Citation

Mendez MF, Parand L. Case Rep. Psychiatry 2020; 2020: e5702578.

Affiliation

Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, USA.

Copyright

(Copyright © 2020, Hindawi Publishing)

DOI

10.1155/2020/5702578

PMID

32082679

PMCID

PMC7008292

Abstract

Brain injury can result in an increase in positive emotions. We describe a 63-year-old man who presented with a prominent personality change after a gunshot wound to the head. He became "content," light-hearted, and prone to joking and punning. Prior to his brain injury, he suffered from frequent depression and suicidal ideation, which subsequently resolved. Examination showed a large right calvarial defect and right facial weakness, along with memory impairment and variable executive functions. Further testing was notable for excellent performance on joke comprehension, good facial emotional recognition, adequate Theory of Mind, and elevated happiness. Neuroimaging revealed loss of much of the right frontal and right anterior lobes and left orbitofrontal injury. This patient, and the literature, suggests that frontal predominant injury can facilitate the emergence of mirth along with a sense of increased happiness possibly from disinhibited activation of the subcortical reward/pleasure centers of the ventral striatal limbic area.

Copyright © 2020 Mario F. Mendez and Leila Parand.

Language: en