E Jaakkola1,2,3, J Joutsa1,4,5,6, E Mäkinen1,2,3, J Johansson6, V Kaasinen1,2,6. 1. Department of Neurology, University of Turku, Turku, Finland. 2. Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland. 3. Department of Nuclear Medicine, Turku University Hospital, Turku, Finland. 4. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 5. Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. 6. Turku PET Centre, Turku University Hospital, Turku, Finland.
Abstract
BACKGROUND AND PURPOSE: Visual hallucinations (VHs) are a common complication of Parkinson's disease (PD). The pathogenesis of VHs in PD is still largely unclear. The aim of this study was to investigate the dopaminergic mechanisms of VHs and specifically whether the degree of striatal dopamine transporter (DAT) function or extrastriatal serotonin transporter (SERT) function can predict the appearance of VHs in patients with PD. METHODS: Twenty-two PD patients scanned with [123 I]FP-CIT single photon emission computed tomography at an early stage of their disease who later developed VHs were identified and compared with 48 non-hallucinating PD patients. The groups were matched for age, medication, disease duration and motor symptom severity. Clinical follow-up after the scan was a median (range) of 6.9 (3.8-9.6) years. Imaging analyses were performed with both regions-of-interest-based and voxel-based (Statistical Parametric Mapping) methods for the striatal and extrastriatal regions. RESULTS: The median interval between the scan and the emergence of VHs was 4.8 years. Patients who developed VHs had 18.4% lower DAT binding in the right ventral striatum (P = 0.009), 16.7% lower binding in the left ventral striatum (P = 0.02) and 18.8% lower binding in the right putamen (P = 0.03) compared to patients who did not develop VHs. CONCLUSIONS: Low striatal DAT function may predispose PD patients to VHs, and the regional distribution of the findings suggests a particular role of the ventral striatum. This is in line with non-PD research that has implicated ventral striatal dysfunction in psychosis.
BACKGROUND AND PURPOSE:Visual hallucinations (VHs) are a common complication of Parkinson's disease (PD). The pathogenesis of VHs in PD is still largely unclear. The aim of this study was to investigate the dopaminergic mechanisms of VHs and specifically whether the degree of striatal dopamine transporter (DAT) function or extrastriatal serotonin transporter (SERT) function can predict the appearance of VHs in patients with PD. METHODS: Twenty-two PDpatients scanned with [123 I]FP-CIT single photon emission computed tomography at an early stage of their disease who later developed VHs were identified and compared with 48 non-hallucinating PDpatients. The groups were matched for age, medication, disease duration and motor symptom severity. Clinical follow-up after the scan was a median (range) of 6.9 (3.8-9.6) years. Imaging analyses were performed with both regions-of-interest-based and voxel-based (Statistical Parametric Mapping) methods for the striatal and extrastriatal regions. RESULTS: The median interval between the scan and the emergence of VHs was 4.8 years. Patients who developed VHs had 18.4% lower DAT binding in the right ventral striatum (P = 0.009), 16.7% lower binding in the left ventral striatum (P = 0.02) and 18.8% lower binding in the right putamen (P = 0.03) compared to patients who did not develop VHs. CONCLUSIONS: Low striatal DAT function may predispose PDpatients to VHs, and the regional distribution of the findings suggests a particular role of the ventral striatum. This is in line with non-PD research that has implicated ventral striatal dysfunction in psychosis.
Authors: Christoph Mueller; Anto P Rajkumar; Yi Min Wan; Latha Velayudhan; Dominic Ffytche; Kallol Ray Chaudhuri; Dag Aarsland Journal: CNS Drugs Date: 2018-07 Impact factor: 5.749
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Authors: John O'Brien; John Paul Taylor; Clive Ballard; Roger A Barker; Clare Bradley; Alistair Burns; Daniel Collerton; Sonali Dave; Rob Dudley; Paul Francis; Andrea Gibbons; Kate Harris; Vanessa Lawrence; Iracema Leroi; Ian McKeith; Michel Michaelides; Chaitali Naik; Claire O'Callaghan; Kirsty Olsen; Marco Onofrj; Rebecca Pinto; Gregor Russell; Peter Swann; Alan Thomas; Prabitha Urwyler; Rimona Sharon Weil; Dominic Ffytche Journal: J Neurol Neurosurg Psychiatry Date: 2020-03-25 Impact factor: 10.154