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Kurita A, Koshikawa H, Akiba T, Seki K, Ishikawa H, Suzuki M. Visual Hallucinations and Impaired Conscious Visual Perception in Parkinson Disease. J Geriatr Psychiatry Neurol 2020; 33:377-385. [PMID: 31808354 DOI: 10.1177/0891988719892318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Visual hallucinations (VHs) are common in patients with Parkinson disease (PD), especially those with dementia, whereas auditory hallucinations are quite rare. Recent studies have revealed the involvement of several regions along the visual information-processing system that contribute to the pathophysiological mechanism of VHs: the eyes and retina, retinofugal projection, lateral geniculate nucleus, striate cortex, ventral pathways in the temporal cortices, and frontal and parietal cortices. In addition, the concurrent involvement of other systems in the brainstem and basal forebrain further modify VHs in PD. In this review, we discuss the pathophysiological association between the regional involvement of these areas and VHs.
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Affiliation(s)
- Akira Kurita
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Hiroaki Koshikawa
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Takeshi Akiba
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Kanako Seki
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Hiroaki Ishikawa
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Megumi Suzuki
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
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Ding C, Palmer CJ, Hohwy J, Youssef GJ, Paton B, Tsuchiya N, Stout JC, Thyagarajan D. Parkinson's disease alters multisensory perception: Insights from the Rubber Hand Illusion. Neuropsychologia 2017; 97:38-45. [DOI: 10.1016/j.neuropsychologia.2017.01.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/17/2017] [Accepted: 01/29/2017] [Indexed: 12/14/2022]
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Gracitelli CPB, Abe RY, Diniz-Filho A, Vaz-de-Lima FB, Paranhos A, Medeiros FA. Ophthalmology issues in schizophrenia. Curr Psychiatry Rep 2015; 17:28. [PMID: 25773224 PMCID: PMC4523638 DOI: 10.1007/s11920-015-0569-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Schizophrenia is a complex mental disorder associated with not only cognitive dysfunctions, such as memory and attention deficits, but also changes in basic sensory processing. Although most studies on schizophrenia have focused on disturbances in higher-order brain functions associated with the prefrontal cortex or frontal cortex, recent investigations have also reported abnormalities in low-level sensory processes, such as the visual system. At very early stages of the disease, schizophrenia patients frequently describe in detail symptoms of a disturbance in various aspects of visual perception that may lead to worse clinical symptoms and decrease in quality of life. Therefore, the aim of this review is to describe the various studies that have explored the visual issues in schizophrenia.
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Affiliation(s)
- Carolina P. B. Gracitelli
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA; Department of Ophthalmology, Federal University of São Paulo, Botucatu Street, 821. Vila Clementino, São Paulo, SP 04023-062, Brazil
| | - Ricardo Y. Abe
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA; ; Department of Ophthalmology, University of Campinas, Vital Brasil Street, 251, Cidade Universitária Zeferino Vaz, Campinas, SP 13083-970, Brazil
| | - Alberto Diniz-Filho
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA; ; Department of Ophthalmology and Otorhinolaryngology, Federal University of Minas Gerais, Alfredo Balena Avenue, 190 Santa Efigenia, Belo Horizonte, MG 30130-100, Brazil
| | | | - Augusto Paranhos
- Department of Ophthalmology, Federal University of São Paulo, Botucatu Street, 821. Vila Clementino, São Paulo, SP 04023-062, Brazil;
| | - Felipe A. Medeiros
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, 9500 Gilman Drive, La Jolla, CA 92093-0946, USA;
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Beaulieu-Boire I, Lang AE. Behavioral effects of levodopa. Mov Disord 2014; 30:90-102. [PMID: 25491470 DOI: 10.1002/mds.26121] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/08/2014] [Accepted: 11/17/2014] [Indexed: 12/15/2022] Open
Abstract
In recent years, levodopa-induced behavioral changes have received increased attention in the medical literature and in clinical practice. The spectrum of these symptoms includes non-motor fluctuations with neuropsychiatric symptoms, compulsive behaviors such as punding, dopamine dysregulation syndrome, and impulse control disorders, psychosis and hallucinations, as well as hypomania and mania. Despite knowledge of the clinical features associated with these behaviors, many of them are probably underdiagnosed. Although the mechanisms underlying behavioral symptoms are still incompletely understood, recent data from imaging and pathological studies have increased our understanding and guided new treatment strategies. Appropriate management remains challenging, because reduction of levodopa (l-dopa) and dopaminergic treatment is often recommended; however, doses required for control of motor symptoms may still induce behavioral changes. Newer modes of delivery of dopaminergic treatment, deep brain stimulation, and nondopaminergic agents may either provide alternatives for treatment of these behavioral problems or permit treatment of parkinsonism with less risk of these behavioral disorders.
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Affiliation(s)
- Isabelle Beaulieu-Boire
- Morton & Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Barnes J, Connelly V, Boubert L, Maravic K. Behavioural coping patterns in Parkinson's patients with visual hallucinations. J Neuropsychol 2013; 7:326-34. [DOI: 10.1111/jnp.12016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 02/06/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Jim Barnes
- Department of Psychology; Oxford Brookes University; Oxford UK
| | - Vince Connelly
- Department of Psychology; Oxford Brookes University; Oxford UK
| | - Laura Boubert
- Department of Psychology; University of Westminster; London UK
| | - Ksenija Maravic
- Department of Psychology; Oxford Brookes University; Oxford UK
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Baggott MJ, Siegrist JD, Galloway GP, Robertson LC, Coyle JR, Mendelson JE. Investigating the mechanisms of hallucinogen-induced visions using 3,4-methylenedioxyamphetamine (MDA): a randomized controlled trial in humans. PLoS One 2010; 5:e14074. [PMID: 21152030 PMCID: PMC2996283 DOI: 10.1371/journal.pone.0014074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 10/20/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The mechanisms of drug-induced visions are poorly understood. Very few serotonergic hallucinogens have been studied in humans in decades, despite widespread use of these drugs and potential relevance of their mechanisms to hallucinations occurring in psychiatric and neurological disorders. METHODOLOGY/PRINCIPAL FINDINGS We investigated the mechanisms of hallucinogen-induced visions by measuring the visual and perceptual effects of the hallucinogenic serotonin 5-HT2AR receptor agonist and monoamine releaser, 3,4-methylenedioxyamphetamine (MDA), in a double-blind placebo-controlled study. We found that MDA increased self-report measures of mystical-type experience and other hallucinogen-like effects, including reported visual alterations. MDA produced a significant increase in closed-eye visions (CEVs), with considerable individual variation. Magnitude of CEVs after MDA was associated with lower performance on measures of contour integration and object recognition. CONCLUSIONS/SIGNIFICANCE Drug-induced visions may have greater intensity in people with poor sensory or perceptual processing, suggesting common mechanisms with other hallucinatory syndromes. MDA is a potential tool to investigate mystical experiences and visual perception. TRIAL REGISTRATION Clinicaltrials.gov NCT00823407.
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Affiliation(s)
- Matthew J Baggott
- Addiction and Pharmacology Research Laboratory, California Pacific Medical Center Research Institute, St Luke's Hospital, San Francisco, California, United States of America.
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Matsui H, Nishinaka K, Oda M, Hara N, Komatsu K, Kubori T, Udaka F. Hypoperfusion of the visual pathway in parkinsonian patients with visual hallucinations. Mov Disord 2007; 21:2140-4. [PMID: 17029272 DOI: 10.1002/mds.21140] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Little is known about the developing mechanisms of visual hallucinations in Parkinson's disease. This study aimed to investigate perfusion changes in parkinsonian patients with visual hallucinations using n-isopropyl-p-[123I]iodoamphetamine ([123I]IMP) single photon emission computed tomography imaging. A total of 70 consecutive patients, including 31 patients with visual hallucinations, and 39 patients without hallucinations, participated in this study. Patients with severe cognitive impairment (Mini-Mental State Examination score < 20), nonvisual hallucinations, or confusion were excluded. We compared brain perfusion changes between the two groups. We found that hallucinatory patients had significant perfusion reductions in the bilateral inferior parietal lobule, inferior temporal gyrus, precuneus gyrus, and occipital cortex compared to nonhallucinatory patients. These results suggested that hypoperfusion of the visual pathway was closely related to visual hallucinations in Parkinson's disease.
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Affiliation(s)
- Hideaki Matsui
- Department of Neurology, Sumitomo Hospital, Kita-ku, Osaka, Japan.
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Matsui H, Udaka F, Tamura A, Oda M, Kubori T, Nishinaka K, Kameyama M. Impaired visual acuity as a risk factor for visual hallucinations in Parkinson's disease. J Geriatr Psychiatry Neurol 2006; 19:36-40. [PMID: 16449759 DOI: 10.1177/0891988705284739] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pathophysiology of hallucinations in Parkinson's disease is poorly understood. This study investigated relationships between visual hallucinations and visual acuity. Twenty-six consecutive patients with Parkinson's disease participated in this study. Patients were divided into two groups: patients with visual hallucinations (VH group) and those without visual hallucinations (no-VH group). Unaided and corrected eyesight was evaluated in all patients, and if frequent use of prescription glasses or contact lenses was involved, eyesight using these lenses was also measured as the patient's own best eyesight. If a patient did not use prescription glasses or contact lenses, the patient's own best eyesight was defined as the unaided eyesight. Multivariate regression analysis demonstrated that agonist use and best eyesight were different after the backward elimination method. Visual hallucinations were closely related not to uncorrected eyesight or unaided eyesight but to the patient's best eyesight. It is suggested that impaired visual acuity is a risk factor for visual hallucinations.
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Affiliation(s)
- Hideaki Matsui
- Department of Neurology, Sumitomo Hospital, Osaka, Japan.
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Matsui H, Udaka F, Tamura A, Oda M, Kubori T, Nishinaka K, Kameyama M. The relation between visual hallucinations and visual evoked potential in Parkinson disease. Clin Neuropharmacol 2005; 28:79-82. [PMID: 15795550 DOI: 10.1097/01.wnf.0000157066.50948.65] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The pathophysiology of hallucinations in Parkinson disease is poorly understood. This study investigated the relation between visual hallucination and visual evoked potentials (VEPs) in Parkinson disease. METHODS Nineteen patients with Parkinson disease were studied. The authors divided patients into 2 groups: patients with visual hallucinations (VH group) and those without visual hallucinations (no-VH group). VEPs using a checkerboard stimulus were recorded under a drug-free state. RESULTS On multivariate regression analysis, only the average P100 latency was selected and remained significant after the backward elimination method. CONCLUSION The authors demonstrated a close association between visual hallucinations and elongated VEP latency in Parkinson disease. VEPs may become one of the predictors for visual hallucination.
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Affiliation(s)
- Hideaki Matsui
- Department of Neurology, Sumitomo Hospital, Osaka, Japan.
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Diederich NJ, Goetz CG, Stebbins GT. Repeated visual hallucinations in Parkinson's disease as disturbed external/internal perceptions: Focused review and a new integrative model. Mov Disord 2004; 20:130-40. [PMID: 15486924 DOI: 10.1002/mds.20308] [Citation(s) in RCA: 193] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Visual hallucinations (VH) in Parkinson's disease (PD) are a chronic complication in 30 to 60% of treated patients and have a multifaceted phenomenology. Flickering, faultive impressions, and illusionary misperceptions precede the core syndrome of stereotyped, colorful images. The patient variably recognizes these images as hallucinations, being rarely irritated or frightened and more often amused as a bystander. Although studies on VH in PD focus on several research domains, no comprehensive, unified theory has been developed to study their pathophysiology. We have adapted Hobson's work on the states of consciousness and propose a model integrating seemingly disparate data on VH. We suggest that VH should be considered as a dysregulation of the gating and filtering of external perception and internal image production. Contributive elements and anatomical links for the model include poor primary vision, reduced activation of primary visual cortex, aberrant activation of associative visual and frontal cortex, lack of suppression or spontaneous emergence of internally generated imagery through the ponto-geniculo-occipital system, intrusion of rapid eye movement dreaming imagery into wakefulness, errative changes of the brainstem filtering capacities through fluctuating vigilance, and medication-related overactivation of mesolimbic systems. Different etiologies likely produce different phenomenologies and the prognosis may not be uniform. This new conceptual framework permits an anatomical view of VH and suggests new, testable hypotheses regarding their pathophysiology and therapy.
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Affiliation(s)
- Nico J Diederich
- Department of Neuroscience, Centre Hospitalier de Luxembourg, Luxembourg.
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Abstract
Neuropsychiatric conditions that involve dopaminergic depletion have been associated with color discrimination deficits along the blue-hue (tritan, or short-wavelength-sensitive) axis. Because dopamine dysregulation may be a major factor in schizophrenia, we investigated color vision in this disorder. The performance of males with schizophrenia (SZ, n = 16) and normal male control subjects (CS, n = 14) was evaluated on five measures of color discrimination. SZ made more hue discrimination errors than CS, but no pattern emerged regarding a hue-specific axis of deficit. Dosage of anti-psychotic medication was not correlated with performance on hue discrimination. These results suggest that in medicated patients with schizophrenia, the dopaminergic disturbance, which may involve system hyperactivity, does not produce tritan-specific color deficits that have been observed in disorders involving dopaminergic hypoactivity.
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Affiliation(s)
- Sarah M Shuwairi
- Department of Psychology; Boston University, 64 Cummington Street, Boston, MA 02215, USA.
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