Javier Pagonabarraga1, Carles Soriano-Mas2, Gisela Llebaria1, Marina López-Solà3, Jesús Pujol3, Jaime Kulisevsky4. 1. Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Instituto de Investigaciones Biomédicas - Sant Pau (IIB-Sant Pau), Autonomous University of Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain. 2. CRC Hospital del Mar, Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital - IDIBELL, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. 3. CRC Hospital del Mar, Barcelona, Spain. 4. Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Instituto de Investigaciones Biomédicas - Sant Pau (IIB-Sant Pau), Autonomous University of Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain. Electronic address: jkulisevsky@santpau.cat.
Abstract
BACKGROUND: Hallucinations are a frequent and severe complication in Parkinson's disease (PD). Minor hallucinations are generally not disturbing, but likely progress to well-structured hallucinations with loss of insight and a great impact on quality of life. Knowledge on the neural bases of minor hallucinations may help to describe those systems associated with the early development of psychotic phenomena in PD. In this study, we aimed to identify the pattern of structural brain alterations associated with minor hallucinations in PD by using voxel-based morphometry (VBM). METHODS: We prospectively collected a sample of 46 non-demented PD patients, with (N = 17) and without (n = 29) minor hallucinations (passage and/or presence hallucinations), and 15 healthy controls. Groups were matched for age, education and global cognitive function. Presence and type of minor psychotic phenomena was assessed by the new MDS-UPDRS. Three dimensional T1-weighted MRI images were acquired with a 1.5 T magnet, and analyzed using optimized VBM. RESULTS: Compared to controls, PD with minor hallucinations (PD-mH) showed reduced gray matter volume bilaterally in different areas of the dorsal visual stream, and in functionally related midbrain and cerebellar structures. Additionally, bilateral gray matter volume increases were observed in the PD-mH group in limbic and paralimbic regions. CONCLUSIONS: Our data support a major role of the dorsal visual stream in the genesis of minor hallucinations in PD, reinforcing the importance of posterior cortical regions for the development of cognitive and psychiatric complications in PD.
BACKGROUND:Hallucinations are a frequent and severe complication in Parkinson's disease (PD). Minor hallucinations are generally not disturbing, but likely progress to well-structured hallucinations with loss of insight and a great impact on quality of life. Knowledge on the neural bases of minor hallucinations may help to describe those systems associated with the early development of psychotic phenomena in PD. In this study, we aimed to identify the pattern of structural brain alterations associated with minor hallucinations in PD by using voxel-based morphometry (VBM). METHODS: We prospectively collected a sample of 46 non-demented PDpatients, with (N = 17) and without (n = 29) minor hallucinations (passage and/or presence hallucinations), and 15 healthy controls. Groups were matched for age, education and global cognitive function. Presence and type of minor psychotic phenomena was assessed by the new MDS-UPDRS. Three dimensional T1-weighted MRI images were acquired with a 1.5 T magnet, and analyzed using optimized VBM. RESULTS: Compared to controls, PD with minor hallucinations (PD-mH) showed reduced gray matter volume bilaterally in different areas of the dorsal visual stream, and in functionally related midbrain and cerebellar structures. Additionally, bilateral gray matter volume increases were observed in the PD-mH group in limbic and paralimbic regions. CONCLUSIONS: Our data support a major role of the dorsal visual stream in the genesis of minor hallucinations in PD, reinforcing the importance of posterior cortical regions for the development of cognitive and psychiatric complications in PD.
Authors: Baijayanta Maiti; Jonathan M Koller; Abraham Z Snyder; Aaron B Tanenbaum; Scott A Norris; Meghan C Campbell; Joel S Perlmutter Journal: Neurology Date: 2019-12-17 Impact factor: 9.910
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Authors: Sang Soo Cho; Antonio P Strafella; Sarah Duff-Canning; Mateusz Zurowski; Anne-Catherine Vijverman; Veronica Bruno; Camila C Aquino; Marion Criaud; Pablo M Rusjan; Sylvain Houle; Susan H Fox Journal: Mov Disord Clin Pract Date: 2017-01-23