Joker: Abnormal laughter really exists!

Nervous, hysterical, defensive, moving, grunting, forced … These are not the adjectives that are lacking for the qualification of laughter. In the case of the Joker, it’s a demented laugh; The insane, painful laughter that each of the on-screen character performers tried to make their own.

We certainly remember the story of Jack Nicholson; Incredible and disturbing hit Ledger, unusual in the Dark Knight. Now we also have to consider Joaquin Phoenix, who is phenomenal in his role. A role for which he admits he had been reading to himself for a long time before taking it.

“If I can’t find the Joker’s laugh, I might even throw it away!” Explained the actress in an interview with Première magazine in the September 2019 issue. “I called Todd to ask him to come home: ‘I’ll try to laugh in front of you, so if that does not work, we’ll fix it.’. He came and it was painfully embarrassing because he was sitting on the couch and watching me and it took me a quarter of an hour to smile. He told me: “You know, it does not matter, if you can not do it, you already have a role.” But I wanted to do it. To be sure. That was one of the crucial moments. “

Below, a small collection of his laughter, edited from the trailers …

To gain inspiration, the actress admitted that she watched hours of videos of patients with personality disorders. “I watched videos of people suffering from abnormal laughter, a neurological disorder that causes people to laugh uncontrollably”. This pathology has a name: prodromal laughter.

Prodromal laughter, Kesako?

First described Neurological review In 1903, Charles Ferre (1852-1907), a French neurologist who practiced at Bicetre Hospital, described this disorder as a pathological, unbearable, and meaningless laugh that declares a case of stroke. In France, this pathology was recently noted by neurologists at the University Hospital of Rouen, in an article published on the Internet on September 21, 2018. Journal of Emergency Medicine.

Abnormal laughter is observed especially in multiple sclerosis, pseudobulbar palsy (due to long-term damage to the medulla connecting the brain and spinal cord), tumors, amyotrophic lateral sclerosis (or Charcot’s disease, degenerative disorder of the spinal cord). .

At the same time, “abnormal laughter” appears as the first manifestation of a stroke. It is a transient symptom that lasts from a few seconds to 30 minutes. It can be observed during ischemic (with artery obstruction) or hemorrhagic stroke (associated with rupture of blood vessels).

With the title of the article Laughter Neurology And published in the Swiss Medical Journal in 2008, chronic abnormal laughter and crying are defined as follows: “Inadequate, uncontrollable laughter and crying of abnormal intensity with a lack of appropriate subjective affect. Subjectively, abnormal laughter and crying are often seen as very disturbing and disabling. However, patients rarely verbally express the problem spontaneously, so the doctor should address it purposefully.

Treatment with antidepressants is most often effective. Inadequate, unnatural or abnormal lack of laughter and smile can also be caused by an emotional disorder caused by both neurological and psychiatric causes.

Below is a video example of a person with abnormal laughter syndrome; This case is caused by pseudobulbar paralysis, caused by damage to the central motor neurons. Be careful, pictures are likely to be offensive and disturbing.

Working neurologist, Patrick Verstichel Is the author of an interesting post on this topic, entitled “Causes of Prodromal Laughter”, posted on the promotion site Future Sciences. He describes the case of the patient he examined: “Activation of laughter requires external stimulation, be it auditory (joke), visual (funny scene) or sensory (tick).

Here is the crucial aspect: the share of the right forehead is most sensitive to humor, paradox, and metaphor, far greater than its left analogue. It acts as a filter, i.e. regulates the appropriate response, which may be fun, but always takes into account the surrounding context and whether it corresponds to laughter depending on the context. “

Then he goes on to say a bit: “In the case of the patient I examined, the injury to the right forehead significantly violated its natural role as an inhibitory filter. Therefore, any situation and any stimulation was considered irresistibly ridiculous and activated the neural chain causing laughter. .

As for the conclusion of his presentation, it is almost hand-sewn for the Joker: “A patient with abnormal laughter causes discomfort to those around him and causes him to distance himself. Reckless laughter in psychoses has the same effect as schizophrenia.”

Due to the rarity of the prodromal laughter phenomenon, and because it is in any case, to date no research has been conducted (and unfortunately) to quantify the phenomenon and to measure the number of patients with this syndrome.