1
|
Non-visual hallucinations in Parkinson's disease: a systematic review. J Neurol 2023; 270:2857-2889. [PMID: 36702960 DOI: 10.1007/s00415-022-11545-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Non-visual hallucinations in Parkinson's disease (PD) can be prevalent and distressing. Most existing research has however, focused on visual hallucinations as well as related risk factors. The current study thus conducted a systematic review to collate existing evidence on non-visual hallucinations in PD, focusing on their prevalence, phenomenology, and clinical-cognitive correlates. METHODS Ninety-one relevant studies were included from a systematic search across PsycINFO APA, PubMed, and Web of Science, for peer-reviewed publications in the English language, from 1970 to the present. These comprised a mix of case (30 studies; n = 56) and group design (62 studies; n = 7346) studies, divided into three somewhat overlapping collections to address our three research foci. RESULTS Prevalence estimates for hallucinations were: auditory 1.5-72.0%, olfactory 1.6-21.0%, somatic-tactile 0.4-22.5%, gustatory 1.0-15.0%, and sensed presence 0.9-73.3%. Phenomenological inquiries revealed descriptions of vivid, consuming events replete with elaborate detail, adversely affecting PD patients in different ways. Overt experiences of multisensory hallucinations were also highly variable (0.4-80%) but exceedingly common, reported by almost half of the 45 included prevalence studies. There was some evidence for modality-specific hallucination predictors, but this was largely tentative, pending robust replication. CONCLUSIONS Marked prevalence figures coupled with phenomenological descriptions implicating distress denote that non-visual and multisensory hallucinations in PD are of clinical significance. More direct research and clinical attention need to be devoted to the study and management of such hallucinatory experiences.
Collapse
|
2
|
Chendo I, Silva C, Duarte GS, Prada L, Voon V, Ferreira JJ. Frequency and Characteristics of Psychosis in Parkinson's Disease: A Systematic Review and Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2022; 12:85-94. [PMID: 34806620 DOI: 10.3233/jpd-212930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Psychotic symptoms are highly frequent in Parkinson's disease (PD) patients and are associated with poor prognosis. They include hallucinations, delusions, and minor psychotic phenomena, including sense of presence, passage hallucinations, and illusions. OBJECTIVE To evaluate the frequency of psychosis in PD patients. METHODS A systematic review and meta-analysis of clinical trials, prospective and retrospective cohort studies, case-control studies, and cross-sectional studies reporting the frequency of psychosis, hallucinations, and delusions in PD. RESULTS Electronic database search wielded 3536 articles, an additional 91 were identified through citation chaining. Of these, 163 were fully inspected, 57 removed, and 106 included as relevant for neuropsychiatric events frequency, with 32 meeting our inclusion criteria (psychosis and/or specific psychotic phenomena). The pooled frequency of psychosis was 20.7% (95% CI 14.5 to 28.6; I2 = 94%, 15 studies; combined n = 2919). None of the pre-defined meta-regressions or subgroup analyses were statistically significant or helped explain the statistical heterogeneity. The pooled frequency of any form of hallucination was 21.6% (95% CI 14.7 to 30.6; I2 = 95%; 18 studies; combined n = 3161). Duration of PD at baseline and mean baseline Hoehn & Yahr stage helped explain the statistical heterogeneity in the meta-analysis of hallucinations. CONCLUSION Based on the available evidence, around a fifth of PD patients experience psychosis or hallucinations. The risk of developing hallucinations is likely moderated by the disease duration, Hoehn & Yahr stage, and the cognitive status.
Collapse
Affiliation(s)
- Ines Chendo
- Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal
- Clínica Universitária de Psiquiatria e de Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- CNS - Campus Neurológico, Torres Vedras, Portugal
| | - Carlos Silva
- Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal
| | - Gonçalo S Duarte
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal
| | - Luisa Prada
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Joaquim J Ferreira
- CNS - Campus Neurológico, Torres Vedras, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal
| |
Collapse
|
3
|
Cognitive and visual processing performance in Parkinson's disease patients with vs without visual hallucinations: A meta-analysis. Cortex 2022; 146:161-172. [PMID: 34864505 DOI: 10.1016/j.cortex.2021.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/27/2021] [Accepted: 11/02/2021] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Cognitive and visual impairments in Parkinson's Disease Psychosis (PDP) raise the question of whether a specific profile of impaired cognition and visual function is linked to vulnerability to visual hallucinations (VHs). Previous studies have limited sample sizes and only included a sub-sample of tests. This is the first meta-analysis quantifying visuo-cognitive impairments in PDP patients across a spectrum of tests and taking into account potential confounding factors such as levodopa medication, illness duration and general cognitive ability. OBJECTIVE Compare visual processing and cognitive performance between PD patients with and without VHs (PDVH and PDnoVH). METHODS Four databases (PubMed, PsychINFO, Scopus, WebOfScience) were searched for studies on visual and/or cognitive performance of PDnoVH and PDVH published up to 02/2020. For each task, means and SDs were extracted and standardized-mean-differences (SMDs) between-groups calculated. Effect-sizes (Hedges' g) were calculated for all comparisons and synthesized in random-effects meta-analyses with robust-variance-estimation (accounting for multiple correlated measures within each study per cognitive/visual domain). Publication bias was assessed with funnel plots and Egger intercept. RESULTS N = 99 studies including 2508 PDVH patients (mean age 68.4 years) and 5318 PDnoVH (mean age 66.4 years) were included in the seven meta-analyses. PDVH patients performed worse than PDnoVH across all measures of cognition and visual processing, with the greatest between-group effect-sizes in executive functions, attention, episodic memory and visual processing. Study characteristics were not significantly associated with between-group differences in the domains investigated. Age-differences were significantly associated with performance differences in general cognition, working memory and executive functions. CONCLUSION Models of PDVH need to incorporate a wider range of cognitive and processing domains than currently included. There is a need for studies disentangling the temporal relationship between cognitive/visual deficits and VHs as early identification of risk before the onset of VHs could mitigate later outcomes such as progression to dementia.
Collapse
|
4
|
Pezzoli S, Sánchez-Valle R, Solanes A, Kempton MJ, Bandmann O, Shin JI, Cagnin A, Goldman JG, Merkitch D, Firbank MJ, Taylor JP, Pagonabarraga J, Kulisevsky J, Blanc F, Verdolini N, Venneri A, Radua J. Neuroanatomical and cognitive correlates of visual hallucinations in Parkinson's disease and dementia with Lewy bodies: Voxel-based morphometry and neuropsychological meta-analysis. Neurosci Biobehav Rev 2021; 128:367-382. [PMID: 34171324 DOI: 10.1016/j.neubiorev.2021.06.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/30/2021] [Accepted: 06/19/2021] [Indexed: 02/04/2023]
Abstract
Visual hallucinations (VH) are common in Parkinson's disease and dementia with Lewy bodies, two forms of Lewy body disease (LBD), but the neural substrates and mechanisms involved are still unclear. We conducted meta-analyses of voxel-based morphometry (VBM) and neuropsychological studies investigating the neuroanatomical and cognitive correlates of VH in LBD. For VBM (12 studies), we used Seed-based d Mapping with Permutation of Subject Images (SDM-PSI), including statistical parametric maps for 50% of the studies. For neuropsychology (35 studies), we used MetaNSUE to consider non-statistically significant unreported effects. VH were associated with smaller grey matter volume in occipital, frontal, occipitotemporal, and parietal areas (peak Hedges' g -0.34 to -0.49). In patients with Parkinson's disease without dementia, VH were associated with lower verbal immediate memory performance (Hedges' g -0.52). Both results survived correction for multiple comparisons. Abnormalities in these brain regions might reflect dysfunctions in brain networks sustaining visuoperceptive, attention, and executive abilities, with the latter also being at the basis of poor immediate memory performance.
Collapse
Affiliation(s)
- Stefania Pezzoli
- Department of Neuroscience, University of Sheffield, Sheffield, UK; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA; Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK
| | - Oliver Bandmann
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Jennifer G Goldman
- Shirley Ryan Ability Lab Parkinson's Disease and Movement Disorders program, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Departments of Physical Medicine and Neurology, Chicago, IL, USA
| | - Doug Merkitch
- Shirley Ryan Ability Lab Parkinson's Disease and Movement Disorders program, Chicago, IL, USA
| | - Michael J Firbank
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain; Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain; Institut d'Investigacions Biomèdiques - Sant Pau (IIB-Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain; Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain; Institut d'Investigacions Biomèdiques - Sant Pau (IIB-Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Frederic Blanc
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; Geriatrics Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France; Team IMIS/Neurocrypto, French National Center for Scientific Research (CNRS), ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - Norma Verdolini
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, UK; Department of Life Sciences, Brunel University London, London, UK
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
5
|
Reckner E, Cipolotti L, Foley JA. Presence phenomena in parkinsonian disorders: Phenomenology and neuropsychological correlates. Int J Geriatr Psychiatry 2020; 35:785-793. [PMID: 32250497 DOI: 10.1002/gps.5303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/12/2020] [Accepted: 03/28/2020] [Indexed: 01/29/2023]
Abstract
INTRODUCTION The feeling of a presence that occurs in the absence of objectively identifiable stimuli is common in parkinsonian disorders. Although previously considered benign and insignificant, recent evidence suggests that presence phenomena may act as the gateway to more severe hallucinations and dementia. Despite this, we still know relatively little about these phenomena. OBJECTIVE To examine parkinsonian disorder patients' subjective experience of presence phenomena, and retrospectively analyse their cognitive correlates, in order to elucidate the emergence of information processing deficits in parkinsonian disorders. METHODS/DESIGN 25 patients who endorsed presence phenomena were asked to complete a semi-structured interview about their experiences. The cognitive profiles of these patients were then compared to those of age- and education-matched patients who denied presence phenomena. RESULTS Patients described the presence as mostly that of an unknown human with neutral valence. Patients who described it as unpleasant were noted to also demonstrate elevated anxiety. Patients who identified the presence as a known person, described it as touching them, or interacted with the presence emotionally or physically demonstrated reduced insight. Patients with presence phenomena demonstrated more frequent impairments in visual processing, executive function and speed of processing. CONCLUSIONS Presence phenomena occur in the company of advancing cognitive impairment and involvement of the posterior cortical functions. Initially encountered as a neutral spatial skeleton, the experience is then shaped by the patient's affective state and level of insight.
Collapse
Affiliation(s)
- Erin Reckner
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Lisa Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,Dipartimento di Scienze Psicologiche, Pedagogiche e della Formazione, Università degli Studi di Palermo, Palermo, Italy
| | - Jennifer A Foley
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.,UCL Institute of Neurology, Queen Square, London, UK
| |
Collapse
|
6
|
Abstract
Parkinson disease has historically been conceptualized as a movement disorder. In recent decades, nonmotor and neuropsychiatric symptoms have become increasingly recognized as being of paramount importance for patients with Parkinson disease. Neuropsychiatric phenomena dominate the course of the other major Lewy body disease, dementia with Lewy bodies. In this review, we survey the clinical relevance of nonmotor and neuropsychiatric symptoms to the heterogeneous presentations of Lewy body disease and their significance to ongoing research in this area. We consider how the nature of Lewy body neuropathology may help explicate the basis of nonmotor and neuropsychiatric symptoms in these two disorders.
Collapse
Affiliation(s)
- Jared T Hinkle
- Medical Scientist Training Program, Johns Hopkins School of Medicine, 1830 E Monument St, Baltimore, MD 21205, USA; Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 300, Baltimore, MD 21287, USA
| | - Gregory M Pontone
- Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 600 North Wolfe Street, Phipps 300, Baltimore, MD 21287, USA; Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
7
|
Eversfield CL, Orton LD. Auditory and visual hallucination prevalence in Parkinson's disease and dementia with Lewy bodies: a systematic review and meta-analysis. Psychol Med 2019; 49:2342-2353. [PMID: 30474581 PMCID: PMC6763539 DOI: 10.1017/s0033291718003161] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 09/21/2018] [Accepted: 10/04/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Non-motor features of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), such as auditory hallucinations (AH), contribute to disease burden but are not well understood. METHODS Systematic review and random-effects meta-analyses of studies reporting AH associated with PD or DLB. Prevalence of visual hallucinations (VH) in identified studies meeting eligibility criteria were included in meta-analyses, facilitating comparison with AH. Synthesis of qualitative descriptions of AH was performed. PubMed, Web of Science and Scopus databases were searched for primary journal articles, written in English, published from 1970 to 2017. Studies reporting AH prevalence in PD or DLB were screened using PRISMA methods. RESULTS Searches identified 4542 unique studies for consideration, of which, 26 met inclusion criteria. AH pooled prevalence in PD was estimated to be 8.9% [95% confidence interval (CI) 5.3-14.5], while in DLB was estimated to be 30.8% (±23.4 to 39.3). Verbal hallucinations, perceived as originating outside the head, were the most common form of AH. Non-verbal AH were also common while musical AH were rare. VH were more prevalent, with an estimated pooled prevalence in PD of 28.2% (±19.1 to 39.5), while in DLB they were estimated to be 61.8% (±49.1 to 73.0). Meta-regression determined that the use of validated methodologies to identify hallucinations produced higher prevalence estimates. CONCLUSIONS AH and VH present in a substantial proportion of PD and DLB cases, with VH reported more frequently in both conditions. Both AH and VH are more prevalent in DLB than PD. There is a need for standardised use of validated methods to detect and monitor hallucinations.
Collapse
Affiliation(s)
- Charlotte Louise Eversfield
- School of Healthcare Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK
| | - Llwyd David Orton
- School of Healthcare Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK
| |
Collapse
|
8
|
Dauwan M, Hoff JI, Vriens EM, Hillebrand A, Stam CJ, Sommer IE. Aberrant resting-state oscillatory brain activity in Parkinson's disease patients with visual hallucinations: An MEG source-space study. Neuroimage Clin 2019; 22:101752. [PMID: 30897434 PMCID: PMC6425119 DOI: 10.1016/j.nicl.2019.101752] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/18/2019] [Accepted: 03/09/2019] [Indexed: 12/31/2022]
Abstract
To gain insight into possible underlying mechanism(s) of visual hallucinations (VH) in Parkinson's disease (PD), we explored changes in local oscillatory activity in different frequency bands with source-space magnetoencephalography (MEG). Eyes-closed resting-state MEG recordings were obtained from 20 PD patients with hallucinations (Hall+) and 20 PD patients without hallucinations (Hall-), matched for age, gender and disease severity. The Hall+ group was subdivided into 10 patients with VH only (unimodal Hall+) and 10 patients with multimodal hallucinations (multimodal Hall+). Subsequently, neuronal activity at source-level was reconstructed using an atlas-based beamforming approach resulting in source-space time series for 78 cortical and 12 subcortical regions of interest in the automated anatomical labeling (AAL) atlas. Peak frequency (PF) and relative power in six frequency bands (delta, theta, alpha1, alpha2, beta and gamma) were compared between Hall+ and Hall-, unimodal Hall+ and Hall-, multimodal Hall+ and Hall-, and unimodal Hall+ and multimodal Hall+ patients. PF and relative power per frequency band did not differ between Hall+ and Hall-, and multimodal Hall+ and Hall- patients. Compared to the Hall- group, unimodal Hall+ patients showed significantly higher relative power in the theta band (p = 0.005), and significantly lower relative power in the beta (p = 0.029) and gamma (p = 0.007) band, and lower PF (p = 0.011). Compared to the unimodal Hall+, multimodal Hall+ showed significantly higher PF (p = 0.007). In conclusion, a subset of PD patients with only VH showed slowing of MEG-based resting-state brain activity with an increase in theta activity, and a concomitant decrease in beta and gamma activity, which could indicate central cholinergic dysfunction as underlying mechanism of VH in PD. This signature was absent in PD patients with multimodal hallucinations.
Collapse
Affiliation(s)
- M Dauwan
- Neuroimaging Center, University Medical Center Groningen, University of Groningen, Neuroimaging Center 3111, Antonius Deusinglaan 2, 9713 AW Groningen, the Netherlands; Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Neuroscience Campus Amsterdam, Postbus 7057, 1007 MB Amsterdam, the Netherlands; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, the Netherlands.
| | - J I Hoff
- Department of Neurology, St. Antonius Ziekenhuis, Nieuwegein, Utrecht, the Netherlands
| | - E M Vriens
- Department of Neurology, Diakonessenhuis Utrecht, the Netherlands
| | - A Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Neuroscience Campus Amsterdam, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - C J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Neuroscience Campus Amsterdam, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - I E Sommer
- Neuroimaging Center, University Medical Center Groningen, University of Groningen, Neuroimaging Center 3111, Antonius Deusinglaan 2, 9713 AW Groningen, the Netherlands; Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Norway
| |
Collapse
|
9
|
Getz SJ, Levin B. Cognitive and Neuropsychiatric Features of Early Parkinson's Disease. Arch Clin Neuropsychol 2018; 32:769-785. [PMID: 29077803 DOI: 10.1093/arclin/acx091] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/05/2017] [Indexed: 12/31/2022] Open
Abstract
The clinical definition of Parkinson's disease (PD) is based on cardinal motor features including bradykinesia as well as an additional symptom of tremor, postural instability, or rigidity. Evidence from neuropathological, imaging, and clinical research suggests a premotor, early phase of PD pathology. Further understanding of the earliest biomarkers of PD is crucial for the development of neuroprotective, disease modifying, cognitive, and psychiatric interventions. Recent research has explored early non-motor markers of PD pathology. This issue is especially timely as the International Parkinson and Movement Disorder Society has recently provided a research definition for prodromal PD which includes combinations of prodromal markers and risk factors aimed at identifying target populations for disease-prevention trials. In this review of early PD, we will outline early non-motor symptoms, early cognitive and neuropsychiatric features, neuropsychological assessment strategies, emerging evidence for early biomarkers, and treatment recommendations.
Collapse
Affiliation(s)
- Sarah J Getz
- Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
10
|
Ffytche DH, Creese B, Politis M, Chaudhuri KR, Weintraub D, Ballard C, Aarsland D. The psychosis spectrum in Parkinson disease. Nat Rev Neurol 2017; 13:81-95. [PMID: 28106066 PMCID: PMC5656278 DOI: 10.1038/nrneurol.2016.200] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication. We discuss recent developments, including recognition of an increase in the prevalence of psychosis with disease duration, addition of new visual symptoms to the psychosis continuum, and identification of frontal executive, visual perceptual and memory dysfunction at different disease stages. In addition, we highlight novel risk factors - for example, autonomic dysfunction - that have emerged from prospective studies, structural MRI evidence of frontal, parietal, occipital and hippocampal involvement, and approval of pimavanserin for the treatment of PD psychosis. The accumulating evidence raises novel questions and directions for future research to explore the clinical management and biomarker potential of PD psychosis.
Collapse
Affiliation(s)
- Dominic H Ffytche
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology &Neuroscience, King's College London, UK. De Crespigny Park, London SE5 8AF, UK
| | - Byron Creese
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- University of Exeter Medical School, University of Exeter, EX1 2LU, UK
| | - Marios Politis
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology &Neuroscience, King's College London, 125 Coldharbour Lane, London SE5 9NU, UK
| | - K Ray Chaudhuri
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, National Parkinson Foundation Centre of Excellence, King's College London/Kings College Hospital, 5 Cutcombe Road, London SE5 9RT, UK
| | - Daniel Weintraub
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania 3615 Chestnut Street, #330, Philadelphia, Pennsylvania 19104, USA
- Parkinson's Disease and Mental Illness Research, Education and Clinical Centres (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Centre 3900 Woodland Avenue, Philadelphia, Pennsylvania 19104, USA
| | - Clive Ballard
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- University of Exeter Medical School, University of Exeter, EX1 2LU, UK
| | - Dag Aarsland
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology &Neuroscience, King's College London, UK. De Crespigny Park, London SE5 8AF, UK
| |
Collapse
|
11
|
ffytche DH, Aarsland D. Psychosis in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:585-622. [DOI: 10.1016/bs.irn.2017.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
12
|
Lenka A, Hegde S, Arumugham SS, Pal PK. Pattern of cognitive impairment in patients with Parkinson's disease and psychosis: A critical review. Parkinsonism Relat Disord 2016; 37:11-18. [PMID: 28057432 DOI: 10.1016/j.parkreldis.2016.12.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 12/11/2016] [Accepted: 12/26/2016] [Indexed: 01/29/2023]
Abstract
Psychosis is one of the debilitating non-motor symptoms (NMS) of Parkinson's disease (PD). Cognitive impairment is considered to be a risk factor for emergence of psychosis in PD. Early detection of relevant cognitive impairment may serve as a predictor for development of psychosis, with implications for prevention and early intervention. However, the exact pattern of cognitive impairment associated with psychosis is not clear. In this article, we aim to critically review the literature on case-control studies in PD patients with and without psychosis in order to understand the pattern of cognitive impairment in those with psychosis. Majority of studies conducted till date have focused on executive and visuospatial functions. Despite some inconsistencies, most of the studies found significant impairment in these domains in PD patients with psychosis compared to those without psychosis. Studies assessing for other cognitive functions such as attention, language and memory in PD patients have also found worse performance in those with psychosis. Although there is enough evidence to suggest that PD patients with psychosis have poor cognitive functioning, it is unclear if these deficits are generalized or specific. The available evidence, which is primarily in the form of cross-sectional studies assessing for specific cognitive deficits, is not adequate to indicate a clear demarcating pattern of cognitive deficits, which differentiates PD patients with and without psychosis. Longitudinal studies with extensive cognitive assessment are warranted.
Collapse
Affiliation(s)
- Abhishek Lenka
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Shantala Hegde
- Department of Clinical Psychology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
| | - Shyam Sundar Arumugham
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| |
Collapse
|
13
|
Hallucinations in schizophrenia and Parkinson's disease: an analysis of sensory modalities involved and the repercussion on patients. Sci Rep 2016; 6:38152. [PMID: 27905557 PMCID: PMC5131286 DOI: 10.1038/srep38152] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/04/2016] [Indexed: 01/29/2023] Open
Abstract
Hallucinations have been described in various clinical populations, but they are neither disorder nor disease specific. In schizophrenia patients, hallucinations are hallmark symptoms and auditory ones are described as the more frequent. In Parkinson's disease, the descriptions of hallucination modalities are sparse, but the hallucinations do tend to have less negative consequences. Our study aims to explore the phenomenology of hallucinations in both hallucinating schizophrenia patients and Parkinson's disease patients using the Psycho-Sensory hAllucinations Scale (PSAS). The main objective is to describe the phenomena of these clinical symptoms in those two specific populations. Each hallucinatory sensory modality significantly differed between Parkinson's disease and schizophrenia patients. Auditory, olfactory/gustatory and cœnesthetic hallucinations were more frequent in schizophrenia than visual hallucinations. The guardian angel item, usually not explored in schizophrenia, was described by 46% of these patients. The combination of auditory and visual hallucinations was the most frequent for both Parkinson's disease and schizophrenia. The repercussion index summing characteristics of each hallucination (frequency, duration, negative aspects, conviction, impact, control and sound intensity) was always higher for schizophrenia. A broader view including widespread characteristics and interdisciplinary works must be encouraged to better understand the complexity of the process involved in hallucinations.
Collapse
|
14
|
Lenka A, Hegde S, Jhunjhunwala KR, Pal PK. Interactions of visual hallucinations, rapid eye movement sleep behavior disorder and cognitive impairment in Parkinson's disease: A review. Parkinsonism Relat Disord 2015; 22:1-8. [PMID: 26639978 DOI: 10.1016/j.parkreldis.2015.11.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/09/2015] [Accepted: 11/17/2015] [Indexed: 01/03/2023]
Abstract
Patients with Parkinson's disease may develop various non-motor symptoms during the course of the illness. Visual hallucinations (VH) and cognitive impairment (CI) are two common non-motor symptoms of Parkinson's disease. Studies have reported association of both VH and CI with presence of rapid eye movement sleep behavior disorder (RBD). Presence of visual hallucinations and cognitive impairment has been described as risk factors for emergence of each other. There is marked overlap in the risk factors for development of RBD, VH and CI in patients with PD. Results of clinical and epidemiological studies as well as studies based on neuroimaging, electrophysiology especially transcranial magnetic stimulation and neuropsycholgical evaluations in PD patients have suggested presence of certain common neurobiological process leading to emergence of RBD, VH and CI. Structural neuroimaging studies using voxel-based morphometry have often reported grey matter atrophy of hippocampus and parahippocampal cortices in PD patients with RBD, VH and CI. Cholinergic dysfunction is common in PD patients with RBD, VH and CI. This review explores the complex interactions of RBD, VH and CI in patients with PD and their potential implications.
Collapse
Affiliation(s)
- Abhishek Lenka
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Shantala Hegde
- Department of Clinical Psychology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Ketan Ramakant Jhunjhunwala
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
| |
Collapse
|
15
|
Pérez-Pérez J, Pagonabarraga J, Fernández-Bobadilla R, Kulisevsky J. "String Hallucinations": Multimodal Tactile and Visual Hallucinations in Parkinson's Disease. Mov Disord Clin Pract 2015; 3:180-183. [PMID: 30713910 DOI: 10.1002/mdc3.12252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/13/2015] [Accepted: 07/19/2015] [Indexed: 11/12/2022] Open
Abstract
The aim of this work was to report on 7 patients presenting a distinctive form of multimodal (tactile and visual) hallucinations for which the term "string hallucinations" is proposed. Having observed a patient interacting with imaginary strips of skin in his hands at our movement disorders unit, we prospectively studied PD patients and caregivers over a 6-month period using a semistructured interview addressed to this particular phenomenon. Demographic characteristics as well as cognitive and motor function were assessed. A total of 7 of 164 PD patients (4.3%) observed during the study period had string hallucinations. One patient was cognitively intact and the other 6 had some degree of cognitive impairment. Common to the phenomenology of the hallucinations was the unpleasant feeling and vision of threads emerging from the subjects' hands. Patients interacted with these "threads," trying to remove them from their hands. Our study identifies a previously undescribed type of hallucinations in PD, characterized by a complex pattern of multimodal tactile and visual hallucinations.
Collapse
Affiliation(s)
- Jesús Pérez-Pérez
- Movement Disorders Unit Neurology Department Hospital de la Santa Creu i Sant Pau. Instituto de investigación biomédica Sant Pau Barcelona Spain.,Universitat Autònoma de Barcelona Barcelona Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit Neurology Department Hospital de la Santa Creu i Sant Pau. Instituto de investigación biomédica Sant Pau Barcelona Spain.,Universitat Autònoma de Barcelona Barcelona Spain
| | - Ramón Fernández-Bobadilla
- Movement Disorders Unit Neurology Department Hospital de la Santa Creu i Sant Pau. Instituto de investigación biomédica Sant Pau Barcelona Spain.,Universitat Autònoma de Barcelona Barcelona Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit Neurology Department Hospital de la Santa Creu i Sant Pau. Instituto de investigación biomédica Sant Pau Barcelona Spain.,Universitat Autònoma de Barcelona Barcelona Spain.,Centro Investigación Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED) Barcelona Spain.,Universitat Oberta de Catalunya Barcelona Spain
| |
Collapse
|
16
|
Wakamori T, Agari T, Yasuhara T, Kameda M, Kondo A, Shinko A, Sasada S, Sasaki T, Furuta T, Date I. Cognitive functions in Parkinson's disease: Relation to disease severity and hallucination. Parkinsonism Relat Disord 2014; 20:415-20. [DOI: 10.1016/j.parkreldis.2014.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 12/16/2013] [Accepted: 01/04/2014] [Indexed: 10/25/2022]
|
17
|
Rana AQ, Siddiqui I, Zangeneh M, Fattah A, Awan N, Yousuf MS. Predicting treatment-seeking for visual hallucinations among Parkinson's disease patients. Psychiatry Clin Neurosci 2013; 67:509-16. [PMID: 23992392 DOI: 10.1111/pcn.12083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/07/2013] [Accepted: 07/09/2013] [Indexed: 11/30/2022]
Abstract
AIM While much research has been conducted towards understanding the basis of visual hallucinations in Parkinson's disease, little has focused on characterizing the content and patients' emotional experience. These factors are likely very influential on a patient's decision to seek treatment, a critical aspect of any symptom from the clinical perspective. METHODS A retrospective chart analysis was performed on Parkinson's disease patients seen in a community-based Parkinson's Disease and Movement Disorder Clinic between 2005 and 2010. RESULTS The study consisted of 334 patients with Parkinson's disease, among whom 10.5% had visual hallucinations. Hoehn and Yahr disease stage (P = 0.001), concurrent presence of dementia (P = 0.001),and sex (P = 0.031) were significant onset predictors. The most significant determinant of treatment-seeking was emotional reaction, namely whether hallucinations were bothersome (P = 0.008). However, the specific type of content during hallucinations was sometimes more influential and contradicted emotional response. CONCLUSION Although treatment-seeking can be predicted by how individuals feel about hallucinations, a patient's decision may not be logically consistent. We suggest that clinicians offer treatment based on patients' recollections and opinions.
Collapse
Affiliation(s)
- Abdul Qayyum Rana
- Parkinson's Clinic of Eastern Toronto and Movement Disorders Centre, Toronto, Canada
| | | | | | | | | | | |
Collapse
|
18
|
Larøi F, Sommer IE, Blom JD, Fernyhough C, ffytche DH, Hugdahl K, Johns LC, McCarthy-Jones S, Preti A, Raballo A, Slotema CW, Stephane M, Waters F. The characteristic features of auditory verbal hallucinations in clinical and nonclinical groups: state-of-the-art overview and future directions. Schizophr Bull 2012; 38:724-33. [PMID: 22499783 PMCID: PMC3406519 DOI: 10.1093/schbul/sbs061] [Citation(s) in RCA: 204] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite a growing interest in auditory verbal hallucinations (AVHs) in different clinical and nonclinical groups, the phenomenological characteristics of such experiences have not yet been reviewed and contrasted, limiting our understanding of these phenomena on multiple empirical, theoretical, and clinical levels. We look at some of the most prominent descriptive features of AVHs in schizophrenia (SZ). These are then examined in clinical conditions including substance abuse, Parkinson's disease, epilepsy, dementia, late-onset SZ, mood disorders, borderline personality disorder, hearing impairment, and dissociative disorders. The phenomenological changes linked to AVHs in prepsychotic stages are also outlined, together with a review of AVHs in healthy persons. A discussion of key issues and future research directions concludes the review.
Collapse
Affiliation(s)
- Frank Larøi
- Department of Psychology, FAPSE, University of Liège, 4000 Liège, Belgium.
| | - Iris E. Sommer
- Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan Dirk Blom
- Parnassia Bavo Group, The Hague, the Netherlands,Department of Psychiatry, University of Groningen, Groningen, the Netherlands
| | | | | | - Kenneth Hugdahl
- Department of Biological Psychology, University of Bergen, Bergen, Norway,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Louise C. Johns
- Department of Psychology, Institute of Psychiatry, King’s College, London, UK
| | - Simon McCarthy-Jones
- ARC Center of Excellence in Cognition and its Disorders, Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Antonio Preti
- Department of Psychology, University of Cagliari, Cagliari, Italy,Centro Medico Genneruxi, Cagliari, Italy
| | | | | | - Massoud Stephane
- VA Medical Center, Department of Psychiatry at the University of Minnesota, Minneapolis, MN
| | - Flavie Waters
- Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, Perth, Australia,School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Perth, Australia
| |
Collapse
|