Ana Marques1, Steven Beze2, Bruno Pereira3, Carine Chassain4, Nathalie Monneyron2, Laure Delaby5, Celine Lambert2, Marie Fontaine6, Philippe Derost6, Bérengère Debilly6, Isabelle Rieu6, Simon J G Lewis7, Frédéric Chiambaretta2, Franck Durif6. 1. Neurology Department, Université Clermont-Auvergne, EA7280, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. ar_marques@chu-clermontferrand.fr. 2. Ophtalmology Department, Université Clermont-Auvergne, EA7280, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. 3. Biostatistics Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. 4. Imaging Department, Université Clermont-Auvergne, EA7280, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. 5. CMRR, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. 6. Neurology Department, Université Clermont-Auvergne, EA7280, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. 7. Brain and Mind Center, Parkinson's Disease Research Clinic, University of Sydney, Sydney, Australia.
Abstract
INTRODUCTION: Whether different mechanisms, particularly ocular pathology, could lead to the emergence of visual hallucinations (VH) (defined as false perceptions with no external stimulus) versus visual illusions (VI) (defined as a misperception of a real stimulus) in Parkinson's disease (PD) remains debated. We assessed retinal, clinical and structural brain characteristics depending on the presence of VH or VI in PD. METHODS: In this case-control study, we compared retinal thickness using optical coherence tomography (OCT), between PD patients with: VI (PD-I; n = 26), VH (PD-H; n = 28), and without VI or VH (PD-C; n = 28), and assessed demographic data, disease severity, treatment, anatomical and functional visual complaints, cognitive and visuo-perceptive functions and MRI brain volumetry for each group of PD patients. RESULTS: Parafoveal retina was thinner in PD-H compared to PD-C (p = 0.005) and PD-I (p = 0.009) but did not differ between PD-I and PD-C (p = 0.85). Multivariate analysis showed that 1/retinal parafoveal thinning and total brain gray matter atrophy were independently associated with the presence of VH compared to PD-I; 2/retinal parafoveal thickness, PD duration, sleep quality impairment and total brain gray matter volume were independent factors associated with the presence of VH compared to PD-C; 3/anterior ocular abnormalities were the only factor independently associated with the presence of illusions compared to PD-C. CONCLUSION: These findings reinforce the hypothesis that there may be different mechanisms contributing to VH and VI in PD, suggesting that these two entities may also have a different prognosis rather than simply lying along a continuous spectrum. REGISTRATION NUMBER: Clinicaltrials.gov number NCT01114321.
INTRODUCTION: Whether different mechanisms, particularly ocular pathology, could lead to the emergence of visual hallucinations (VH) (defined as false perceptions with no external stimulus) versus visual illusions (VI) (defined as a misperception of a real stimulus) in Parkinson's disease (PD) remains debated. We assessed retinal, clinical and structural brain characteristics depending on the presence of VH or VI in PD. METHODS: In this case-control study, we compared retinal thickness using optical coherence tomography (OCT), between PD patients with: VI (PD-I; n = 26), VH (PD-H; n = 28), and without VI or VH (PD-C; n = 28), and assessed demographic data, disease severity, treatment, anatomical and functional visual complaints, cognitive and visuo-perceptive functions and MRI brain volumetry for each group of PD patients. RESULTS: Parafoveal retina was thinner in PD-H compared to PD-C (p = 0.005) and PD-I (p = 0.009) but did not differ between PD-I and PD-C (p = 0.85). Multivariate analysis showed that 1/retinal parafoveal thinning and total brain gray matter atrophy were independently associated with the presence of VH compared to PD-I; 2/retinal parafoveal thickness, PD duration, sleep quality impairment and total brain gray matter volume were independent factors associated with the presence of VH compared to PD-C; 3/anterior ocular abnormalities were the only factor independently associated with the presence of illusions compared to PD-C. CONCLUSION: These findings reinforce the hypothesis that there may be different mechanisms contributing to VH and VI in PD, suggesting that these two entities may also have a different prognosis rather than simply lying along a continuous spectrum. REGISTRATION NUMBER: Clinicaltrials.gov number NCT01114321.
Authors: Nicholas Murphy; Alison Killen; Rajnish Kumar Gupta; Sara Graziadio; Lynn Rochester; Michael Firbank; Mark R Baker; Charlotte Allan; Daniel Collerton; John-Paul Taylor; Prabitha Urwyler Journal: Front Neurol Date: 2021-01-28 Impact factor: 4.003
Authors: Iris van der Lijn; Gera A de Haan; Famke Huizinga; Fleur E van der Feen; A Wijnand F Rutgers; Catherina Stellingwerf; Teus van Laar; Joost Heutink Journal: J Parkinsons Dis Date: 2022 Impact factor: 5.520