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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.
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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
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Cucca A, Manara CV, Catalan M, Liccari M, Antonutti L, Lombardo TMI, Cenacchi V, Rangan S, Mingolo S, Crisafulli C, Dore F, Murgia M, Agostini T, Manganotti P. Using illusions to understand hallucinations: differences in perceptual performances on illusory figures may underscore specific visuoperceptual impairments in Parkinson's disease. Front Neurosci 2023; 17:1256224. [PMID: 38125403 PMCID: PMC10732246 DOI: 10.3389/fnins.2023.1256224] [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: 07/10/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023] Open
Abstract
Visual hallucinations are prevalent, potentially disabling symptoms of Parkinson's Disease. Multiple impairments in bottom-up sensory processing and top-down perceptual modulation are implicated in the pathophysiology of these phenomena. In healthy individuals, visual illusions are elicited by illusory figures through parametric manipulations of geometrical configurations, contrast, color, or spatial relationships between stimuli. These illusory percepts provide insight on the physiologic processes subserving conscious and unconscious perception. In this exploratory, cross-sectional, controlled study, perceptual performance on illusory figures was assessed on 11 PD patients with hallucinations, 10 non-hallucinating PD patients, and 10 age-matched healthy individuals. In order to characterize potential neural substrates of perceptual performances, patients' brain metabolic patterns on FDG PET were also analyzed. Illusions relying on attentional modulation and global perception were attenuated in PD patients without hallucinations. This pattern was no longer recognizable in hallucinating patients. Conversely, illusory effects normally counteracted by figure to background segregation and overlapping figures recognition were enhanced in PD patients with hallucinations. FDG PET findings further suggest that perceptual differences between PD patients might be linked to abnormal top-down perceptual modulation.
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Affiliation(s)
- Alberto Cucca
- Department of Life Sciences, University of Trieste, Trieste, Italy
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
| | | | - Mauro Catalan
- Neurology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Marco Liccari
- Neurology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Lucia Antonutti
- Neurology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Valentina Cenacchi
- Neurology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Sophie Rangan
- Neurology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Serena Mingolo
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Carmelo Crisafulli
- Nuclear Medicine, Imaging Diagnostic Department University Hospital and Health Services of Trieste, Trieste, Italy
| | - Franca Dore
- Nuclear Medicine, Imaging Diagnostic Department University Hospital and Health Services of Trieste, Trieste, Italy
| | - Mauro Murgia
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Tiziano Agostini
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Neurology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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