authenticity perception in vocal emotions.

Although emotional mimicry is ubiquitous in social interactions, its mechanisms and roles remain disputed. A prevalent view is that imitating others' expressions facilitates emotional understanding, but the evidence is mixed and almost entirely based on facial emotions. In a preregistered study, we asked whether inhibiting orofacial mimicry affects authenticity perception in vocal emotions. Participants listened to authentic and posed laughs and cries, while holding a pen between the teeth and lips to inhibit orofacial responses (n = 75), or while responding freely without a pen (n = 75). They made authenticity judgments and rated how much they felt the conveyed emotions (emotional contagion). Mimicry inhibition decreased the accuracy of authenticity perception in laughter and crying, and in posed and authentic vocalizations. It did not affect contagion ratings, however, nor performance in a cognitive control task, ruling out the effort of holding the pen as an explanation for the decrements in authenticity perception. Laughter was more contagious than crying, and authentic vocalizations were more contagious than posed ones, regardless of whether mimicry was inhibited or not. These findings confirm the role of mimicry in emotional understanding and extend it to auditory emotions. They also imply that perceived emotional contagion can be unrelated to mimicry. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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.

The Effect of Pressure Changes During Mechanical Insufflation-Exsufflation on Respiratory and Airway Physiology.

BACKGROUND: Respiratory muscle weakness can impair cough function, leading to lower respiratory tract infections. These infections are an important contributor to morbidity and mortality in patients with neuromuscular disease. Mechanical insufflation-exsufflation (MIE) is used to augment cough function in these patients. Although MIE is widely used, there are few data to advise on the optimal technique. Since the introduction of MIE, the recommended pressures to be delivered have increased. There are concerns regarding the use of higher pressures and their potential to cause lung derecruitment and upper airway closure. RESEARCH QUESTION: What is the impact of high-pressure MIE (HP-MIE) on lung recruitment, respiratory drive, upper airway flow, and patient comfort, compared with low-pressure MIE (LP-MIE), in patients with respiratory muscle weakness? STUDY DESIGN AND METHODS: Clinically stable patients using domiciliary MIE with respiratory muscle weakness secondary to Duchenne muscle dystrophy, spinal cord injury, or long-term tracheostomy ventilation received LP-MIE (30/-30 cm H2O) and HP-MIE (60/-60 cm H2O) in a random sequence. Lung recruitment, neural respiratory drive, and cough peak expiratory flow were measured throughout, and patients reported comfort and breathlessness following each intervention. RESULTS: A total of 29 patients (10 with Duchenne muscle dystrophy, eight with spinal cord injury, and 11 with long-term tracheostomy ventilation) were included in this study. HP-MIE augmented cough peak expiratory flow compared with LP-MIE (mean cough peak expiratory flow HP-MIE 228 ± 81 L/min vs LP-MIE 179 ± 67 L/min; P = .0001) without any significant change in lung recruitment, neural respiratory drive, or patient-reported breathlessness. However, in patients with more pronounced respiratory muscle weakness, HP-MIE resulted in an increased rate of upper airway closure and patient discomfort that may have an impact on clinical efficacy. INTERPRETATION: HP-MIE did not lead to lung derecruitment or breathlessness compared with LP-MIE. However, it was poorly tolerated in individuals with advanced respiratory muscle weakness. HP-MIE generates more upper airway closure than LP-MIE, which may be missed if cough peak expiratory flow is used as the sole titration target. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; No.: NCT02753959; URL: www. CLINICALTRIALS: gov.

Blindness influences emotional authenticity perception in voices: Behavioral and ERP evidence.

The ability to distinguish spontaneous from volitional emotional expressions is an important social skill. How do blind individuals perceive emotional authenticity? Unlike sighted individuals, they cannot rely on facial and body language cues, relying instead on vocal cues alone. Here, we combined behavioral and ERP measures to investigate authenticity perception in laughter and crying in individuals with early- or late-blindness onset. Early-blind, late-blind, and sighted control participants (n = 17 per group, N = 51) completed authenticity and emotion discrimination tasks while EEG data were recorded. The stimuli consisted of laughs and cries that were either spontaneous or volitional. The ERP analysis focused on the N1, P2, and late positive potential (LPP). Behaviorally, early-blind participants showed intact authenticity perception, but late-blind participants performed worse than controls. There were no group differences in the emotion discrimination task. In brain responses, all groups were sensitive to laughter authenticity at the P2 stage, and to crying authenticity at the early LPP stage. Nevertheless, only early-blind participants were sensitive to crying authenticity at the N1 and middle LPP stages, and to laughter authenticity at the early LPP stage. Furthermore, early-blind and sighted participants were more sensitive than late-blind ones to crying authenticity at the P2 and late LPP stages. Altogether, these findings suggest that early blindness relates to facilitated brain processing of authenticity in voices, both at early sensory and late cognitive-evaluative stages. Late-onset blindness, in contrast, relates to decreased sensitivity to authenticity at behavioral and brain levels.

Is song processing distinct and special in the auditory cortex?

Is the singing voice processed distinctively in the human brain? In this Perspective, we discuss what might distinguish song processing from speech processing in light of recent work suggesting that some cortical neuronal populations respond selectively to song and we outline the implications for our understanding of auditory processing. We review the literature regarding the neural and physiological mechanisms of song production and perception and show that this provides evidence for key differences between song and speech processing. We conclude by discussing the significance of the notion that song processing is special in terms of how this might contribute to theories of the neurobiological origins of vocal communication and to our understanding of the neural circuitry underlying sound processing in the human cortex.

Decoding brain basis of laughter and crying in natural scenes.

Laughter and crying are universal signals of prosociality and distress, respectively. Here we investigated the functional brain basis of perceiving laughter and crying using naturalistic functional magnetic resonance imaging (fMRI) approach. We measured haemodynamic brain activity evoked by laughter and crying in three experiments with 100 subjects in each. The subjects i) viewed a 20-minute medley of short video clips, and ii) 30 min of a full-length feature film, and iii) listened to 13.5 min of a radio play that all contained bursts of laughter and crying. Intensity of laughing and crying in the videos and radio play was annotated by independent observes, and the resulting time series were used to predict hemodynamic activity to laughter and crying episodes. Multivariate pattern analysis (MVPA) was used to test for regional selectivity in laughter and crying evoked activations. Laughter induced widespread activity in ventral visual cortex and superior and middle temporal and motor cortices. Crying activated thalamus, cingulate cortex along the anterior-posterior axis, insula and orbitofrontal cortex. Both laughter and crying could be decoded accurately (66-77% depending on the experiment) from the BOLD signal, and the voxels contributing most significantly to classification were in superior temporal cortex. These results suggest that perceiving laughter and crying engage distinct neural networks, whose activity suppresses each other to manage appropriate behavioral responses to others' bonding and distress signals.

Task-irrelevant auditory metre shapes visuomotor sequential learning.

The ability to learn and reproduce sequences is fundamental to every-day life, and deficits in sequential learning are associated with developmental disorders such as specific language impairment. Individual differences in sequential learning are usually investigated using the serial reaction time task (SRTT), wherein a participant responds to a series of regularly timed, seemingly random visual cues that in fact follow a repeating deterministic structure. Although manipulating inter-cue interval timing has been shown to adversely affect sequential learning, the role of metre (the patterning of salience across time) remains unexplored within the regularly timed, visual SRTT. The current experiment consists of an SRTT adapted to include task-irrelevant auditory rhythms conferring a sense of metre. We predicted that (1) participants' (n = 41) reaction times would reflect the auditory metric structure; (2) that disrupting the correspondence between the learned visual sequence and auditory metre would impede performance; and (3) that individual differences in sensitivity to rhythm would predict the magnitude of these effects. Altering the relationship via a phase shift between the trained visual sequence and auditory metre slowed reaction times. Sensitivity to rhythm was predictive of reaction times over all. In an exploratory analysis, we, moreover, found that approximately half of participants made systematically different responses to visual cues on the basis of the cues' position within the auditory metre. We demonstrate the influence of auditory temporal structures on visuomotor sequential learning in a widely used task where metre and timing are rarely considered. The current results indicate sensitivity to metre as a possible latent factor underpinning individual differences in SRTT performance.

Temporal origin of mouse claustrum and development of its cortical projections.

The claustrum is known for its extensive connectivity with many other forebrain regions, but its elongated shape and deep location have made further study difficult. We have sought to understand when mouse claustrum neurons are born, where they are located in developing brains, and when they develop their widespread connections to the cortex. We established that a well-characterized parvalbumin plexus, which identifies the claustrum in adults, is only present from postnatal day (P) 21. A myeloarchitectonic outline of the claustrum can be derived from a triangular fiber arrangement from P15. A dense patch of Nurr1+ cells is present at its core and is already evident at birth. Bromodeoxyuridine birth dating of forebrain progenitors reveals that the majority of claustrum neurons are born during a narrow time window centered on embryonic day 12.5, which is later than the adjacent subplate and endopiriform nucleus. Retrograde tracing revealed that claustrum projections to anterior cingulate (ACA) and retrosplenial cortex (RSP) follow distinct developmental trajectories. Claustrum-ACA connectivity matures rapidly and reaches adult-like innervation density by P10, whereas claustrum-RSP innervation emerges later over a protracted time window. This work establishes the timeline of claustrum development and provides a framework for understanding how the claustrum is built and develops its unique connectivity.

Robert Provine: the critical human importance of laughter, connections and contagion.

Robert Provine made several critically important contributions to science, and in this paper, we will elaborate some of his research into laughter and behavioural contagion. To do this, we will employ Provine's observational methods and use a recorded example of naturalistic laughter to frame our discussion of Provine's work. The laughter is from a cricket commentary broadcast by the British Broadcasting Corporation in 1991, in which Jonathan Agnew and Brian Johnston attempted to summarize that day's play, at one point becoming overwhelmed by laughter. We will use this laughter to demonstrate some of Provine's key points about laughter and contagious behaviour, and we will finish with some observations about the importance and implications of the differences between humans and other mammals in their use of contagious laughter. This article is part of the theme issue 'Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience'.

Mu-opioid receptor system modulates responses to vocal bonding and distress signals in humans.

Laughter is a contagious prosocial signal that conveys bonding motivation; adult crying conversely communicates desire for social proximity by signalling distress. Endogenous mu-opioid receptors (MORs) modulate sociability in humans and non-human primates. In this combined PET-fMRI study (n = 17), we tested whether central MOR tone is associated with regional brain responses to social signals of laughter and crying. MOR availability was measured with positron emission tomography (PET) using the high-affinity agonist radioligand [11C]carfentanil. Haemodynamic responses to social laughter and crying vocalizations were measured using functional magnetic resonance imaging (fMRI). Social laughter evoked activation in the auditory cortex, insula, cingulate cortex, amygdala, primary and secondary somatosensory cortex, and primary and secondary motor cortex; crying sounds led to more restricted activation in the auditory cortex and nearby areas. MOR availability was negatively correlated with the haemodynamic responses to social laughter in the primary and secondary somatosensory cortex, primary and secondary motor cortex, posterior insula, posterior cingulate cortex, precuneus, cuneus, temporal gyri and lingual gyrus. For crying-evoked activations, MOR availability was negatively correlated with medial and lateral prefrontal haemodynamic responses. Altogether our findings highlight the role of the MOR system in modulating acute brain responses to both positive and negative social signals. This article is part of the theme issue 'Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience'.

Up-front cell-free DNA next generation sequencing improves target identification in UK first line advanced non-small cell lung cancer (NSCLC) patients.

BACKGROUND: Genomic sequencing is necessary for first-line advanced non-small cell lung cancer (aNSCLC) treatment decision-making. Tissue next generation sequencing (NGS) is standard but tissue quantity, quality, and time-to-results remains problematic. Here, we compare upfront cell-free-DNA (cfDNA) NGS clinical utility against routine tissue testing in patients with aNSCLC. METHODS: cfDNA-NGS was performed in consecutive, newly identified aNSCLC patients between December 2019-October 2021 alongside routine tissue genotyping. Variants were interpreted using AMP/ASCO/CAP guidelines. The primary endpoint was tier-1 variants detected on cfDNA-NGS. cfDNA-NGS results were compared to tissue results. RESULTS: Of 311 patients, 282 (91%) had an informative cfDNA-NGS test; 118 (38%) patients had a tier-1 variant identified by cfDNA-NGS. Of 243 patients with paired tissue-cfDNA tests, 122 (50%) tissue tests were informative; 85 (35%) tissue tests identified a tier-1 variant. cfDNA-NGS detected 39 additional tier-1 variants compared to tissue alone, increasing the tier-1 detection rate by 46% (from 85 to 124). The sensitivity of cfDNA-NGS relative to tissue was 75% (25% tissue tier-1 variants were not detected on cfDNA-NGS); 33% of cfDNA tier-1 variants were not identified on tissue tests. Median time from request-to-report was shorter for cfDNA-NGS versus tissue (8 versus 22 days; p < 0.0001). A total of 245 (79%) patients received first-line systemic-therapy: 49 (20%) with cfDNA-NGS results alone. Median time from sampling-to-commencement of first-line treatment was shorter for cfDNA-NGS blood draw versus first tissue biopsy (16 versus 35 days; p < 0.0001). CONCLUSIONS: cfDNA-NGS increased the tier-1 variant detection rate with high concordance with tissue, and halves time-to-treatment. 'Plasma-first' upfront cfDNA-NGS use should be considered routinely for aNSCLC.

Listeners are sensitive to the speech breathing time series: Evidence from a gap detection task.

The effect of non-speech sounds, such as breathing noise, on the perception of speech timing is currently unclear. In this paper we report the results of three studies investigating participants' ability to detect a silent gap located adjacent to breath sounds during naturalistic speech. Experiment 1 (n = 24, in-person) asked whether participants could either detect or locate a silent gap that was added adjacent to breath sounds during speech. In Experiment 2 (n = 182; online), we investigated whether different placements within an utterance were more likely to elicit successful detection of gaps. In Experiment 3 (n = 102; online), we manipulated the breath sounds themselves to examine the effect of breath-specific characteristics on gap identification. Across the study, we document consistent effects of gap duration, as well as gap placement. Moreover, in Experiment 2, whether a gap was positioned before or after an interjected breath significantly predicted accuracy as well as the duration threshold at which gaps were detected, suggesting that nonverbal aspects of audible speech production specifically shape listeners' temporal expectations. We also describe the influences of the breath sounds themselves, as well as the surrounding speech context, that can disrupt objective gap detection performance. We conclude by contextualising our findings within the literature, arguing that the verbal acoustic signal is not "speech itself" per se, but rather one part of an integrated percept that includes speech-related respiration, which could be more fully explored in speech perception studies.