1
|
Devenyi RA, Hamedani AG. Visual dysfunction in dementia with Lewy bodies. Curr Neurol Neurosci Rep 2024; 24:273-284. [PMID: 38907811 PMCID: PMC11258179 DOI: 10.1007/s11910-024-01349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE OF REVIEW To review the literature on visual dysfunction in dementia with Lewy bodies (DLB), including its mechanisms and clinical implications. RECENT FINDINGS Recent studies have explored novel aspects of visual dysfunction in DLB, including visual texture agnosia, mental rotation of 3-dimensional drawn objects, and reading fragmented letters. Recent studies have shown parietal and occipital hypoperfusion correlating with impaired visuoconstruction performance. While visual dysfunction in clinically manifest DLB is well recognized, recent work has focused on prodromal or mild cognitive impairment (MCI) due to Lewy body pathology with mixed results. Advances in retinal imaging have recently led to the identification of abnormalities such as parafoveal thinning in DLB. Patients with DLB experience impairment in color perception, form and object identification, space and motion perception, visuoconstruction tasks, and illusions in association with visual cortex and network dysfunction. These symptoms are associated with visual hallucinations, driving impairment, falls, and other negative outcomes.
Collapse
Affiliation(s)
- Ryan A Devenyi
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ali G Hamedani
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
2
|
Alsemari A, Boscarino JJ. Neuropsychological and neuroanatomical underpinnings of the face pareidolia errors on the noise pareidolia test in patients with mild cognitive impairment and dementia due to Lewy bodies. J Clin Exp Neuropsychol 2024:1-11. [PMID: 38949538 DOI: 10.1080/13803395.2024.2372876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE Prior research on the Noise Pareidolia Test (NPT) has demonstrated its clinical utility in detecting patients with mild cognitive impairment and dementia due to Lewy Body Disease (LBD). However, few studies to date have investigated the neuropsychological factors underlying pareidolia errors on the NPT across the clinical spectrum of LBD. Furthermore, to our knowledge, no research has examined the relationship between cortical thickness using MRI data and NPT subscores. As such, this study sought to explore the neuropsychological and neuroanatomical factors influencing performance on the NPT utilizing the National Alzheimer's Coordinating Center Lewy Body Dementia Module. METHODS Our sample included participants with normal cognition (NC; n = 56), LBD with mild cognitive impairment (LBD-MCI; n = 97), and LBD with dementia (LBD-Dementia; n = 94). Archival data from NACC were retrospectively analyzed for group differences in neuropsychological test scores and cognitive and psychiatric predictors of NPT scores. Clinicoradiological correlates between NPT subscores and a small subsample of the above LBD participants were also examined. RESULTS Analyses revealed significant differences in NPT scores among groups. Regression analysis demonstrated that dementia severity, attention, and visuospatial processing contributed approximately 24% of NPT performance in LBD groups. Clinicoradiological analysis suggests a potential contribution of the right fusiform gyrus, but not the inferior occipital gyrus, to NPT pareidolia error scores. CONCLUSIONS Our findings highlight the interplay of attention and visuoperceptual functions in complex pareidolia in LBD. Further investigation is needed to refine the utility of NPT scores in clinical settings, including identifying patients at risk for visual illusions and hallucinations.
Collapse
Affiliation(s)
- Ahmad Alsemari
- Department of Neurology, Cleveland Clinic, Cleveland, Ohio OH, USA
| | - Joseph J Boscarino
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida FL, USA
| |
Collapse
|
3
|
Collerton D, Tsuda I, Nara S. Episodic Visual Hallucinations, Inference and Free Energy. ENTROPY (BASEL, SWITZERLAND) 2024; 26:557. [PMID: 39056919 PMCID: PMC11275595 DOI: 10.3390/e26070557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/21/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
Understandings of how visual hallucinations appear have been highly influenced by generative approaches, in particular Friston's Active Inference conceptualization. Their core proposition is that these phenomena occur when hallucinatory expectations outweigh actual sensory data. This imbalance occurs as the brain seeks to minimize informational free energy, a measure of the distance between predicted and actual sensory data in a stationary open system. We review this approach in the light of old and new information on the role of environmental factors in episodic hallucinations. In particular, we highlight the possible relationship of specific visual triggers to the onset and offset of some episodes. We use an analogy from phase transitions in physics to explore factors which might account for intermittent shifts between veridical and hallucinatory vision. In these triggered forms of hallucinations, we suggest that there is a transient disturbance in the normal one-to-one correspondence between a real object and the counterpart perception such that this correspondence becomes between the real object and a hallucination. Generative models propose that a lack of information transfer from the environment to the brain is one of the key features of hallucinations. In contrast, we submit that specific information transfer is required at onset and offset in these cases. We propose that this transient one-to-one correspondence between environment and hallucination is mediated more by aberrant discriminative than by generative inference. Discriminative inference can be conceptualized as a process for maximizing shared information between the environment and perception within a self-organizing nonstationary system. We suggest that generative inference plays the greater role in established hallucinations and in the persistence of individual hallucinatory episodes. We further explore whether thermodynamic free energy may be an additional factor in why hallucinations are temporary. Future empirical research could productively concentrate on three areas. Firstly, subjective perceptual changes and parallel variations in brain function during specific transitions between veridical and hallucinatory vision to inform models of how episodes occur. Secondly, systematic investigation of the links between environment and hallucination episodes to probe the role of information transfer in triggering transitions between veridical and hallucinatory vision. Finally, changes in hallucinatory episodes over time to elucidate the role of learning on phenomenology. These empirical data will allow the potential roles of different forms of inference in the stages of hallucinatory episodes to be elucidated.
Collapse
Affiliation(s)
- Daniel Collerton
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Ichiro Tsuda
- AIT Center, Sapporo City University, Sapporo 005-0864, Japan;
| | - Shigetoshi Nara
- Graduate School of Environmental, Life, Natural Science and Technology, Electrical and Electronic Engineering Department, Okayama University, Okayama 700-8530, Japan;
| |
Collapse
|
4
|
Ishimaru D, Kanemoto H, Hotta M, Nagata Y, Koizumi F, Satake Y, Taomoto D, Ikeda M. Case report: Environmental adjustment for visual hallucinations in dementia with Lewy bodies based on photo assessment of the living environment. Front Psychiatry 2024; 15:1283156. [PMID: 38559397 PMCID: PMC10978580 DOI: 10.3389/fpsyt.2024.1283156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background Visual hallucinations (VH) are associated with visual prediction error in patients with dementia with Lewy bodies (DLB). Given this relationship, environmental adjustments have been suggested, but detailed contents for implementing such environmental adjustments and assessments are poorly documented. This case report preliminarily demonstrates methods for improving VH through our experience with two patients with DLB. We conducted familial interviews to assess the phenomenological features of VH and reviewed photographs of patients' homes to identify the environmental triggers of VH, known as photo assessment of the living environment (PA-LE). Case description Patient 1 was a 78-year-old woman with a Mini-Mental State Examination (MMSE) score of 11/30. She experienced seeing a stranger, children, and cats at home, which frightened her. VH frequently occurred in the living room and bedroom. The PA-LE showed that several environmental features, such as cushions on a sofa, the pattern on a carpet under a table, and clothing on hangers, were suggestive triggers of VH. Patient 2 was an 88-year-old woman with a MMSE score of 5/30. She had seen strangers, children, and animals at home, some of which were linked to a theft delusion. VH frequently occurred in the living room and bedroom. The PA-LE found that several environmental features, such as clothing on hangers and dolls, were suggestive of VH triggers. Non-pharmacological approaches were tailored to the patients' environmental and psychological states using interviews and PA-LE. This included removing environmental triggers, reducing negative mood, and providing coping strategies for VH. This improved their VH and their caregivers' knowledge of VH. Conclusion Phenomenological assessments using photographs of the patient's home could identify the environmental triggers associated with VH in patients with DLB and assist in environmental adjustments.
Collapse
Affiliation(s)
- Daiki Ishimaru
- Department of Medical Technology, Osaka University Hospital, Suita, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hideki Kanemoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Maki Hotta
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuma Nagata
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Fuyuki Koizumi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuto Satake
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daiki Taomoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| |
Collapse
|
5
|
Nakata T, Shimada K, Iba A, Oda H, Terashima A, Koide Y, Kawasaki R, Yamada T, Ishii K. Differential diagnosis of MCI with Lewy bodies and MCI due to Alzheimer's disease by visual assessment of occipital hypoperfusion on SPECT images. Jpn J Radiol 2024; 42:308-318. [PMID: 37861956 DOI: 10.1007/s11604-023-01501-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Predicting progression of mild cognitive impairment (MCI) to Alzheimer's disease (AD) or dementia with Lewy bodies (DLB) is important. We evaluated morphological and functional differences between MCI with Lewy bodies (MCI-LB) and MCI due to AD (MCI-AD), and a method for differentiating between these conditions using brain MRI and brain perfusion SPECT. METHODS A continuous series of 101 subjects, who had visited our memory clinic and met the definition of MCI, were enrolled retrospectively. They were consisted of 60 MCI-LB and 41 MCI-AD subjects. Relative cerebral blood flow (rCBF) on SPECT images and relative brain atrophy on MRI images were evaluated. We performed voxel-based analysis and visually inspected brain perfusion SPECT images for regional brain atrophy, occipital hypoperfusion and the cingulate island sign (CIS), for differential diagnosis of MCI-LB and MCI-AD. RESULTS MRI showed no significant differences in regional atrophy between the MCI-LB and MCI-AD groups. In MCI-LB subjects, occipital rCBF was significantly decreased compared with MCI-AD subjects (p < 0.01, family wise error [FWE]-corrected). Visual inspection of occipital hypoperfusion had sensitivity, specificity, and accuracy values of 100%, 73.2% and 89.1%, respectively, for differentiating MCI-LB and MCI-AD. Occipital hypoperfusion was offered higher diagnostic utility than the CIS. CONCLUSIONS The occipital lobe was the region with significantly decreased rCBF in MCI-LB compared with MCI-AD subjects. Occipital hypoperfusion on brain perfusion SPECT may be a more useful imaging biomarker than the CIS for visually differentiating MCI-LB and MCI-AD.
Collapse
Affiliation(s)
- Takashi Nakata
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan.
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, Japan.
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan.
| | - Kenichi Shimada
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
| | - Akiko Iba
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
- Department of Psychiatry, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Hyogo Mental Health Center, 3 Noborio, Kamitanigami, Yamadacho, Kita-Ku, Kobe, Hyogo, Japan
| | - Haruhiko Oda
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
- Hyogo Mental Health Center, 3 Noborio, Kamitanigami, Yamadacho, Kita-Ku, Kobe, Hyogo, Japan
| | - Akira Terashima
- Neurocognitive Disorders Medical Center, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, 670-8560, Japan
- Department of Aging Brain and Cognitive Disorders, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himji, Hyogo, Japan
| | - Yutaka Koide
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, Japan
| | - Ryota Kawasaki
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, Japan
| | - Takahiro Yamada
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, Japan
| | - Kazunari Ishii
- Department of Radiology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, Japan
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, 3-264 Kamiyacho, Himeji, Hyogo, Japan
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, 520 Saisho-Ko, Himeji, Hyogo, Japan
| |
Collapse
|
6
|
Matsumoto T, Koh J, Sakata M, Nakayama Y, Yorozu S, Taruya J, Takahashi M, Miyamoto K, Ito H. Noise Pareidolia Test in Parkinson's Disease and Atypical Parkinsonian Syndromes: A Retrospective Study. Cureus 2024; 16:e55436. [PMID: 38567204 PMCID: PMC10986643 DOI: 10.7759/cureus.55436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Pareidolias, or visual misperceptions, are a non-motor symptom of Parkinson's disease (PD) with unclear pathophysiology. The noise pareidolia test (NPT) is a tool for screening pareidolias. The usefulness of the NPT in differentiating PD from atypical parkinsonian syndromes (APS) is also unknown. METHODS We retrospectively investigated 74 patients with PD and 18 patients with APS who took the NPT. Correlations between the number of pareidolic responses, gray matter volume, and cerebral blood flow were also examined in the patients with PD. RESULTS The median number of pareidolic responses in patients with PD and patients with APS was 0 (interquartile range (IQR): 0-3) and 0 (IQR: 0-1), respectively, and tended to be higher in patients with PD than in those with APS (p = 0.077). It was significantly higher in patients with PD who had hallucinations (2; IQR: 0-9) (p = 0.016). The area under the receiver operating characteristic curve for the number of pareidolic responses in the NPT was 0.62 when used to differentiate PD and APS, and the optimal cutoff number of pareidolic responses was 2/3. Sensitivity and specificity were 25.7% and 100%, respectively. In the PD group, the number of pareidolic responses was correlated with age (r = 0.27; p = 0.021) and the Frontal Assessment Battery (FAB) score (r = -0.34; p = 0.0099). Magnetic resonance imaging showed no significant correlation between the number of pareidolic responses and the volume of focal gray matter. On cerebral hypoperfusion mapping, the left parietal lobe had a significant correlation with the number of pareidolic responses (r = 0.35; p = 0.027). CONCLUSION The number of pareidolic responses in NPT was suggested to be useful as a red flag to rule out APS in differentiating PD from APS. In PD without dementia, the number of pareidolic responses was associated with reduced blood flow in the left parietal lobe.
Collapse
Affiliation(s)
- Takuya Matsumoto
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Jinsoo Koh
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Mayumi Sakata
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | | | - Shoko Yorozu
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Junko Taruya
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Maiko Takahashi
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | | | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| |
Collapse
|
7
|
Kim S, Choi JH, Woo KA, Joo JY, Jeon B, Lee JY. Clinical correlates of pareidolias and color discrimination deficits in idiopathic REM sleep behavior disorder and Parkinson's disease. J Neural Transm (Vienna) 2024; 131:141-148. [PMID: 38110521 DOI: 10.1007/s00702-023-02724-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
Visuoperceptual dysfunction is common in Parkinson's disease (PD) and is also reported in its prodromal phase, isolated REM sleep behavior disorder (iRBD). We aimed to investigate color discrimination ability and complex visual illusions known as pareidolias in patients with iRBD and PD compared to healthy controls, and their associating clinical factors. 46 iRBD, 43 PD, and 64 healthy controls performed the Farnsworth-Munsell 100 hue test and noise pareidolia tests. Any relationship between those two visual functions and associations with prodromal motor and non-motor manifestations were evaluated, including MDS-UPDRS part I to III, Cross-Cultural Smell Identification Test, sleep questionnaires, and comprehensive neuropsychological assessment. iRBD and PD patients both performed worse on the Farnsworth-Munsell 100 hue test and had greater number of pareidolias compared to healthy controls. No correlations were found between the extent of impaired color discrimination and pareidolia scores in either group. In iRBD patients, pareidolias were associated with frontal executive dysfunction, while impaired color discrimination was associated with visuospatial dysfunction, hyposmia, and higher MDS-UPDRS-III scores. Pareidolias in PD patients correlated with worse global cognition, whereas color discrimination deficits were associated with frontal executive dysfunction. Color discrimination deficits and pareidolias are frequent but does not correlate with each other from prodromal to clinically established stage of PD. The different pattern of clinical associates with the two visual symptoms suggests that evaluation of both color and pareidolias may aid in revealing the course of neurodegeneration in iRBD and PD patients.
Collapse
Affiliation(s)
- Seoyeon Kim
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji-Hyun Choi
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung Ah Woo
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Young Joo
- Department of Neurology, Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
8
|
Firbank MJ, Collerton D, Morgan KD, Schumacher J, Donaghy PC, O'Brien JT, Thomas A, Taylor J. Functional connectivity in Lewy body disease with visual hallucinations. Eur J Neurol 2024; 31:e16115. [PMID: 37909801 PMCID: PMC11235993 DOI: 10.1111/ene.16115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND AND PURPOSE Visual hallucinations are a common, potentially distressing experience of people with Lewy body disease (LBD). The underlying brain changes giving rise to visual hallucinations are not fully understood, although previous models have posited that alterations in the connectivity between brain regions involved in attention and visual processing are critical. METHODS Data from 41 people with LBD and visual hallucinations, 48 with LBD without visual hallucinations and 60 similarly aged healthy comparator participants were used. Connections were investigated between regions in the visual cortex and ventral attention, dorsal attention and default mode networks. RESULTS Participants with visual hallucinations had worse cognition and motor function than those without visual hallucinations. In those with visual hallucinations, reduced functional connectivity within the ventral attention network and from the visual to default mode network was found. Connectivity strength between the visual and default mode network correlated with the number of correct responses on a pareidolia task, and connectivity within the ventral attention network with visuospatial performance. CONCLUSIONS Our results add to evidence of dysfunctional connectivity in the visual and attentional networks in those with LBD and visual hallucinations.
Collapse
Affiliation(s)
- Michael J. Firbank
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Daniel Collerton
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | | | - Julia Schumacher
- Deutsches Zentrum für Neurodegenerative Erkrankungen Standort Rostock/GreifswaldRostockMecklenburg‐VorpommernGermany
- Department of NeurologyUniversity Medical Center RostockRostockGermany
| | - Paul C. Donaghy
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - John T. O'Brien
- Department of Psychiatry, School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Alan Thomas
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - John‐Paul Taylor
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| |
Collapse
|
9
|
McCann E, Lee S, Coleman F, O’Sullivan JD, Nestor PJ. Pareidolias are a function of visuoperceptual impairment. PLoS One 2023; 18:e0293942. [PMID: 37930972 PMCID: PMC10627440 DOI: 10.1371/journal.pone.0293942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023] Open
Abstract
Pareidolias, or the misperception of ambiguous stimuli as meaningful objects, are complex visual illusions thought to be phenomenologically similar to Visual Hallucination (VH). VH are a major predictor of dementia in Parkinson's Disease (PD) and are included as a core clinical feature in Dementia with Lewy Bodies (DLB). A newly developed Noise Pareidolia Test (NPT) was proposed as a possible surrogate marker for VH in DLB patients as increased pareidolic responses correlated with informant-corroborated accounts of VH. This association could, however, be mediated by visuoperceptual impairment. To understand the drivers of performance on the NPT, we contrasted performances in patient groups that varied both in terms of visuoperceptual ability and rates of VH. N = 43 patients were studied of whom n = 13 had DLB or PD with Dementia (PDD); n = 13 had PD; n = 12 had typical, memory-onset Alzheimer's Disease (tAD); and n = 5 had Posterior Cortical Atrophy (PCA) due to Alzheimer's disease. All patient groups reported pareidolias. Within the Lewy body disorders (PD, DLB, PDD), there was no significant difference in pareidolic response rates between hallucinating and non-hallucinating patients. Visuoperceptual deficits and pareidolic responses were most frequent in the PCA group-none of whom reported VH. Regression analyses in the entire patient cohort indicated that pareidolias were strongly predicted by visuoperceptual impairment but not by the presence of VH. These findings suggest that pareidolias reflect the underlying visuoperceptual impairment of Lewy body disorders, rather than being a direct marker for VH.
Collapse
Affiliation(s)
- Emily McCann
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
| | - Soohyun Lee
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
| | - Felicia Coleman
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
| | - John D. O’Sullivan
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- Department of Neurology, Royal Brisbane & Women’s Hospital, Herston, Queensland, Australia
| | - Peter J. Nestor
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- Mater Neurosciences Centre, Mater Hospital, South Brisbane, Queensland, Australia
| |
Collapse
|
10
|
Yoshida T, Mori T, Shimizu H, Tachibana A, Yoshino Y, Ochi S, Yamazaki K, Ozaki Y, Kawabe K, Horiuchi F, Komori K, Iga JI, Ueno SI. Analysis of factors related to cognitive impairment in a community-based, complete enumeration survey in Japan: the Nakayama study. Psychogeriatrics 2023; 23:876-884. [PMID: 37483119 DOI: 10.1111/psyg.13012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The number of patients with cognitive disorders is rapidly increasing in the world, becoming not only a medical problem, but also a social problem. There have been many reports that various factors are associated with cognitive dysfunction, but the factors have not yet been fully identified. This was a community-based complete enumeration study which aimed to identify risk and protective factors for dementia. METHODS The first phase included all residents aged 65 years or older in a town in Japan. They completed many examinations, such as living conditions questionnaires, physical examination, Mini-Mental State Examination, and brain magnetic resonance imaging. The participants with suspected cognitive impairment underwent additional examinations for detailed evaluation in the second phase. Statistical analysis was performed to identify risk and protective factors for dementia after all participants were diagnosed. RESULTS There were 927 participants in the baseline evaluation; 611 (65.9%) were healthy, 165 (17.8%) had mild cognitive impairment (MCI), and 151 (16.3%) had dementia. The age-standardised prevalence of dementia was 9.5%. Statistical analyses for amnestic MCI and Alzheimer's disease showed that risk factors for cognitive decline were diabetes mellitus, low activities of daily living, and living alone, and that protective factors were history of exercise and drinking habit. CONCLUSION The present findings suggest that several lifestyle-related diseases and factors are associated with cognitive decline. These results support similar findings from previous studies and will be helpful for preventing dementia in the future.
Collapse
Affiliation(s)
- Taku Yoshida
- Department of Psychiatry, Zaidan Niihama Hospital, Niihama, Japan
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takaaki Mori
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Psychiatry, Heisei Hospital, Ozu, Japan
| | - Hideaki Shimizu
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Psychiatry, Heisei Hospital, Ozu, Japan
| | - Ayumi Tachibana
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Psychiatry, Matsukaze Hospital, Shikokuchuou, Japan
| | - Yuta Yoshino
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shinichiro Ochi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kiyohiro Yamazaki
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yuki Ozaki
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kentaro Kawabe
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Fumie Horiuchi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kenjiro Komori
- Department of Psychiatry, Zaidan Niihama Hospital, Niihama, Japan
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Office of Psychology, Department of Psychiatry, Juzen-Yurinoki Hospital, Niihama, Japan
| | - Jun-Ichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shu-Ichi Ueno
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| |
Collapse
|
11
|
Watanabe H, Uchiyama M, Yokoi K, Mamiya Y, Narita W, Iizuka O, Baba T, Suzuki K, Mori E, Nishio Y. Behavioral and neural correlates of pareidolic illusions in dementia with Lewy bodies. Parkinsonism Relat Disord 2023; 113:105513. [PMID: 37441885 DOI: 10.1016/j.parkreldis.2023.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/25/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023]
Abstract
INTRODUCTION Pareidolia, a form of visual illusions phenomenologically similar to complex visual hallucinations, is a phenomenon that is associated with visual hallucinations in dementia with Lewy bodies (DLB). This study aimed to identify commonalities and differences in behavioral and neural correlates between pareidolic illusions and visual hallucinations in DLB. METHODS Forty-three patients with DLB underwent the scene pareidolia test, which evokes and measures pareidolic illusions, and standardized neuropsychological and behavioral assessments. Regional cerebral blood flow (rCBF) was measured by single-photon emission computed tomography. Factor analysis was performed to assess the relationships among pareidolic illusions, cognitive functions, and behavioral symptoms. Partial least squares correlation analysis was used to investigate the relationship between these symptoms and rCBF. RESULTS Factor analysis yielded three behavior factors: the first factor (hallucinations/fluctuations) consisted of pareidolic illusions, visual hallucinations, and fluctuating cognition; the second factor (general cognitive function) consisted of general cognitive function and working memory; and the third factor (visual processing) consisted of visual processing and pareidolic illusions. Partial least squares correlation analysis identified two brain-behavior correlation patterns: (1) rCBF reduction in the frontal and perisylvian/periventricular regions was associated with lower general cognitive function and lower visual processing; and (2) rCBF reduction in the bilateral occipitotemporal cortex was associated with more severe hallucinations/fluctuations and lower visual processing. CONCLUSIONS At the behavioral level, pareidolic illusions are associated with visual hallucinations, fluctuating cognition, and visual processing in DLB. At the neural level, pareidolic illusions may arise from the synergistic effects of global neuropathological changes and occipitotemporal cortical dysfunctions.
Collapse
Affiliation(s)
- Hiroyuki Watanabe
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Makoto Uchiyama
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Speech, Language and Hearing Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kayoko Yokoi
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuyuki Mamiya
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Occupational Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Wataru Narita
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Osamu Iizuka
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toru Baba
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neurology, National Hospital Organization Sendai-Nishitaga Hospital, Sendai, Japan
| | - Kyoko Suzuki
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan
| | - Yoshiyuki Nishio
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan; Department of Psychiatry and Neurology, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.
| |
Collapse
|
12
|
Watanabe H, Hikida S, Ikeda M, Mori E. Aphasic mild cognitive impairment in prodromal dementia with Lewy bodies. Front Neurol 2023; 14:1128566. [PMID: 37077573 PMCID: PMC10106638 DOI: 10.3389/fneur.2023.1128566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/22/2023] [Indexed: 04/05/2023] Open
Abstract
IntroductionThis study aimed to determine the characteristics of aphasic mild cognitive impairment (aphasic MCI), which is characterized by a progressive and relatively prominent language impairment compared with other cognitive impairments, in the prodromal phase of dementia with Lewy bodies (DLB).MethodsOf the 26 consecutive patients with aphasic MCI who had been prospectively recruited at our hospital, 8 patients were diagnosed with prodromal DLB and underwent language, neurological, neuropsychological, and neuroimaging (N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography; IMP-SPECT) testing. Three of these patients also underwent cholinesterase inhibitor therapy with donepezil.ResultsIn our aphasic MCI cohort, the clinical diagnosis of probable prodromal DLB accounted for more than 30% of cases; therefore, the presence of language impairment in prodromal DLB was not very uncommon. Five patients were diagnosed with progressive anomic aphasia and three with logopenic progressive aphasia. Anomic aphasia was characterized by apparent anomia but relatively preserved repetition and comprehension ability and logopenic progressive aphasia by anomia, phonemic paraphasia, and impaired repetition. IMP-SPECT revealed hypoperfusion of the temporal and parietal lobes in the left hemisphere in all but one patient. All patients who underwent cholinesterase inhibitor therapy with donepezil showed improvement in general cognitive function, including language function.DiscussionThe clinical and imaging features of aphasic MCI in prodromal DLB are similar to those observed in Alzheimer's disease. Progressive fluent aphasia, such as progressive anomic aphasia and logopenic progressive aphasia, is one of the clinical presentations in prodromal state of DLB. Our findings provide further insight into the clinical spectrum of prodromal DLB and may contribute to the development of medication for progressive aphasia caused by cholinergic insufficiency.
Collapse
Affiliation(s)
- Hiroyuki Watanabe
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Brain Function Center, Nippon Life Hospital, Osaka, Japan
- *Correspondence: Hiroyuki Watanabe
| | - Sakura Hikida
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Brain Function Center, Nippon Life Hospital, Osaka, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Brain Function Center, Nippon Life Hospital, Osaka, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan
- Brain Function Center, Nippon Life Hospital, Osaka, Japan
| |
Collapse
|
13
|
Shahid M, Rawls A, Ramirez V, Ryman S, Santini VE, Yang L, Sha SJ, Hall JN, Montine TJ, Lin A, Tian L, Henderson VW, Cholerton B, Yutsis M, Poston KL. Illusory Responses across the Lewy Body Disease Spectrum. Ann Neurol 2023; 93:702-714. [PMID: 36511519 PMCID: PMC10231422 DOI: 10.1002/ana.26574] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/22/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study was undertaken to study pareidolias, or perceived meaningful objects in a meaningless stimulus, in patients across the Lewy body (LB) disease spectrum, where most do not report hallucinations or delusions. METHODS We studied illusory responses on the Noise Pareidolia Task in 300 participants (38 cognitively impaired LB, 65 cognitively unimpaired LB, 51 Alzheimer disease spectrum [AD-s], 146 controls). Pairwise between-group comparisons examined how diagnosis impacts the number of illusory responses. Ordinal regression analysis compared the number of illusory responses across diagnosis groups, adjusting for age, sex, and education. Analyses were repeated after removing participants with reported hallucinations or delusions. RESULTS Cognitively impaired LB participants were 12.3, 4.9, and 4.6 times more likely than control, cognitively unimpaired LB, and AD-s participants, respectively, to endorse illusory responses. After adjusting for age, sex, and education, the probability of endorsing 1 or more illusory responses was 61% in the cognitively impaired LB group, compared to 26% in AD-s, 25% in cognitively unimpaired LB, and 12% in control participants. All results were similar after repeated analysis only in participants without hallucinations or delusions. In LB without hallucinations or delusions, 52% with mild cognitive impairment and 66.7% with dementia endorsed at least 1 illusory response. INTERPRETATION We found illusory responses are common in cognitively impaired LB patients, including those without any reported psychosis. Our data suggest that, prior to the onset of hallucinations and delusions, the Noise Pareidolia Task can easily be used to screen for unobtrusive pareidolias in all LB patients. ANN NEUROL 2023;93:702-714.
Collapse
Affiliation(s)
- Marian Shahid
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Ashley Rawls
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Veronica Ramirez
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sephira Ryman
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Translational Neuroscience, Mind Research Network, Albuquerque, NM, USA
| | - Veronica E Santini
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Laurice Yang
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sharon J Sha
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jacob N Hall
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Neurology Center of Southern California, Temecula, CA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Amy Lin
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Victor W Henderson
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Brenna Cholerton
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Maya Yutsis
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathleen L Poston
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
14
|
Palmisano A, Chiarantoni G, Bossi F, Conti A, D'Elia V, Tagliente S, Nitsche MA, Rivolta D. Face pareidolia is enhanced by 40 Hz transcranial alternating current stimulation (tACS) of the face perception network. Sci Rep 2023; 13:2035. [PMID: 36739325 PMCID: PMC9899232 DOI: 10.1038/s41598-023-29124-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Pareidolia refers to the perception of ambiguous sensory patterns as carrying a specific meaning. In its most common form, pareidolia involves human-like facial features, where random objects or patterns are illusionary recognized as faces. The current study investigated the neurophysiological correlates of face pareidolia via transcranial alternating current stimulation (tACS). tACS was delivered at gamma (40 Hz) frequency over critical nodes of the "face perception" network (i.e., right lateral occipito-temporal and left prefrontal cortex) of 75 healthy participants while completing four face perception tasks ('Mooney test' for faces, 'Toast test', 'Noise pareidolia test', 'Pareidolia task') and an object perception task ('Mooney test' for objects). In this single-blind, sham-controlled between-subjects study, participants received 35 min of either Sham, Online, (40Hz-tACS_ON), or Offline (40Hz-tACS_PRE) stimulation. Results showed that face pareidolia was causally enhanced by 40Hz-tACS_PRE in the Mooney test for faces in which, as compared to sham, participants more often misperceived scrambled stimuli as faces. In addition, as compared to sham, participants receiving 40Hz-tACS_PRE showed similar reaction times (RTs) when perceiving illusory faces and correctly recognizing noise stimuli in the Toast test, thus not exhibiting hesitancy in identifying faces where there were none. Also, 40Hz-tACS_ON induced slower rejections of face pareidolia responses in the Noise pareidolia test. The current study indicates that 40 Hz tACS can enhance pareidolic illusions in healthy individuals and, thus, that high frequency (i.e., gamma band) oscillations are critical in forming coherent and meaningful visual perception.
Collapse
Affiliation(s)
- Annalisa Palmisano
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy.
| | - Giulio Chiarantoni
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy
| | | | - Alessio Conti
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Vitiana D'Elia
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Serena Tagliente
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors (IfADo), Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Davide Rivolta
- Department of Education, Psychology, and Communication, University of Bari Aldo Moro, Bari, Italy.,School of Psychology, University of East London (UEL), London, UK
| |
Collapse
|
15
|
Lhotka M, Ischebeck A, Helmlinger B, Zaretskaya N. No common factor for illusory percepts, but a link between pareidolia and delusion tendency: A test of predictive coding theory. Front Psychol 2023; 13:1067985. [PMID: 36798645 PMCID: PMC9928206 DOI: 10.3389/fpsyg.2022.1067985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
Predictive coding theory is an influential view of perception and cognition. It proposes that subjective experience of the sensory information results from a comparison between the sensory input and the top-down prediction about this input, the latter being critical for shaping the final perceptual outcome. The theory is able to explain a wide range of phenomena extending from sensory experiences such as visual illusions to complex pathological states such as hallucinations and psychosis. In the current study we aimed at testing the proposed connection between different phenomena explained by the predictive coding theory by measuring the manifestation of top-down predictions at progressing levels of complexity, starting from bistable visual illusions (alternating subjective experience of the same sensory input) and pareidolias (alternative meaningful interpretation of the sensory input) to self-reports of hallucinations and delusional ideations in everyday life. Examining the correlation structure of these measures in 82 adult healthy subjects revealed a positive association between pareidolia proneness and a tendency for delusional ideations, yet without any relationship to bistable illusions. These results show that only a subset of the phenomena that are explained by the predictive coding theory can be attributed to one common underlying factor. Our findings thus support the hierarchical view of predictive processing with independent top-down effects at the sensory and cognitive levels.
Collapse
Affiliation(s)
- Magdalena Lhotka
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria
| | - Anja Ischebeck
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria,BioTechMed-Graz, Graz, Austria
| | - Birgit Helmlinger
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria,BioTechMed-Graz, Graz, Austria
| | - Natalia Zaretskaya
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria,BioTechMed-Graz, Graz, Austria,*Correspondence: Natalia Zaretskaya, ✉
| |
Collapse
|
16
|
Tolea MI, Camacho S, Cohen IR, Galvin JE. Mindfulness and Care Experience in Family Caregivers of Persons Living with Dementia. J Alzheimers Dis Rep 2023; 7:151-164. [PMID: 36891256 PMCID: PMC9986707 DOI: 10.3233/adr-220069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
Background Greater mindfulness, the practice of awareness and living in the moment without judgement, has been linked to positive caregiving outcomes in dementia caregivers and its impact attributed to greater decentering and emotion regulation abilities. Whether the impact of these mindfulness-based processes varies across caregiver subgroups is unclear. Objective Analyze cross-sectional associations between mindfulness and caregiver psychosocial outcomes, considering different caregiver and patient characteristics. Methods A total of 128 family caregivers of persons living with Alzheimer's disease and related disorders were assessed on several mindfulness measures (i.e., global; decentering, positive emotion regulation, negative emotion regulation) and provided self-reported appraisals of caregiving experience; care preparedness; confidence, burden, and depression/anxiety. Bivariate relationships between mindfulness and caregiver outcomes were assessed with Pearson's correlations and stratified by caregiver (women versus men; spouse versus adult child) and patient (mild cognitive impairment (MCI) versus Dementia; AD versus dementia with Lewy bodies; low versus high symptom severity) characteristics. Results Greater mindfulness was associated with positive outcomes and inversely associated with negative outcomes. Stratification identified specific patterns of associations across caregiver groups. Significant correlations were found between all mindfulness measures and caregiving outcomes in male and MCI caregivers while the individual mindfulness component of positive emotion regulation was significantly correlated to outcomes in most caregiver groups. Conclusion Our findings support a link between caregiver mindfulness and improved caregiving outcomes and suggest directions of inquiry into whether the effectiveness of dementia caregiver-support interventions may be improved by targeting specific mindfulness processes or offering a more inclusive all-scope approach depending on individual caregiver or patient characteristics.
Collapse
Affiliation(s)
- Magdalena I Tolea
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Simone Camacho
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Iris R Cohen
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| |
Collapse
|
17
|
Romagnano V, Sokolov AN, Steinwand P, Fallgatter AJ, Pavlova MA. Face pareidolia in male schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:112. [PMID: 36517504 PMCID: PMC9751144 DOI: 10.1038/s41537-022-00315-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/09/2022] [Indexed: 05/22/2023]
Abstract
Faces are valuable signals for efficient social interaction. Yet, social cognition including the sensitivity to a coarse face scheme may be deviant in schizophrenia (SZ). Tuning to faces in non-face images such as shadows, grilled toasts, or ink blots is termed face pareidolia. This phenomenon is poorly investigated in SZ. Here face tuning was assessed in 44 male participants with SZ and person-by-person matched controls by using recently created Face-n-Thing images (photographs of non-face objects to a varying degree resembling a face). The advantage of these images is that single components do not automatically trigger face processing. Participants were administered a set of images with upright and inverted (180° in the image plane) orientation. In a two-alternative forced-choice paradigm, they had to indicate whether an image resembled a face. The findings showed that: (i) With upright orientation, SZ patients exhibited deficits in face tuning: they provided much fewer face responses than controls. (ii) Inversion generally hindered face pareidolia. However, while in neurotypical males, inversion led to a drastic drop in face impression, in SZ, the impact of orientation was reduced. (iii) Finally, in accord with the signal detection theory analysis, the sensitivity index (d-prime) was lower in SZ, whereas no difference occurred in decision criterion. The outcome suggests altered face pareidolia in SZ is caused by lower face sensitivity rather than by alterations in cognitive bias. Comparison of these findings with earlier evidence confirms that tuning to social signals is lower in SZ, and warrants tailored brain imaging research.
Collapse
Affiliation(s)
- Valentina Romagnano
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Alexander N Sokolov
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Patrick Steinwand
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Marina A Pavlova
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany.
| |
Collapse
|
18
|
Pepin AB, Harel Y, O'Byrne J, Mageau G, Dietrich A, Jerbi K. Processing visual ambiguity in fractal patterns: Pareidolia as a sign of creativity. iScience 2022; 25:105103. [PMID: 36164655 PMCID: PMC9508550 DOI: 10.1016/j.isci.2022.105103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/18/2022] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
Creativity is a highly valued and beneficial skill that empirical research typically probes using “divergent thinking” (DT) tasks such as problem solving and novel idea generation. Here, in contrast, we examine the perceptual aspect of creativity by asking whether creative individuals are more likely to perceive recognizable forms in ambiguous stimuli –a phenomenon known as pareidolia. To this end, we designed a visual task in which participants were asked to identify as many recognizable forms as possible in cloud-like fractal images. We found that pareidolic perceptions arise more often and more rapidly in highly creative individuals. Furthermore, high-creatives report pareidolia across a broader range of image contrasts and fractal dimensions than do low creatives. These results extend the established body of work on DT by introducing divergent perception as a complementary manifestation of the creative mind, thus clarifying the perception-creation link while opening new paths for studying creative behavior in humans. Creativity has been linked to divergent thinking Creativity is associated with enhanced pareidolia (i.e., divergent perception) High-creatives report pareidolia across a broader range of image fractal dimensions Divergent perception constitutes a promising phenomenon for the study of creativity
Collapse
Affiliation(s)
- Antoine Bellemare Pepin
- Department of Psychology, Université de Montréal, Montréal, H2V 2S9 Québec, Canada.,Department of Music, Concordia University, Montréal, H4B1R6 Québec, Canada
| | - Yann Harel
- Department of Psychology, Université de Montréal, Montréal, H2V 2S9 Québec, Canada
| | - Jordan O'Byrne
- Department of Psychology, Université de Montréal, Montréal, H2V 2S9 Québec, Canada
| | - Geneviève Mageau
- Department of Psychology, Université de Montréal, Montréal, H2V 2S9 Québec, Canada
| | - Arne Dietrich
- Department of Psychology, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Karim Jerbi
- Department of Psychology, Université de Montréal, Montréal, H2V 2S9 Québec, Canada.,MILA (Quebec Artificial Intelligence Institute), Montreal, Quebec, Canada.,UNIQUE Center (Quebec Neuro-AI Research Center), Montreal, Quebec, Canada
| |
Collapse
|
19
|
Khera A, Stopschinski BE, Chiang HS. Evidence-Based Evaluation and Management of Cognitive Impairment in Dementia With Lewy Bodies. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220901-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
20
|
Murayama N, Ota K, Iseki E. The Bender Gestalt Test is useful for clinically diagnosing dementia with Lewy bodies: Analysis of its sensitivity, specificity, and clinical characteristics of the figure copy. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-6. [PMID: 36121098 DOI: 10.1080/23279095.2022.2122059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A previous study that evaluated the ability of the Bender Gestalt Test (BGT) to discriminate between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) suggested that a total score of 98 is the optimal cutoff value for discriminating between these two diseases and that DLB tends to exhibit unique errors; i.e., "element deformation" and "gestalt destruction." The objectives of the present study were: (1) to examine the sensitivity and specificity of a total BGT score of 98 as a cutoff value in greater numbers of DLB patients than in the previous study, (2) to set a new cutoff value if a cutoff value of 98 is not optimal, and (3) to clarify the frequency of element deformation and gestalt destruction in DLB patients. The participants were 133 DLB patients, 65 AD patients, and 30 cognitively normal elderly people. All of the participants underwent the Mini-Mental State Examination, BGT, and brain magnetic resonance imaging. As a result, the total BGT score cutoff value of 98 showed low sensitivity (0.58), and a cutoff value of 84 was indicated to be the optimal cutoff value for discriminating between DLB and AD. In addition, 32 out of 133 DLB patients and one out of 65 AD patients exhibited element deformation or gestalt destruction. This study suggested that the BGT is a useful neuropsychological test for differentiating DLB from AD. In addition, the need to evaluate the spatial and perceptual difficulties of DLB patients with various types of visual stimulation is also discussed.
Collapse
Affiliation(s)
- Norio Murayama
- Faculty of Humanities and Social Sciences, Showa Women's University, Tokyo, Japan
| | - Kazumi Ota
- Senior Mental Clinic Nihonbashi-Ningyocho, Tokyo, Japan
| | - Eizo Iseki
- Senior Mental Clinic Nihonbashi-Ningyocho, Tokyo, Japan
| |
Collapse
|
21
|
Hashimoto Y, Kano O, Ebihara S. Noise pareidolia test for predicting delirium in hospitalized older patients with cognitive decline. Geriatr Gerontol Int 2022; 22:883-888. [PMID: 36071029 DOI: 10.1111/ggi.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022]
Abstract
AIM Although older people are at an increased risk of developing delirium during hospitalization, no definitive screening tools exist to predict the condition. This study aimed to examine the effectiveness of the noise pareidolia test (NPT) as a tool for predicting the onset of post-hospitalization delirium in older adults. METHODS Hospitalized patients who were cared for by a multidisciplinary geriatric care team owing to behavioral symptoms, difficulties in communication, and a history of dementia or delirium were analyzed. The NPT was performed on patients who could complete a Mini-Mental State Examination within 3 days of admission. Demographic and clinical data were recorded on the same day as the NPT or within 3 days of admission. Delirium was assessed using the observation-based Delirium Screening Tool (DST). RESULTS Of 96 patients, 59 were in the DST-negative group and 37 in the DST-positive group. Benzodiazepine agonist use, serum potassium levels, and the number of images in which pareidolia was noted (i.e., the NPT score) significantly differed between groups. Logistic regression analysis identified benzodiazepine agonist use (odds ratio, 2.897; P = 0.032), serum potassium levels (odds ratio, 0.427; P = 0.041) and NPT scores (odds ratio, 1.253; P = 0.017) as significant predictors of DST results. The receiver operating characteristic curve analysis showed an NPT score of 1 as the appropriate cutoff value. CONCLUSIONS A positive NPT score was identified as an independent predictor of delirium in older patients admitted to an acute care hospital with cognitive dysfunction. Geriatr Gerontol Int 2022; ••: ••-••.
Collapse
Affiliation(s)
- Yutaka Hashimoto
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.,Department of Geriatric Nursing, Toho University Faculty of Nursing, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.,Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
22
|
Shimizu H, Mori T, Yoshida T, Tachibana A, Ozaki T, Yoshino Y, Ochi S, Sonobe N, Matsumoto T, Komori K, Iga JI, Ninomiya T, Ueno SI, Ikeda M. Secular trends in the prevalence of dementia based on a community-based complete enumeration in Japan: the Nakayama Study. Psychogeriatrics 2022; 22:631-641. [PMID: 35753054 PMCID: PMC9541546 DOI: 10.1111/psyg.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The number of dementia patients is increasing worldwide, especially in Japan, which has the world's highest ageing population. The increase in the number of older people with dementia is a medical and socioeconomic problem that needs to be prevented, but the actual situation is still not fully understood. METHODS Four cross-sectional studies on dementia were conducted in 1997, 2004, 2012, and 2016 for complete enumeration of all residents aged 65 years and older. We examined the secular trends in the prevalence of all-cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and other/unclassified dementia. RESULTS The age-standardised prevalence of all-cause dementia significantly increased (4.5% in 1997, 5.7% in 2004, 5.3% in 2012, 9.5% in 2016; P for trend <0.05). Similar trends were observed for AD (1.7%, 3.0%, 2.5% and 4.9%, respectively; P for trend <0.05) and other/unclassified dementia (0.8%, 1.0%, 1.0% and 2.2%, respectively; P for trend <0.05), whereas no significant change in VaD was seen (2.1%, 1.8%, 1.8%, 2.4%, respectively; P for trend = 0.77). The crude prevalence of all-cause dementia and AD increased from 1997 to 2016 among participants aged 75-79 years and ≥85 years (all P for trend <0.05). Similar trends were observed for other/unclassified dementia among participants aged ≥80 years (all P for trend <0.05), but not in VaD. CONCLUSIONS The prevalence of dementia has increased beyond the ageing of the population, suggesting that factors in addition to ageing are involved in the increase in the number of older people with dementia. To control the increase in the number of older people with dementia, elucidation of secular trends in the incidence, mortality, and prognosis of dementia as well as the factors that promote and protect against dementia, and development of preventive strategies are necessary.
Collapse
Affiliation(s)
| | - Takaaki Mori
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | - Taku Yoshida
- Department of Neuropsychiatry, Zaidan Niihama Hospital, Niihama, Japan
| | - Ayumi Tachibana
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | - Tomoki Ozaki
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yuta Yoshino
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shinichiro Ochi
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | | | | | - Kenjiro Komori
- Office of Psychology, Department of Psychiatry, Juzen-Yurinoki Hospital, Niihama, Japan
| | - Jun-Ichi Iga
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shu-Ichi Ueno
- Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Toon, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
23
|
Haroon M, Dissanayaka NN, Angwin AJ, Comans T. How Effective are Pictures in Eliciting Information from People Living with Dementia? A Systematic Review. Clin Gerontol 2022:1-14. [PMID: 35672952 DOI: 10.1080/07317115.2022.2085643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Decline in language and cognitive functioning often deprives people living with moderate-to-severe dementia of self-reporting their quality of life (QoL) on the written and verbal formats of questionnaires. This systematic review aimed to evaluate the effectiveness of pictorial tools as an alternative method for enabling people living with dementia to self-report their QoL. METHODS PubMed, PsycINFO, CINAHL, and EMBASE were searched. Primary research studies reporting on information elicitation from people living with dementia through pictures were deemed eligible. Six studies satisfied the inclusion criteria. Methodological quality of the studies was evaluated through Downs and Black checklist. Data was extracted according to population, intervention, comparator, and outcomes (PICO) and results were summarized and supplemented by narrative synthesis. RESULTS Compared to usual communication methods, pictorial tools were found to have a superior effect on comprehension of conversations and decision-making abilities, minimal effect on preference consistency, and an undeterminable effect on discourse features. CONCLUSIONS There is consistent evidence that pictures enhance comprehension and might facilitate decision-making abilities. CLINICAL IMPLICATIONS QoL information can be elicited more effectively through pictorial tools. Future studies warrant development of pictorial versions of standardized QoL tools which will assist the inclusion of people living with severe dementia.
Collapse
Affiliation(s)
- Muhammad Haroon
- Centre for Health Services Research, Faculty of Medicine, the University of Queensland, Brisbane, Australia
| | - Nadeeka N Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, the University of Queensland, Brisbane, Australia.,School of Psychology, the University of Queensland, Brisbane, Australia.,Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - Anthony J Angwin
- School of Health and Rehabilitation Sciences, the University of Queensland, Brisbane, Australia
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Medicine, the University of Queensland, Brisbane, Australia
| |
Collapse
|
24
|
Yoritaka A, Hayashi T, Fusegi K, Inami R, Hattori N. Prospective Five-Year Follow-Up of Patients with Schizophrenia Suspected with Parkinson's Disease. PARKINSON'S DISEASE 2022; 2022:2727515. [PMID: 35698464 PMCID: PMC9188471 DOI: 10.1155/2022/2727515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 05/04/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE It is difficult to distinguish patients with schizophrenia with neuroleptic-induced parkinsonism (NIP) from those with existing idiopathic Parkinson's disease when their striatal dopamine transporter uptake is reduced. There is a possibility of misdiagnosis of Parkinson's disease in patients with schizophrenia as schizophrenia with NIP, which leads to inappropriate treatment. This prospective study aimed at determining the underlying pathophysiology using detailed clinical and psychological assessments. METHODS We enrolled six patients with schizophrenia who had parkinsonism and were diagnosed with Parkinson's disease according to the Movement Disorder Society Clinical Diagnostic Criteria, except for the fifth absolute exclusion criteria. RESULTS Five patients had been treated with neuroleptics for 20 years. One patient refused treatment for schizophrenia. All patients had impaired cognitive function at enrolment, olfactory dysfunction, and constipation. All patients were treated with dopaminergic therapy, and their parkinsonism substantially improved; one woman in her 40s experienced a wearing-off effect and dyskinesia. The uptake of dopamine transporter in the striatum decreased by 13%/year during the study period. CONCLUSION Some patients with schizophrenia and parkinsonism benefit from dopaminergic therapy. Some of these patients may also exhibit Lewy pathology.
Collapse
Affiliation(s)
- Asako Yoritaka
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Tetsuo Hayashi
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiko Fusegi
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Rie Inami
- Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| |
Collapse
|
25
|
Wang C, Yu L, Mo Y, Wood LC, Goon C. Pareidolia in a Built Environment as a Complex Phenomenological Ambiguous Stimuli. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095163. [PMID: 35564558 PMCID: PMC9103170 DOI: 10.3390/ijerph19095163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/02/2022]
Abstract
Pareidolia is a kind of misperception caused by meaningless, ambiguous stimuli perceived with meaning. Pareidolia in a built environment may trigger the emotions of residents, and the most frequently observed pareidolian images are human faces. Through a pilot experiment and an in-depth questionnaire survey, this research aims to compare built environmental pareidolian phenomena at different time points (6 a.m., 12 p.m., 2 a.m.) and to determine people’s sensitivity and reactions towards pareidolia in the built environment. Our findings indicate that the differences in stress level do not influence the sensitivity and reactions towards pareidolia in the built environment; however, age does, and the age of 40 seems to be a watershed. Females are more likely to identify pareidolian faces than males. Smokers, topers, and long-term medicine users are more sensitive to pareidolian images in the built environment. An unexpected finding is that most pareidolian images in built environments are much more easily detected in the early morning and at midnight but remain much less able to be perceived at midday. The results help architects better understand people’s reactions to pareidolia in the built environment, thus allowing them to decide whether to incorporate it appropriately or avoid it consciously in building design.
Collapse
Affiliation(s)
- Chen Wang
- Intelligence and Automation in Construction Fujian Province Higher-Educational Engineering Research Centre, College of Civil Engineering, Huaqiao University, Xiamen 361021, China; (C.W.); (L.Y.)
| | - Liangcheng Yu
- Intelligence and Automation in Construction Fujian Province Higher-Educational Engineering Research Centre, College of Civil Engineering, Huaqiao University, Xiamen 361021, China; (C.W.); (L.Y.)
| | - Yiyi Mo
- College of Civil Engineering, Huaqiao University, Xiamen 361021, China;
- Correspondence:
| | - Lincoln C. Wood
- Department of Management, University of Otago, Dunedin 9054, New Zealand;
| | - Carry Goon
- College of Civil Engineering, Huaqiao University, Xiamen 361021, China;
| |
Collapse
|
26
|
The clinical approach to the identification of higher-order visual dysfunction in neurodegenerative disease. Curr Neurol Neurosci Rep 2022; 22:229-242. [PMID: 35320467 DOI: 10.1007/s11910-022-01186-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW This review is intended to assist the reader in gaining the knowledge and skills necessary for the recognition and assessment of higher-order visual dysfunction due to neurodegenerative diseases including Alzheimer's disease, dementia with Lewy bodies, Parkinson's dementia, corticobasal degeneration, Creutzfeldt-Jakob disease, and the posterior cortical atrophy syndrome. Clinical problem-solving and pattern recognition must be developed and practiced to accurately diagnosis disturbances of higher-order visual function, and knowledge of higher-order visual brain regions and their visual syndromes forms the foundation for deciphering symptoms presented by patients and/or their care partners. Tests of higher-order visual dysfunction must be assembled by the clinician and assessment can take time and effort. The use of screening tests, follow-up visits, and formal neuropsychological referrals are critical components for accurate diagnosis and these principles are reviewed here. RECENT FINDINGS A recent survey of neuro-ophthalmologists revealed that over half of the respondents report that 5-10% of their new patient referrals carry a diagnosis of neurodegenerative disease and many patients were referred for visual symptoms of unknown cause. Despite over a century of discovery related to higher-order visual functions of the human brain, translation of discovery to the clinical assessment of patients has been slow or absent. As with the approach to translational medicine in general, to see meaningful progress, an interdisciplinary approach is indispensable. The first step involves the application of discoveries from the field visual neuroscience by clinicians from the fields of ophthalmology, neurology, and neuropsychology, and from the disciplines of neuro-ophthalmology and behavioral neurology. The unmet need for recognition, assessment, and management of higher-order visual dysfunction in neurodegeneration is evident and clinicians can contribute to closing the gap by using the approach and the tools outlined in the review.
Collapse
|
27
|
Rahman‐Filipiak A, Sadaghiyani S, Davis K, Bhaumik AK, Paulson HL, Giordani B, Hampstead BM. Validation of the National Alzheimer's Coordinating Center (NACC) Lewy Body Disease Module neuropsychological tests. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12279. [PMID: 35155734 PMCID: PMC8828993 DOI: 10.1002/dad2.12279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study assessed the construct validity and clinical utility of the National Alzheimer's Coordinating Center Lewy Body Dementia (LBD) Module, consisting of the Speeded Attention and Noise Pareidolia Tasks. METHODS Participants included 459 older adults diagnosed as cognitively normal (n = 202), or with non-amnestic mild cognitive impairment (n = 61), amnestic mild cognitive impairment (n = 96), Alzheimer's disease dementia (n = 44), or LBD (n = 56). RESULTS Speeded Attention demonstrated strong convergent validity and moderate discriminant validity when compared to established neuropsychological tests. Noise Pareidolia demonstrated strong discriminant validity, but limited convergent validity. Noise Pareidolia scores were significantly lower in those with reported hallucinations, delusions, or REM sleep behavior disorder symptoms. LBD Module tests discriminated well between cognitively normal adults and those with LBD. DISCUSSION The LBD Module demonstrates promising construct validity and clinical utility, which support its use across research and clinical settings.
Collapse
Affiliation(s)
- Annalise Rahman‐Filipiak
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
| | - Shima Sadaghiyani
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Katrail Davis
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
| | | | - Henry L. Paulson
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
- Department of NeurologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Bruno Giordani
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
| | - Benjamin M. Hampstead
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
- Mental Health ServiceVA Ann Arbor Health Care SystemAnn ArborMichiganUSA
| |
Collapse
|
28
|
Nakata T, Shimada K, Iba A, Oda H, Terashima A, Koide Y, Kawasaki R, Yamada T, Ishii K. Correlation between noise pareidolia test scores for visual hallucinations and regional cerebral blood flow in dementia with Lewy bodies. Ann Nucl Med 2022; 36:384-392. [DOI: 10.1007/s12149-022-01717-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/10/2022] [Indexed: 01/08/2023]
|
29
|
Sasaki C, Yokoi K, Takahashi H, Hatakeyama T, Obara K, Wada C, Hirayama K. Visual illusions in Parkinson's disease: an interview survey of symptomatology. Psychogeriatrics 2022; 22:38-48. [PMID: 34617361 PMCID: PMC9293438 DOI: 10.1111/psyg.12771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/31/2021] [Accepted: 09/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several types of visual illusions can occur in Parkinson's disease (PD). However, the prevalence and types of specific illusions experienced by patients with PD remain unclear. This study aimed to investigate the types of illusions. METHODS A questionnaire of visual illusions was developed through a literature review in consultation with clinicians and neurologists. Based on the questionnaire, 40 consecutive patients with PD were asked a series of Yes/No questions regarding 20 types of visual illusions since the onset of PD. If participants answered 'Yes', they were then asked to detail their experience(s). RESULTS In total, 30 patients with PD had experienced visual illusions since disease onset; among them, 25 were still experiencing them at the time of the study. The most commonly observed illusion types were dysmorphopsia, complex visual illusions, metachromatopsia, and diplopia. Other observed illusions included textural illusions, macropsia, micropsia, teleopsia, pelopsia, kinetopsia, akinetopsia, Zeitraffer/Zeitlupen phenomena, tilt illusion, upside-down illusion, and palinopsia. Additionally, aberrant perception of surface orientation (inclination) was reported, which is yet to be reported in association with any disease. Visual illusions had detrimental effects on the patients' daily lives in some cases. CONCLUSIONS Systematic interviews regarding the incidence and details of visual illusions experienced by patients with PD could offer important information regarding their quality of life.
Collapse
Affiliation(s)
- Chinami Sasaki
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan.,National Hospital Organization Akita Hospital, Akita, Japan.,National Hospital Organization Miyagi Hospital, Yamamoto, Japan
| | - Kayoko Yokoi
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | | | | | - Koji Obara
- National Hospital Organization Akita Hospital, Akita, Japan
| | - Chizu Wada
- National Hospital Organization Akita Hospital, Akita, Japan
| | - Kazumi Hirayama
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| |
Collapse
|
30
|
Caruana N, Seymour K. Objects that induce face pareidolia are prioritized by the visual system. Br J Psychol 2021; 113:496-507. [PMID: 34923634 DOI: 10.1111/bjop.12546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
The human visual system has evolved specialized neural mechanisms to rapidly detect faces. Its broad tuning for facial features is thought to underlie the illusory perception of faces in inanimate objects, a phenomenon called face pareidolia. Recent studies on face pareidolia suggest that the mechanisms underlying face processing, at least at the early stages of visual encoding, may treat objects that resemble faces as real faces; prioritizing their detection. In our study, we used breaking continuous flash suppression (b-CFS) to examine whether the human visual system prioritizes the detection of objects that induce face pareidolia over stimuli matched for object content. Similar to previous b-CFS results using real face stimuli, we found that participants detected the objects with pareidolia faces faster than object-matched control stimuli. Given that face pareidolia has been more frequently reported amongst individuals prone to hallucinations, we also explored whether this rapid prioritization is intact in individuals with schizophrenia, and found evidence suggesting that it was. Our findings suggest that face pareidolia engages a broadly tuned mechanism that facilitates rapid face detection. This may involve the proposed fast subcortical pathway that operates outside of visual awareness.
Collapse
Affiliation(s)
- Nathan Caruana
- Department of Cognitive Science, Macquarie University, Sydney, New South Wales, Australia.,Perception in Action Research Centre, Macquarie University, Sydney, New South Wales, Australia
| | - Kiley Seymour
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia.,The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, New South Wales, Australia.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| |
Collapse
|
31
|
Shimada T, Uehara T, Nagasawa T, Hasegawa M, Maeda Y, Kawasaki Y. A case report of late-onset schizophrenia differentiated from a dementing disorder. Neurocase 2021; 27:467-473. [PMID: 34949153 DOI: 10.1080/13554794.2021.2016858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report a case of late-onset schizophrenia that required differentiation from a dementing disorder. The patient was an 83-year-old woman who had experienced auditory hallucinations since she was 67 years old. The patient had slightly elevated total tau and slightly decreased amyloid β1-42, cerebrospinal fluid biomarkers. This case was identified as late-onset schizophrenia. However, the results of cerebrospinal fluid biomarkers indicated that neurofibrillary tangles and neuronal death, which are characteristic of Alzheimer 's disease, may also have been present. Late-onset schizophrenia should be treated based on an appropriate differential diagnosis, including neuropathological consideration of dementing disorders.
Collapse
Affiliation(s)
- Takamitsu Shimada
- Department of Neuropsychiatry, Kanazawa Medical University, Kahoku-county, Ishikawa, Japan.,Department of Psychiatry, Medical Corporation Sekijinkai Okabe Hospital, Kanazawa-City, Ishikawa, Japan
| | - Takashi Uehara
- Department of Neuropsychiatry, Kanazawa Medical University, Kahoku-county, Ishikawa, Japan
| | - Tatsuya Nagasawa
- Department of Neuropsychiatry, Kanazawa Medical University, Kahoku-county, Ishikawa, Japan
| | - Mitsuru Hasegawa
- Department of Psychiatry, Medical Corporation Sekijinkai Okabe Hospital, Kanazawa-City, Ishikawa, Japan
| | - Yoshiki Maeda
- Department of Psychiatry, Medical Corporation Sekijinkai Okabe Hospital, Kanazawa-City, Ishikawa, Japan.,Department of Psychiatry, Medical Corporation Okabe Clinic, Kanazawa-City, Ishikawa, Japan
| | - Yasuhiro Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Kahoku-county, Ishikawa, Japan
| |
Collapse
|
32
|
de Bustamante Simas ML, Maranhão ACT, Lacerda AM, Teixeira FS, Freire CHR, da Silva Raposo CC, de Menezes GMM. Pictorial size perception in schizophrenia. PSICOLOGIA-REFLEXAO E CRITICA 2021; 34:36. [PMID: 34806134 PMCID: PMC8606485 DOI: 10.1186/s41155-021-00201-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
In this study, we compared visual pictorial size perception between healthy volunteers (CG) and an experimental group (EG) of people diagnosed with schizophrenia. We have been using paintings by Salvador Dalí and Rorschach plates to estimate visual pictorial size perception. In this transversal, ex post facto, and quasi-experimental study, we observed differences between EG and CG. Schizophrenic in-patients perceived sizes about 1.3-fold greater than healthy volunteers (p=0.006), implying that pictorial size perception is altered in some way in schizophrenia. Considering the present and previous results, this measurement of diameter size of first pictorial perception may be a useful estimate of some aspects of perceptual alterations that may be associated with psychotic symptoms in prodromal and acute schizophrenic episodes and other related mental states. Eventually, this may help in preventing people from evolving to acute episodes.
Collapse
Affiliation(s)
- Maria Lúcia de Bustamante Simas
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Ana Cristina Taunay Maranhão
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Aline Mendes Lacerda
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Flora Silva Teixeira
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Carlos Henrique Resende Freire
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Cecília Coimbra da Silva Raposo
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Georgia Mônica Marque de Menezes
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Recife, Brazil
| |
Collapse
|
33
|
Pareidolia in Parkinson's Disease and Multiple System Atrophy. PARKINSONS DISEASE 2021; 2021:2704755. [PMID: 34754412 PMCID: PMC8572613 DOI: 10.1155/2021/2704755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/08/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022]
Abstract
Pareidolia is a visual illusion of meaningful objects that arise from ambiguous forms embedded in visual scenes. Previous studies showed that pareidolias are frequently observed in patients with Parkinson's disease (PD) as well as dementia with Lewy bodies. However, whether pareidolias are useful for differentiating PD from other neurodegenerative parkinsonism disorders including multiple system atrophy (MSA) is unclear. The noise pareidolia test (NPT) was performed in 40 and 48 patients with PD and MSA, respectively. A receiver operating characteristic (ROC) curve analysis was used to evaluate sensitivity and specificity. Results of neuropsychological tests were also compared between patients with PD with and without pareidolias. Visual hallucinations were present in none of the subjects. Pareidolic response in the NPT was observed in 47.5% and 18.8% of patients with PD and MSA, respectively. The number of pareidolic responses in patients with PD was significantly larger compared with patients with MSA (P=0.001). ROC curve analyses showed the sensitivity and specificity at 33% and 98%, respectively. Among patients with PD, those with pareidolias demonstrated higher State-Trait Anxiety Inventory-state (P=0.044) and State-Trait Anxiety Inventory-trait (P=0.044) than those without pareidolias. Pareidolias can be found in patients with PD without visual hallucinations, and the pareidolia test may be a highly specific test for differentiating PD from MSA. Thus, anxiety may be associated with pareidolias in patients with PD.
Collapse
|
34
|
Decreased frontotemporal connectivity in patients with parkinson's disease experiencing face pareidolia. NPJ PARKINSONS DISEASE 2021; 7:90. [PMID: 34620877 PMCID: PMC8497472 DOI: 10.1038/s41531-021-00237-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022]
Abstract
The precise neural underpinnings of face pareidolia in patients with Parkinson’s disease (PD) remain unclear. We aimed to clarify face recognition network abnormalities associated with face pareidolia in such patients. Eighty-three patients with PD and 40 healthy controls were recruited in this study. Patients with PD were classified into pareidolia and nonpareidolia groups. Volumetric analyses revealed no significant differences between the pareidolia (n = 39) and nonpareidolia (n = 44) patient groups. We further observed decreased functional connectivity among regions of interest in the bilateral frontotemporal lobes in patients with pareidolia. Seed-based analysis using bilateral temporal fusiform cortices as seeds revealed significantly decreased connectivity with the bilateral inferior medial prefrontal cortices in the pareidolia group. Post hoc regression analysis further demonstrated that the severity of face pareidolia was negatively correlated with functional connectivity between the bilateral temporal fusiform and medial prefrontal cortices. Our findings suggest that top-down modulation of the face recognition network is impaired in patients with PD experiencing face pareidolia.
Collapse
|
35
|
Galvin JE, Chrisphonte S, Cohen I, Greenfield KK, Kleiman MJ, Moore C, Riccio ML, Rosenfeld A, Shkolnik N, Walker M, Chang LC, Tolea MI. Characterization of dementia with Lewy bodies (DLB) and mild cognitive impairment using the Lewy body dementia module (LBD-MOD). Alzheimers Dement 2021; 17:1675-1686. [PMID: 33793069 PMCID: PMC8484363 DOI: 10.1002/alz.12334] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The National Institute on Aging Alzheimer's Disease Research Center program added the Lewy body dementia module (LBD-MOD) to the Uniform Data Set to facilitate LBD characterization and distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). We tested the performance of the LBD-MOD. METHODS The LBD-MOD was completed in a single-site study in 342 participants: 53 controls, 78 AD, and 110 DLB; 79 mild cognitive impairment due to AD (MCI-AD); and 22 MCI-DLB. RESULTS DLB differed from AD in extrapyramidal symptoms, hallucinations, apathy, autonomic features, REM sleep behaviors, daytime sleepiness, cognitive fluctuations, timed attention tasks, and visual perception. MCI-DLB differed from MCI-AD in extrapyramidal features, mood, autonomic features, fluctuations, timed attention tasks, and visual perception. Descriptive data on LBD-MOD measures are provided for reference. DISCUSSION The LBD-MOD provided excellent characterization of core and supportive features to differentiate DLB from AD and healthy controls while also characterizing features of MCI-DLB.
Collapse
Affiliation(s)
- James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Stephanie Chrisphonte
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Iris Cohen
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Keri K. Greenfield
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Michael J. Kleiman
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Claudia Moore
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Mary Lou Riccio
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Amie Rosenfeld
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Niurka Shkolnik
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Marcia Walker
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Lun-Ching Chang
- Department of Mathematical Sciences, Florida Atlantic University
| | - Magdalena I. Tolea
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| |
Collapse
|
36
|
Marek A. [Auditory phenomena as differential diagnostics to tinnitus]. Laryngorhinootologie 2021; 100:712-719. [PMID: 34461649 DOI: 10.1055/a-1516-4720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION In the auditory system, subjective tinnitus is known as phantom perception. Humans also report illusionary misperceptions of real listening impressions and complex scene-like acoustic fantasies without external hearing stimulus. The exact pathophysiological relationships of the auditory phenomena are still unclear. Important comorbidities include hearing loss, brain disease and mental disorders. METHODS In a literature search in the PubMed database, publications were evaluated until March 2021 on the search terms tinnitus, palinacousis, pareidolia, synesthesia, aura, acoustic hallucination with regard to similarities and differences to subjective tinnitus. RESULTS Subjective tinnitus can occur together with other auditory phenomena in an individual. Diagnostically important is the relationship between hearing loss and tinnitus as well as between tinnitus and hearing loss in the corresponding frequency range. With hearing loss, other auditory phenomena may occur. CONCLUSION The occurrence of various auditory phenomena simultaneously in a person suggests an auditory perceptual continuum with common physiological processing structures. People with hearing loss should be asked about the various auditory phenomena. For all auditory phenomena, audiometric examination should be part of the diagnostic standard.
Collapse
Affiliation(s)
- Astrid Marek
- HNO-Universitätsklinik Bochum, Ruhr-Universität Bochum, Medizinische Fakultät, Bochum, Germany
| |
Collapse
|
37
|
Revankar GS, Kajiyama Y, Hattori N, Shimokawa T, Nakano T, Mihara M, Mori E, Mochizuki H. Prestimulus Low-Alpha Frontal Networks Are Associated with Pareidolias in Parkinson's Disease. Brain Connect 2021; 11:772-782. [PMID: 33858200 DOI: 10.1089/brain.2020.0992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Pareidolias are visual phenomena wherein ambiguous, abstract forms or shapes appear meaningful due to incorrect perception. In Parkinson's disease (PD), patients susceptible to visual hallucinations experience visuo-perceptual deficits in the form of pareidolias. Although pareidolias necessitate top-down modulation of visual processing, the cortical dynamics of internally generated perceptual priors on these visual misperceptions is unknown. Objectives: To study prestimulus-related electroencephalography (EEG) spectral and network abnormalities in PD patients experiencing pareidolias. Methods: Twenty-one PD in-patients and 10 age-matched controls were evaluated. Neuropsychological assessments included tests for cognition, attention, and executive functions. Pareidolias were quantified by using the "noise pareidolia test" with simultaneous EEG recording. The PD patients were subdivided into two groups-those with high pareidolia counts (n = 10) and those without (n = 11). The EEG was analyzed 1000 msec before stimulus presentation in the spectral domain (theta, low-alpha, and high-alpha frequencies) with corresponding graph networks to evaluate network properties. Statistical analysis included analysis of variance and multiple regression to evaluate the differences. Results: The PD patients with high pareidolia counts were older with lower scores on neuropsychological tests. Their prestimulus EEG low-alpha band showed a tendency toward higher frontal activity (p = 0.07). Graph networks showed increased normalized clustering coefficient (p = 0.05) and lower frontal degree centrality (p = 0.005). These network indices correlated positively to patients' pareidolia scores. Discussion: We suggest that pareidolias in PD are a consequence of an abnormal top-down modulation of visual processing; they are defined by their frontal low-alpha spectral and network alterations in the prestimulus phase due to a dissonance between patients' internally generated mental processing with external stimuli. Impact statement Pareidolias in Parkinson's disease (PD) are considered to be promising early markers of visual hallucinations and an indicator of PD prognosis. In certain susceptible PD patients, pareidolias can be evoked and studied. Here, via electroencephalography, we aimed at understanding this visual phenomenon by studying how neural information is processed before stimulus presentation in such patients. Using spectral and graph network measures, we revealed how top-down modulated internally generated processes affect visual perception in patients with pareidolias. Our findings highlight how prestimulus network alterations in the frontal cortex shape poststimulus pareidolic manifestations in PD.
Collapse
Affiliation(s)
- Gajanan S Revankar
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuta Kajiyama
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Noriaki Hattori
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Rehabilitation, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Tetsuya Shimokawa
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), Osaka, Japan
| | - Tomohito Nakano
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masahito Mihara
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Neurology, Kawasaki Medical College, Okayama, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University, Osaka, Japan
| | - Hideki Mochizuki
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan
| |
Collapse
|
38
|
Göbel N, Möller JC, Hollenstein N, Binder A, Oechsner M, Ide J, Urwyler P, Cazzoli D, Müri RM. Face Perception and Pareidolia Production in Patients With Parkinson's Disease. Front Neurol 2021; 12:669691. [PMID: 34413822 PMCID: PMC8370466 DOI: 10.3389/fneur.2021.669691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
In Parkinson's disease (PD) patients, visual misperceptions are a major problem within the non-motor symptoms. Pareidolia, i.e., the tendency to perceive a specific, meaningful image in an ambiguous visual pattern, is a phenomenon that occurs also in healthy subjects. Literature suggests that the perception of face pareidolia may be increased in patients with neurodegenerative diseases. We aimed to examine, within the same experiment, face perception and the production of face pareidolia in PD patients and healthy controls (HC). Thirty participants (15 PD patients and 15 HC) were presented with 47 naturalistic photographs in which faces were embedded or not. The likelihood to perceive the embedded faces was modified by manipulating their transparency. Participants were asked to decide for each photograph whether a face was embedded or not. We found that PD patients were significantly less likely to recognize embedded faces than controls. However, PD patients also perceived faces significantly more often in locations where none were actually present than controls. Linear regression analyses showed that gender, age, hallucinations, and Multiple-Choice Vocabulary Intelligence Test (MWT) score were significant predictors of face pareidolia production in PD patients. Montreal Cognitive Assessment (MoCA) was a significant predictor for pareidolia production in PD patients in trials in which a face was embedded in another region [F (1, 13) = 24.4, p = <0.001]. We conclude that our new embedded faces paradigm is a useful tool to distinguish face perception performance between HC and PD patients. Furthermore, we speculate that our results observed in PD patients rely on disturbed interactions between the Dorsal (DAN) and Ventral Attention Networks (VAN). In photographs in which a face is present, the VAN may detect this as a behaviourally relevant stimulus. However, due to the deficient communication with the DAN in PD patients, the DAN would not direct attention to the correct location, identifying a face at a location where actually none is present.
Collapse
Affiliation(s)
- Nicole Göbel
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jens Carsten Möller
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland.,Department of Neurology, Philipps University, Marburg, Germany
| | - Nathalie Hollenstein
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Andreas Binder
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Matthias Oechsner
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Jörg Ide
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Prabitha Urwyler
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Gerontechnology and Rehabilitation Group, ARTORG Center, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Gerontechnology and Rehabilitation Group, ARTORG Center, University of Bern, Bern, Switzerland
| | - René M Müri
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Gerontechnology and Rehabilitation Group, ARTORG Center, University of Bern, Bern, Switzerland
| |
Collapse
|
39
|
Salge JH, Pollmann S, Reeder RR. Anomalous visual experience is linked to perceptual uncertainty and visual imagery vividness. PSYCHOLOGICAL RESEARCH 2021; 85:1848-1865. [PMID: 32476064 PMCID: PMC8289756 DOI: 10.1007/s00426-020-01364-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/20/2020] [Indexed: 11/29/2022]
Abstract
An imbalance between top-down and bottom-up processing on perception (specifically, over-reliance on top-down processing) can lead to anomalous perception, such as illusions. One factor that may be involved in anomalous perception is visual mental imagery, which is the experience of "seeing" with the mind's eye. There are vast individual differences in self-reported imagery vividness, and more vivid imagery is linked to a more sensory-like experience. We, therefore, hypothesized that susceptibility to anomalous perception is linked to individual imagery vividness. To investigate this, we adopted a paradigm that is known to elicit the perception of faces in pure visual noise (pareidolia). In four experiments, we explored how imagery vividness contributes to this experience under different response instructions and environments. We found strong evidence that people with more vivid imagery were more likely to see faces in the noise, although removing suggestive instructions weakened this relationship. Analyses from the first two experiments led us to explore confidence as another factor in pareidolia proneness. We, therefore, modulated environment noise and added a confidence rating in a novel design. We found strong evidence that pareidolia proneness is correlated with uncertainty about real percepts. Decreasing perceptual ambiguity abolished the relationship between pareidolia proneness and both imagery vividness and confidence. The results cannot be explained by incidental face-like patterns in the noise, individual variations in response bias, perceptual sensitivity, subjective perceptual thresholds, viewing distance, testing environments, motivation, gender, or prosopagnosia. This indicates a critical role of mental imagery vividness and perceptual uncertainty in anomalous perceptual experience.
Collapse
Affiliation(s)
- Johannes H Salge
- Department of Experimental Psychology, Institute of Psychology, Otto-Von-Guericke University, Magdeburg, Germany
| | - Stefan Pollmann
- Department of Experimental Psychology, Institute of Psychology, Otto-Von-Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Beijing Key Laboratory of Learning and Cognition and School of Psychology, Capital Normal University, Beijing, China
| | - Reshanne R Reeder
- Department of Experimental Psychology, Institute of Psychology, Otto-Von-Guericke University, Magdeburg, Germany.
- Center for Behavioral Brain Sciences, Magdeburg, Germany.
| |
Collapse
|
40
|
Nagahama Y, Okina T, Suzuki N, Matsuda M. Prevalence of the core clinical features and the other neuropsychiatric symptoms in dementia with Lewy bodies. Psychogeriatrics 2021; 21:443-445. [PMID: 33759303 DOI: 10.1111/psyg.12687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Yasuhiro Nagahama
- Department of Psychiatry and Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan.,Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Japan
| | - Tomoko Okina
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Japan
| | - Norio Suzuki
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Japan
| | - Minoru Matsuda
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Japan.,Department of Neurology, Izuminomori Clinic, Sendai, Japan
| |
Collapse
|
41
|
Murakami H, Shiraishi T, Umehara T, Omoto S, Takahashi M, Motegi H, Maku T, Sato T, Takatsu H, Komatsu T, Bono K, Sakai K, Mitsumura H, Iguchi Y. Face pareidolia is associated with right striatal dysfunction in drug-naïve patients with Parkinson's disease. Neurol Sci 2021; 42:5327-5334. [PMID: 33884529 DOI: 10.1007/s10072-021-05238-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIM Some patients with Parkinson's disease (PD) present with pareidolia, an illusion of a meaningless stimulus as a familiar object known to the observer. Since the striatum is associated with processing of visual information, we investigated correlations of pareidolia with motor symptoms and striatal dopaminergic function. METHOD A noise pareidolia test, assessment of motor symptoms using MDS-UPDRS and 123I-Ioflupane SPECT were performed in 58 drug-naïve PD patients. A number of images in which a participant noticed an illusory face (number of illusory responses) were compared with motor assessment scores and uptake of 123I-ioflupane in the striatum. RESULTS Of the 58 participants, 22 had at least one illusory response. Mean scores for MDS-UPDRS part III (p<0.05), rigidity (p<0.05), and rigidity on the left side of the body (p<0.01) in patients with pareidolia were significantly higher than those in patients without pareidolia. Uptake of 123I-ioflupane in the right caudate nucleus (p<0.05), anterior putamen (p<0.01), and posterior putamen (p<0.01) in patients with pareidolia was significantly lower than in patients without pareidolia. In the 22 patients with pareidolia, the number of illusory responses was significantly correlated with total scores for MDS-UPDRS part III (r=0.443, p<0.05) and subscores for bradykinesia (r=0.440, p<0.05) and bradykinesia on the left side of the body (r=0.564, p<0.01). The prevalence of pareidolia in left-dominant parkinsonism (16/30 patients) was higher than that in right-dominant parkinsonism (6/28 patients) (p<0.05 by chi-square test). CONCLUSION Pareidolia in PD patients is associated with dysfunction in the right striatum.
Collapse
Affiliation(s)
- Hidetomo Murakami
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan.
| | - Tomotaka Shiraishi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Shusaku Omoto
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Maki Takahashi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Haruhiko Motegi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Takahiro Maku
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Hiroki Takatsu
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Keiko Bono
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 108-8461, Japan
| |
Collapse
|
42
|
Innis AD, Tolea MI, Galvin JE. The Effect of Baseline Patient and Caregiver Mindfulness on Dementia Outcomes. J Alzheimers Dis 2021; 79:1345-1367. [PMID: 33427746 PMCID: PMC8324319 DOI: 10.3233/jad-201292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Mindfulness is the practice of awareness and living in the present moment without judgment. Mindfulness-based interventions may improve dementia-related outcomes. Before initiating interventions, it would be beneficial to measure baseline mindfulness to understand targets for therapy and its influence on dementia outcomes. OBJECTIVE This cross-sectional study examined patient and caregiver mindfulness with patient and caregiver rating scales and patient cognitive performance and determined whether dyadic pairing of mindfulness influences patient outcomes. METHODS Individuals (N = 291) underwent comprehensive evaluations, with baseline mindfulness assessed using the 15-item Applied Mindfulness Process Scale (AMPS). Correlation, regression, and mediation models tested relationships between patient and caregiver mindfulness and outcomes. RESULTS Patients had a mean AMPS score of 38.0±11.9 and caregivers had a mean AMPS score of 38.9±11.5. Patient mindfulness correlated with activities of daily living, behavior and mood, health-related quality of life, subjective cognitive complaints, and performance on episodic memory and attention tasks. Caregiver mindfulness correlated with preparedness, care confidence, depression, and better patient cognitive performance. Patients in dyads with higher mindfulness had better cognitive performance, less subjective complaints, and higher health-related quality of life (all p-values<0.001). Mindfulness effects on cognition were mediated by physical activity, social engagement, frailty, and vascular risk factors. CONCLUSION Higher baseline mindfulness was associated with better patient and caregiver outcomes, particularly when both patients and caregivers had high baseline mindfulness. Understanding the baseline influence of mindfulness on the completion of rating scales and neuropsychological test performance can help develop targeted interventions to improve well-being in patients and their caregivers.
Collapse
Affiliation(s)
- Ashley D. Innis
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Magdalena I. Tolea
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
43
|
Tolea MI, Heo J, Chrisphonte S, Galvin JE. A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults. J Alzheimers Dis 2021; 82:1755-1768. [PMID: 34219721 PMCID: PMC8483620 DOI: 10.3233/jad-210269] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today's US population, and requires laboratory biomarkers, which are not always available. OBJECTIVE Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. METHODS Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. RESULTS Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by > 85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. CONCLUSION mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.
Collapse
Affiliation(s)
- Magdalena I. Tolea
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - Jaeyeong Heo
- Department of Neurology, Harbor UCLA Medical Center
| | - Stephanie Chrisphonte
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine
| |
Collapse
|
44
|
Abo Hamza EG, Kéri S, Csigó K, Bedewy D, Moustafa AA. Pareidolia in Schizophrenia and Bipolar Disorder. Front Psychiatry 2021; 12:746734. [PMID: 34955913 PMCID: PMC8702957 DOI: 10.3389/fpsyt.2021.746734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
While there are many studies on pareidolia in healthy individuals and patients with schizophrenia, to our knowledge, there are no prior studies on pareidolia in patients with bipolar disorder. Accordingly, in this study, we, for the first time, measured pareidolia in patients with bipolar disorder (N = 50), and compared that to patients with schizophrenia (N = 50) and healthy controls (N = 50). We have used (a) the scene test, which consists of 10 blurred images of natural scenes that was previously found to produce illusory face responses and (b) the noise test which had 32 black and white images consisting of visual noise and 8 images depicting human faces; participants indicated whether a face was present on these images and to point to the location where they saw the face. Illusory responses were defined as answers when observers falsely identified objects that were not on the images in the scene task (maximum illusory score: 10), and the number of noise images in which they reported the presence of a face (maximum illusory score: 32). Further, we also calculated the total pareidolia score for each task (the sum number of images with illusory responses in the scene and noise tests). The responses were scored by two independent raters with an excellent congruence (kappa > 0.9). Our results show that schizophrenia patients scored higher on pareidolia measures than both healthy controls and patients with bipolar disorder. Our findings are agreement with prior findings on more impaired cognitive processes in schizophrenia than in bipolar patients.
Collapse
Affiliation(s)
- Eid G Abo Hamza
- Psychology Department, College of Humanities and Sciences, Ajman University, Ajman, United Arab Emirates.,College of Education, Tanta University, Tanta, Egypt
| | - Szabolcs Kéri
- National Institute of Psychiatry and Addictions, Budapest, Hungary.,Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.,Department of Physiology, University of Szeged, Szeged, Hungary
| | - Katalin Csigó
- National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Dalia Bedewy
- Psychology Department, College of Humanities and Sciences, Ajman University, Ajman, United Arab Emirates.,College of Education, Tanta University, Tanta, Egypt
| | - Ahmed A Moustafa
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,School of Psychology & Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia
| |
Collapse
|
45
|
Bogolepova A, Vasenina E, Gomzyakova N, Gusev E, Dudchenko N, Emelin A, Zalutskaya N, Isaev R, Kotovskaya Y, Levin O, Litvinenko I, Lobzin V, Martynov M, Mkhitaryan E, Nikolay G, Palchikova E, Tkacheva O, Cherdak M, Chimagomedova A, Yakhno N. Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients. Zh Nevrol Psikhiatr Im S S Korsakova 2021. [DOI: 10.17116/jnevro20211211036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
46
|
Galvin JE, Tolea MI, Moore C, Chrisphonte S. The Number Symbol Coding Task: A brief measure of executive function to detect dementia and cognitive impairment. PLoS One 2020; 15:e0242233. [PMID: 33253192 PMCID: PMC7703969 DOI: 10.1371/journal.pone.0242233] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Alzheimer's disease and related dementias (ADRD) affect over 5.7 million Americans and over 35 million people worldwide. Detection of mild cognitive impairment (MCI) and early ADRD is a challenge to clinicians and researchers. Brief assessment tools frequently emphasize memory impairment, however executive dysfunction may be one of the earliest signs of impairment. To address the need for a brief, easy-to-score, open-access test of executive function for use in clinical practice and research, we created the Number Symbol Coding Task (NSCT). METHODS This study analyzed 320 consecutive patient-caregiver dyads who underwent a comprehensive evaluation including the Clinical Dementia Rating (CDR), patient and caregiver versions of the Quick Dementia Rating System (QDRS), caregiver ratings of behavior and function, and neuropsychological testing, with a subset undergoing volumetric magnetic resonance imaging (MRI). Estimates of cognitive reserve were calculated using education, combined indices of education and occupation, and verbal IQ. Psychometric properties of the NSCT including data quality, data distribution, floor and ceiling effects, construct and known-groups validity, discriminability, and clinical profiles were determined. RESULTS The patients had a mean age of 75.3±9.2 years (range 38-98y) with a mean education of 15.7±2.8 years (range 6-26y) of education. The patients had a mean CDR-SB of 4.8±4.7 (range 0-18) and a mean MoCA score of 18.6±7.1 (range 1-30). The mean NSCT score was 30.1±13.8 and followed a normal distribution. All healthy controls and MCI cases were able to complete the NSCT. The NSCT showed moderate-to-strong correlations with clinical and neuropsychological measures with the strongest association (all p's < .001) for measures with executive components (e.g., Judgement and Problem Solving box of the CDR, Decision Making and Problem Solving domain of the QDRS, Trailmaking B, and Cognigram Attention and Executive Composite Scores). Women slightly outperformed men, and individuals with lower educational attainment and lower education-occupation indices had lower NSCT scores. Decreasing NSCT scores corresponded to older age, worse cognitive scores, higher CDR sum of boxes scores, worse caregiver ratings of function and behavior, worse patient and informant QDRS ratings, and smaller hippocampal volumes and hippocampal occupancy scores. The NSCT provided excellent discrimination (AUC: .866; 95% CI: .82-.91) with a cut-off score of 36 providing the best combination of sensitivity (0.880) and specificity (0.759). Combining the NSCT with patient QDRS and caregiver QDRS ratings improved discrimination (AUC: .908; 95% CI: .87-.94). DISCUSSION The NSCT is a brief, 90-second executive task that incorporates attention, planning and set-switching that can be completed by individuals into the moderate-to-severe stages of dementia. The NSCT may be a useful tool for dementia screening, case-ascertainment in epidemiological or community-based ADRD studies, and in busy primary care settings where time is limited. Combining the NSCT with a brief structured interview tool such as the QDRS may provide excellent power to detect cognitive impairment. The NSCT performed well in comparison to standardized scales of a comprehensive cognitive neurology evaluation across a wide array of sociodemographic variables in a brief fashion that could facilitate its use in clinical care and research.
Collapse
Affiliation(s)
- James E. Galvin
- Department of Neurology, Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Magdalena I. Tolea
- Department of Neurology, Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Claudia Moore
- Department of Neurology, Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Stephanie Chrisphonte
- Department of Neurology, Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| |
Collapse
|
47
|
Galvin JE, Tolea MI, Chrisphonte S. The positive and negative appraisals of caregiving (PANAC) scale: A new measure to examine the caregiving experience in Alzheimer's disease and related dementias. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12104. [PMID: 33283038 PMCID: PMC7683961 DOI: 10.1002/trc2.12104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Dementia caregiving is often examined as a monolithic experience describing the challenges caregivers face, exploring one construct at a time, with little research on the positive experiences of caregiving. To address this, we developed the Positive and Negative Appraisals of Caregiving (PANAC) scale. METHODS PANAC was validated in 253 patient-caregiver dyads. Factor analyses revealed a two-factor solution: Positive Appraisals (PAs) and Negative Appraisals (NAs). Psychometric properties were compared with patient and caregiver characteristics and outcomes, disease stage, and etiology. RESULTS Internal consistency was good with Cronbach's alpha: 0.82 NA and 0.80 PA (P < 0.001). NA correlated with patient and caregiver characteristics, whereas PA correlated only with caregiver characteristics. The PA/NA ratio could be used to capture change due to an intervention. DISCUSSION The PANAC scale is a useful measure of the overall caregiver experience accounting for negative and positive experiences and may be used to tailor support to individual caregivers.
Collapse
Affiliation(s)
- James E. Galvin
- Department of NeurologyComprehensive Center for Brain HealthUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Magdalena I. Tolea
- Department of NeurologyComprehensive Center for Brain HealthUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Stephanie Chrisphonte
- Department of NeurologyComprehensive Center for Brain HealthUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| |
Collapse
|
48
|
Inagawa Y, Kanetaka H, Tsugawa A, Sakurai S, Serisawa S, Shimizu S, Sakurai H, Hanyu H. Efficacy of Olfactory and Pareidolia Tests Compared With That of Indicative Biomarkers in Diagnosis of Dementia With Lewy Bodies. Front Neurol 2020; 11:540291. [PMID: 33041991 PMCID: PMC7517047 DOI: 10.3389/fneur.2020.540291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose: Although olfactory decline and visual hallucinations are useful in distinguishing dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) in a clinical setting, neither is easy to evaluate objectively. The pareidolia test is used to assess susceptibility to visual hallucinations, while in Japan, the Odor Stick Identification Test for the Japanese (OSIT-J) is used to objectively quantify olfactory decline. The present study investigated the efficacy of these olfactory and pareidolia tests in differentiating AD from DLB. Their usefulness was then compared with that of the indicative biomarkers in neuroimaging for a clinical diagnosis of DLB listed in the Fourth Consensus Report of the Dementia with Lewy Bodies Consortium. Methods: A total of 24 probable DLB and 22 probable AD patients were enrolled. All underwent 4 diagnostic procedures: uptake of dopamine transporter in single photon emission computed tomography (DaT-SPECT) and meta-iodobenzylguanidine (MIBG) in myocardial scintigraphy, the pareidolia test, and OSIT-J. The sensitivity, specificity, and accuracy of these methods in differentiating DLB from AD were compared. Results: Sensitivity and specificity in differentiating DLB from AD were 86 and 100% by the heart-to-mediastinum ratio of MIBG uptake; 82 and 96% by the specific binding ratio on DaT-SPECT; 77 and 67% by the combination of OSIT-J and pareidolia test scores; 73 and 62% by the pareidolia test scores; and 77 and 58% by the OSIT-J scores, respectively. Conclusions: The present results suggest that the pareidolia and OSIT-J tests may be considered before resorting to nuclear neuroimaging in the diagnosis of DLB.
Collapse
|
49
|
Revankar GS, Hattori N, Kajiyama Y, Nakano T, Mihara M, Mori E, Mochizuki H. Ocular fixations and presaccadic potentials to explain pareidolias in Parkinson's disease. Brain Commun 2020; 2:fcaa073. [PMID: 32954309 PMCID: PMC7425388 DOI: 10.1093/braincomms/fcaa073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/27/2020] [Accepted: 05/04/2020] [Indexed: 01/05/2023] Open
Abstract
In Parkinson's disease, a precursor phenomenon to visual hallucinations presents as 'pareidolias' which make ambiguous forms appear meaningful. To evoke and detect pareidolias in patients, a noise pareidolia test was recently developed, although its task-dependent mechanisms are yet to be revealed. When subjected to this test, we hypothesized that patients exhibiting pareidolias would show altered top-down influence of visual processing allowing us to demonstrate the influence of pareidolic illusionary behaviour in Parkinson's disease patients. To that end, we evaluated eye-movement strategies and fixation-related presaccadic activity on scalp EEG when participants performed the test. Twelve healthy controls and 21 Parkinson's disease patients, evaluated for cognitive, visuo-spatial and executive functions, took a modified computer-based version of the noise pareidolia test in a free-viewing EEG eye-tracking experiment. Eye-tracking metrics (fixation-related durations and counts) documented the eye movement behaviour employed in correct responses (face/noise) and misperceptions (pareidolia/missed) during early and late visual search conditions. Simultaneously, EEG recorded the presaccadic activity in frontal and parietal areas of the brain. Based on the noise pareidolia test scores, we found certain Parkinson's disease patients exhibited pareidolias whereas others did not. ANOVA on eye-tracking data showed that patients dwelled significantly longer to detect faces and pareidolias which affected both global and local search dynamics depending on their visuo-perceptual status. Presaccadic activity in parietal electrodes for the groups was positive for faces and pareidolias, and negative for noise, though these results depended mainly on saccade size. However, patients sensitive to pareidolias showed a significantly higher presaccadic potential on frontal electrodes independent of saccade sizes, suggesting a stronger frontal activation for pareidolic stimuli. We concluded with the following interpretations (i) the noise pareidolia test specifically characterizes visuo-perceptual inadequacies in patients despite their wide range of cognitive scores, (ii) Parkinson's disease patients dwell longer to converge attention to pareidolic stimuli due to abnormal saccade generation proportional to their visuo-perceptual deficit during early search, and during late search, due to time-independent alteration of visual attentional network and (iii) patients with pareidolias show increased frontal activation reflecting the allocation of attention to irrelevant targets that express the pareidolic phenomenon. While the disease per se alters the visuo-perceptual and oculomotor dynamics, pareidolias occur in Parkinson's disease due to an abnormal top-down modulation of visual processing that affects visual attention and guidance to ambiguous stimuli.
Collapse
Affiliation(s)
- Gajanan S Revankar
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Noriaki Hattori
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan.,Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Osaka 5650871, Japan
| | - Yuta Kajiyama
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Tomohito Nakano
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Masahito Mihara
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University, Osaka 5650871, Japan
| | - Hideki Mochizuki
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| |
Collapse
|
50
|
Honeycutt L, Gagnon JF, Pelletier A, De Roy J, Montplaisir JY, Postuma RB. Pareidolias and cognition in isolated REM sleep behavior disorder. Parkinsonism Relat Disord 2020; 75:76-79. [PMID: 32492550 DOI: 10.1016/j.parkreldis.2020.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/23/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Though visual illusions and hallucinations are common in dementia with Lewy bodies (DLB) and Parkinson's disease (PD), they are not typically observed clinically in prodromal stages, including isolated REM sleep behavior disorder (iRBD). False-noise errors on the pareidolia test (seeing faces when none are present) may be an effective measure of susceptibility to future hallucinations in iRBD. METHODS One hundred patients with iRBD underwent the 20-image pareidolia test. Clinical markers were assessed and a neuropsychological battery was administered. An exploratory analysis on the impact of pareidolic errors on phenoconversion was also performed. RESULTS In our cohort, 17 patients (17%) made false-noise pareidolic errors. These patients had significantly lower total Montreal Cognitive Assesment (MoCA) scores (26.7 ± 2.3 vs. 24.4 ± 2.6, B = -1.88, 95% CI: [-3.17, -0.59]), with lower subcomponent MoCA scores on memory and visuospatial-executive sections. Pareidolic errors were also associated with lower visuospatial, attention/executive, and memory scores on the neuropsychological tests. Furthermore, after 1.6 years follow-up, 3/16 (19%) patients making pareidolic errors had phenoconverted at time of publication compared to 6/71 (8%) patients who did not make errors. CONCLUSION Pareidolic errors in patients with iRBD are associated with poorer overall cognition and may indicate higher risk of DLB.
Collapse
Affiliation(s)
- Lucy Honeycutt
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada
| | - Jean-François Gagnon
- Centre d'Études Avancées en Médecine du Sommeil, CIUSSS-NÎM-Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Amélie Pelletier
- Centre d'Études Avancées en Médecine du Sommeil, CIUSSS-NÎM-Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Department of Neurology, The Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Jessie De Roy
- Centre d'Études Avancées en Médecine du Sommeil, CIUSSS-NÎM-Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Jacques Y Montplaisir
- Centre d'Études Avancées en Médecine du Sommeil, CIUSSS-NÎM-Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Ronald B Postuma
- Department of Neurology, McGill University, Montreal General Hospital, Montreal, Canada; Centre d'Études Avancées en Médecine du Sommeil, CIUSSS-NÎM-Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Department of Neurology, The Research Institute of the McGill University Health Centre, Montreal, Canada.
| |
Collapse
|