Pathological Joking or Witzelsucht Revisited

J Neuropsychiatry Clin Neurosci. 2016 Summer;28(3):162-7. doi: 10.1176/appi.neuropsych.15090238. Epub 2016 Feb 22.

Abstract

Humor, or the perception or elicitation of mirth and funniness, is distinguishable from laughter and can be differentially disturbed by neuropsychiatric disease. The authors describe two patients with constant joking, or Witzelsucht, in the absence of pseudobulbar affect and review the literature on pathological humor. These patients had involvement of frontal structures, impaired appreciation of nonsimple humor, and a compulsion for disinhibited joking. Current neuroscience suggests that impaired humor integration from right lateral frontal injury and disinhibition from orbitofrontal damage results in disinhibited humor, preferentially activating limbic and subcortical reward centers. Additional frontal-subcortical circuit dysfunction may promote pathological joking as a compulsion.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Behavioral Symptoms / diagnostic imaging*
  • Behavioral Symptoms / psychology*
  • Cerebral Cortex / diagnostic imaging
  • Humans
  • Laughter*
  • Male
  • Middle Aged
  • Tomography, Emission-Computed, Single-Photon