Cognitive correlates of hallucinations and delusions in Parkinson's disease

Factor, Stewart A.; Scullin, Michael K.; Sollinger, Ann; Land, J.O.; Wood-Siverio, Cathy; Zanders, Lavezza; Freeman, Alan; Bliwise, Donald L.; McDonald, William M.; Goldstein, Felicia C.

doi:10.1016/j.jns.2014.10.033

Cited by 57 publications

(52 citation statements)

References 23 publications

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“…Delusions in parkinsonism are less frequently described than PD-ICD, and the prevalence of VHs greatly varies between 2% and 16% of patients, according to different studies,1,77–84 probably due to different disease durations in the described cohorts or because the reported data were not controlled for pharmacological management of psychosis. In this regard, a recent cohort study reported that delusions of sin/guilt or grandiosity were relatively frequent (35% of delusional patient), as well as delusions of reference (30%), while delusions of jealousy were less frequent (13%) 1.…”

Section: Methodsmentioning

confidence: 99%

“…Psychotic symptoms have been reported to occur in ~60% of patients with Parkinson’s disease (PD)1 and are even more common in patients with dementia with Lewy bodies (DLB); for example, visual hallucinations (VHs) and delusions occur in 60% to 70% of DLB patients, respectively 2,3…”

Section: Introductionmentioning

confidence: 99%

“…The result of this approach is that psychosis in PD and parkinsonisms is currently titrated, perhaps simplistically, as the occurrence of just two core symptoms, hallucinations and delusions 1. In contrast, the broader definition provided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ) for psychotic disorder describes psychosis within the classification item schizophrenia spectrum,5 as being characterized by abnormalities in one or more of the following five domains: delusions, hallucinations, but also disorganized thinking, grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…From a historical perspective, the term psychosis has received a number of different definitions, ranging from a broad “impairment that grossly interferes with the capacity to meet ordinary demands of life”,7 “gross impairment in reality testing”8 to the narrow restriction of prominent hallucinations in any modality 1,9…”

Section: Introductionmentioning

confidence: 99%

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Psychosis in parkinsonism: an unorthodox approach

Onofrj

Carrozzino

D’Amico

et al. 2017

NDT

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Psychosis in Parkinson’s disease (PD) is currently considered as the occurrence of hallucinations and delusions. The historical meaning of the term psychosis was, however, broader, encompassing a disorganization of both consciousness and personality, including behavior abnormalities, such as impulsive overactivity and catatonia, in complete definitions by the International Classification of Diseases-10 (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Our review is aimed at reminding that complex psychotic symptoms, including impulsive overactivity and somatoform disorders (the last being a recent controversial entity in PD), were carefully described in postencephalitic parkinsonism (PEP), many decades before dopaminergic treatment era, and are now described in other parkinsonisms than PD. Eminent neuropsychiatrists of the past century speculated that studying psychosis in PEP might highlight its mechanisms in other conditions. Yet, functional assessments were unavailable at the time. Therefore, the second part of our article reviews the studies of neural correlates of psychosis in parkinsonisms, by taking into account both theories on the narrative functions of the default mode network (DMN) and hypotheses on DMN modulation.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Psychosis in parkinsonism: an unorthodox approach

Onofrj

Carrozzino

D’Amico

et al. 2017

NDT

View full text Add to dashboard Cite

show abstract

“…3 As PD progresses, formed visual hallucinations occur with preserved insight (recognition that the experiences are not real). In later PD stages, insight may become lost with the development of false explanations about the experiences (secondary delusions), hallucinations in other sensory modalities (auditory, tactile or olfactory), delusions (eg, themes of guilt or grandiosity 4 ) and misidentification syndromes (eg, the belief that someone familiar has been replaced by an imposter 5 ). Such symptoms are an important treatment priority as they precipitate the move into a care home from living independently 6 7 and impact on quality of life.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for early psychosis in PD: insights from the Parkinson's Progression Markers Initiative

ffytche

Pereira

Ballard

et al. 2017

J Neurol Neurosurg Psychiatry

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Parkinson's Disease (PD) psychosis refers to the spectrum of illusions, formed hallucinations and delusions that occur in PD. Visual hallucinations and illusions are thought to be caused by specific cognitive and higher visual function deficits and patients who develop such symptoms early in the disease course have greater rates of cognitive decline and progression to dementia. To date, no studies have investigated whether such deficits are found prior to the onset of PD psychosis. Here we compare baseline cognitive, biomarker (structural imaging and cerebrospinal fluid) and other PD psychosis risk factor data in patients who go on to develop illusions or hallucinations within 3-4 years of follow-up in the Parkinson's Progression Markers Initiative cohort of newly diagnosed PD. Of n=423 patients with PD, n=115 (27%) reported predominantly illusions with median onset at 19.5 months follow-up. At study entry these patients had reduced CSF amyloid Aß1-42, lower olfaction scores, higher depression scores and increased REM sleep behaviour disorder symptoms compared to patients without early onset PD psychosis but no differences in cognitive, higher visual or structural imaging measures. A subset of patients with early onset formed hallucinations (n=21) had reduced higher visual function at baseline, cortical thinning in parietal, occipital and frontal cortex and reduced hippocampal volume. The findings suggest early onset illusions and formed hallucinations are linked to amyloid pathology in PD and point to a difference in the underlying pathophysiological mechanism of illusions and formed hallucinations, with implications for their respective links to future cognitive decline.

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Domain‐specific cognitive impairment in non‐demented Parkinson's disease psychosis

Hinkle

Perepezko

Bakker

et al. 2017

Int J Geriat Psychiatry

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Introduction In Parkinson's disease (PD), psychosis is associated with cognitive impairment that may be more profound in particular cognitive domains. Our goal was to determine whether psychosis in non‐demented PD participants is associated with domain‐specific cognitive impairment on the Mini‐Mental State Exam (MMSE). Methods The Morris K. Udall Parkinson's Disease Research Center of Excellence Longitudinal Study at Johns Hopkins is a prospective study that was initiated in 1998. Clinical assessments are conducted at two‐year intervals at the Johns Hopkins Hospital. We analyzed data from 137 enrolled participants with idiopathic PD. Psychosis diagnoses were established by psychiatrist interview per DSM‐IV criteria. An incident dementia diagnosis resulted in exclusion from analysis for that evaluation and any future evaluations in that participant. We used logistic regression with generalized estimated equations (GEE) to model the time‐varying relationship between MMSE subscale scores and psychosis, adjusting for potential confounding variables identified through univariable analysis. Results Thirty‐one unique psychosis cases were recorded among non‐demented participants. Fifty total evaluations with psychosis present were analyzed. In multivariable regressions, psychosis was associated with lower scores on the orientation (relative odds ratio, rOR: 0.73; 95% CI: 0.58–0.93; p = 0.011), language (rOR: 0.64; 95% CI: 0.48–0.86; p = 0.003), and intersecting pentagon (rOR: 0.43; 95% CI: 0.20–0.92 p = 0.030) subscales of the MMSE. Conclusions In PD, executive dysfunction, disorientation, and impaired language comprehension may be associated with psychosis. Our findings suggest that the corresponding MMSE subscales may be useful in identifying participants with a higher likelihood of developing psychosis. Copyright © 2017 John Wiley & Sons, Ltd.

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Cognitive correlates of hallucinations and delusions in Parkinson's disease

Cited by 57 publications

References 23 publications

Psychosis in parkinsonism: an unorthodox approach

Psychosis in parkinsonism: an unorthodox approach

Risk factors for early psychosis in PD: insights from the Parkinson's Progression Markers Initiative

Domain‐specific cognitive impairment in non‐demented Parkinson's disease psychosis

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