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Visual Hallucinations and Cognitive Impairment in Parkinson's Disease

Published online by Cambridge University Press:  23 September 2014

Hee Kyung Park
Affiliation:
Department of Neurology, Inje University Ilsan-Paik Hospital, Goyang Department of Neurology, University of Ulsan College of Medicine Department of Neurology, College of Medicine, Hanyang University
Jae Seung Kim
Affiliation:
Department of Neurology, Inje University Ilsan-Paik Hospital, Goyang
Ki Chun Im
Affiliation:
Sogang Institute of Advanced Technology, Sogang University, Seoul
Mi Jung Kim
Affiliation:
Department of Neurology, University of Ulsan College of Medicine
Jae-Hong Lee
Affiliation:
Department of Neurology, University of Ulsan College of Medicine
Myoung C. Lee
Affiliation:
Department of Neurology, Cheongshim International Medical Center, Gapyeong, Korea
Juhan Kim
Affiliation:
Department of Neurology, College of Medicine, Hanyang University
Sun Ju Chung*
Affiliation:
Department of Neurology, University of Ulsan College of Medicine
*
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea. E-mail: sjchung@amc.seoul.kr
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Abstract:

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Background:

Visual hallucination (VH) is a common psychotic symptom in patients with Parkinson's disease (PD) and may be a significant predictor of cognitive impairment (CI) in such patients.

Objective:

This study aimed to investigate the pattern of glucose metabolism of VH and the relationship between VH and CI in PD.

Methods:

We studied 28 PD patients, including 15 with VH (PD-VH) and 13 without VH (PD-NVH). Of the 15 PD-VH patients, 8 patients had cognitive impairment (PD-VHCI) whereas 7 did not (PD-VHNCI). All patients underwent [18F] fluorodeoxyglucose positron emission tomography ([18F] FDG PET) followed by statistical parametric mapping (SPM) analyses.

Results:

Compared to the patients with PDNVH, PD-VHNCI patients showed glucose hypometabolism in the inferior and middle temporal cortices, fusiform gyri, and frontal areas, suggesting the involvement of the ventral visual pathway. Compared to the patients with PDNVH, PD-VHCI patients showed glucose hypometabolism in the temporoparietal association cortices with scattered frontal areas.

Conclusion:

Dysfunction of ventral visual pathway involving the temporal lobe may play a key role in VH development in PD patients. The evolving distribution from the ventral visual pathway to more extensive posterior cortices in PD-VHCI patients suggests that VH may be a prodromal symptom occurring prior to CI in PD patients.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2013

References

1.Fenelon, G, Mahieux, F, Huon, R, Ziegler, M.Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors. Brain. 2000;123:733–45.CrossRefGoogle ScholarPubMed
2.Ravina, B, Marder, K, Fernandez, HH, et al.Diagnostic criteria for psychosis in Parkinson's disease: report of an NINDS, NIMH work group. Mov Disord. 2007;22(8):10618.CrossRefGoogle ScholarPubMed
3.Williams, DR, Lees, AJ.Visual hallucinations in the diagnosis of idiopathic Parkinson's disease: a retrospective autopsy study. Lancet Neurol. 2005;4(10):605–10.CrossRefGoogle ScholarPubMed
4.Goetz, CG, Stebbins, GT.Risk factors for nursing home placement in advanced Parkinson's disease. Neurology. 1993;43(11):22279.CrossRefGoogle ScholarPubMed
5.Ramírez-Ruiz, B, Martí, MJ, Tolosa, E, et al.Cerebral atrophy in Parkinson's disease patients with visual hallucinations. Eur J Neurol. 2007;14(7):7506.CrossRefGoogle ScholarPubMed
6.Oishi, N, Udaka, F, Kameyama, M, Sawamoto, N, Hashikawa, K, Fukuyama, H.Regional cerebral blood flow in Parkinson disease with nonpsychotic visual hallucinations. Neurology. 2005;65(11):170815.CrossRefGoogle ScholarPubMed
7.Matsui, H, Nishinaka, K, Oda, M, et al.Hypoperfusion of the visual pathway in parkinsonian patients with visual hallucinations. Mov Disord. 2006;21(12):21404.CrossRefGoogle ScholarPubMed
8.Boecker, H, Ceballos-Baumann, AO, Volk, D, Conrad, B, Forstl, H, Haussermann, P.Metabolic alterations in patients with Parkinson disease and visual hallucinations. Arch Neurol. 2007 July;64(7):9848.CrossRefGoogle ScholarPubMed
9.Nagano-Saito, A, Washimi, Y, Arahata, Y, et al.Visual hallucination in Parkinson's disease with FDG PET. Mov Disord. 2004;19(7):8016.CrossRefGoogle ScholarPubMed
10.Harding, AJ, Broe, GA, Halliday, GM.Visual hallucinations in Lewy body disease relate to Lewy bodies in the temporal lobe. Brain. 2002;125(2):391403.CrossRefGoogle ScholarPubMed
11.Aarsland, D, Bronnick, K, Ehrt, U, et al.Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress. J Neurol Neurosurg Psychiatry. 2007;78(1):3642.CrossRefGoogle ScholarPubMed
12.Santangelo, G, Trojano, L, Vitale, C, et al.A neuropsychological longitudinal study in Parkinson's patients with and without hallucinations. Mov Disord. 2007;22(16):241825.CrossRefGoogle ScholarPubMed
13.Ramirez-Ruiz, B, Junque, C, Marti, MJ, Valldeoriola, F, Tolosa, E.Neuropsychological deficits in Parkinson's disease patients with visual hallucinations. Mov Disord. 2006;21(9):14837.CrossRefGoogle ScholarPubMed
14.Ibarretxe-Bilbao, N, Ramirez-Ruiz, B, Junque, C, et al.Differential progression of brain atrophy in Parkinson's disease with and without visual hallucinations. J Neurol Neurosurg Psychiatry. 2010;81(6):6507.Google ScholarPubMed
15.Hughes, AJ, Daniel, SE, Kilford, L, Lees, AJ.Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):1814.CrossRefGoogle ScholarPubMed
16.Cummings, JL, Mega, M, Gray, K, Rosenberg-Thompson, S, Carusi, DA, Gornbein, J.The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):230814.CrossRefGoogle ScholarPubMed
17.McKeith, IG, Dickson, DW, Lowe, J, et al.Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65(12):186372.CrossRefGoogle ScholarPubMed
18.Kang, YW.A normative study of the Korean-mini mental state examination (K-MMSE) in the elderly. Korean J Psychol. 2006;25:112.Google Scholar
19.Lee, J-Y, Lee, Dong Woo, Cho, S-J, et al.Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the Montreal cognitive assessment. J Geriatr Psychiatry Neurol. 2008;21(2):104–10.CrossRefGoogle ScholarPubMed
20.Fahn, S, Elton, RL, Members of the UPDRS Development Committee. The Unified Parkinson's Disease Rating Scale. In Fahn, S, Marsden, CD, Goldstein, M, Calne, DB, eds: Recent Developments in Parkinson's Disease, Vol. 2. Florham Park, NJ: Macmillan Healthcare Information, 1987. pp. 153163, 293-304.Google Scholar
21.Soonawala, D, Amin, T, Ebmeier, KP, et al.Statistical parametric mapping of (99m)Tc-HMPAO-SPECT images for the diagnosis of Alzheimer's disease: normalizing to cerebellar tracer uptake. Neuroimage. 2002;17(3):1193–202.CrossRefGoogle ScholarPubMed
22.Klein, RC, de Jong, BM, de Vries, JJ, Leenders, KL.Direct comparison between regional cerebral metabolism in progressive supranuclear palsy and Parkinson's disease. Mov Disord. 2005;20(8):102130.CrossRefGoogle ScholarPubMed
23.Gallagher, DA, Parkkinen, L, O'Sullivan, SS, et al.Testing an aetiological model of visual hallucinations in Parkinson's disease. Brain. 2011;134:3299–309.CrossRefGoogle ScholarPubMed
24.Matsui, H, Nishinaka, K, Oda, M, et al.Hypoperfusion of the visual pathway in parkinsonian patients with visual hallucinations. Mov Disord. 2006;21(12): 21404.CrossRefGoogle ScholarPubMed
25.Ballanger, B, Strafella, AP, van Eimeren, T, et al.Serotonin 2A receptors and visual hallucinations in Parkinson disease. Arch Neurol. 2010;67(4):416–21.CrossRefGoogle ScholarPubMed
26.Papapetropoulos, S, McCorquodale, DS, Gonzalez, J, Jean-Gilles, L, Mash, DC.Cortical and amygdalar Lewy body burden in Parkinson's disease patients with visual hallucinations. Parkinsonism Relat Disord. 2006;12(4):2536.CrossRefGoogle ScholarPubMed
27.Braak, H, Del Tredici, K, Rub, U, de Vos, RA, Jansen Steur, EN, Braak, E.Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol Aging. 2003;24(2):197211.CrossRefGoogle ScholarPubMed
28.de Maindreville, AD, Fenelon, G, Mahieux, F.Hallucinations in Parkinson's disease: a follow-up study. Mov Disord. 2005;20(2):2127.CrossRefGoogle ScholarPubMed
29.Dalrymple-Alford, JC, MacAskill, MR, Nakas, CT, et al.The MoCA: well-suited screen for cognitive impairment in Parkinson disease. Neurology. 2010;75(19):171725.CrossRefGoogle ScholarPubMed