Cognitive Correlates of Visual and Minor Hallucinations in Parkinson’s Disease

Lenka, Abhishek; Hegde, Shantala; Arumugham, Shyam Sundar; Singh, Parjit S.; Yadav, Ravi; Pal, Pramod Kumar

doi:10.1017/cjn.2021.507

Cited by 4 publications

(6 citation statements)

References 29 publications

(34 reference statements)

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“…Despite the fact that total mean MoCA scores were relatively similar between patients with and without psychotic manifestations, by analyzing the individual items of MoCA scale, poorer performance in executive, visuospatial, naming and abstraction domains was revealed in patients with PD-associated psychotic symptoms (p < 0.05). This is in accordance with recent literature findings [42]. Visual hallucinations have been associated with multidomain cognitive dysfunction in PD including deficits in executive function [43], sustained attention [44] and visuospatial-perceptual functions [45].…”

Section: Discussionsupporting

confidence: 93%

Comprehensive Evaluation of Psychotic Features and Their Clinical Correlates in Early Parkinson’s Disease

Pachi,

Papadopoulos,

Koros

et al. 2023

JPD

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Background: Some reports suggest that psychotic features may occur in the early stages of Parkinson’s disease (PD), but sensitive tools have not been utilized. Objective: The aim was to evaluate the presence of psychotic symptoms using detailed scales and to assess the association with clinical characteristics. Methods: Healthy controls and patients within three years of PD onset were recruited. Participants were examined for psychotic symptoms using two different instruments: the Comprehensive Assessment of At-Risk Mental States (CAARMS) and a 10 question PD specific psychosis severity scale (10PDQ). In the PD group, medication use, motor and non-motor symptoms were documented. Results: Based on CAARMS and 10PDQ scales, psychotic features were present in 39% (27/70) of patients and 4% (3/74) of controls. The prevalence of passage hallucinations and illusions was significantly higher in PD compared to the control group. The presence of PD-associated psychotic features was not significantly affected by medication, motor severity or global cognitive status. Higher prevalence of overall non-motor manifestations, REM sleep behavior disorder (RBD) and depressive symptoms was significantly associated with the manifestation of psychotic features in PD [(adjusted OR:1.3; 95% CI:1.1-1.6; p = 0.003), (adjusted OR:1.3; 95% CI:1.0-1.6; p = 0.023), and (adjusted OR:1.2; 95% CI:1.0-1.4;p = 0.026)]. Conclusions: Psychotic phenomena mainly of minor nature are highly common in early PD. Cumulative non-motor symptoms, RBD and depressive features are associated with the presence of psychotic symptoms in this non-demented, early-stage PD population. More studies are needed to clarify the mechanisms that contribute to the onset of psychotic features in early PD.

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Section: Discussionsupporting

confidence: 93%

Comprehensive Evaluation of Psychotic Features and Their Clinical Correlates in Early Parkinson’s Disease

Pachi,

Papadopoulos,

Koros

et al. 2023

JPD

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“…Our results are in line with previous studies reporting visuo‐spatial impairments in LBD patients with VH 19,20,22,32 as well as in LBD patients with isolated MVH 38,39 . While previous studies have found visuo‐spatial impairments on other VOSP subtests (Dot Counting 20 and Position Discrimination 19 ), only one other recent study reported finding similar impairments specifically on the VOSP CA in LBD patients with VH 54 .…”

Section: Discussionsupporting

confidence: 93%

“…There is considerable previous evidence of impaired performance of LBD patients with VH on the Stroop test 24,25,30,63,64 . Consistent with our findings, LBD patients with isolated MVH have not been found to be impaired on the Stroop test 38 …”

Section: Discussionsupporting

confidence: 92%

“…17,24 Additionally, functional neuroimaging studies have uncovered a pattern of increased frontal activation coupled with a decreased activation of the visual cortices in response to visual stimuli in LBD patients with chronic VH. 67 This pattern may be indicative of an aberrant interaction of top-down and bottom-up systems, 38,67 thereby providing a contextual framework to interpret the current findings of executive dysfunction in combination with higher-order visual processing impairments in association with CVH.…”

Section: Impairment In Executive Functioningmentioning

confidence: 89%

“…Among those that did make this distinction, many found comparable cognitive performance in patients with MVH and no VH, 34–36 leading to the suggestion that MVH may predate measurable cognitive decline 37 . However, other studies found impairments in attentional, 38 executive functioning, 38 memory 38 and higher‐order visual processing 39 cognitive domains, as well as self‐reports of CI 34 . Since MVH and CVH in LBD are understood to be on a spectrum, 7 it is reasonable to assume that CI in association with VH should follow a similar progressive pattern.…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological correlates of visual hallucinatory phenomena in Lewy body disease

Puntambekar,

A. Foley

2023

Int J Geriat Psychiatry

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Objectives: Visual hallucinations (VH) ranging from minor to complex, are the most common psychiatric feature of Lewy Body Disease (LBD). Despite their high prevalence and poor prognostic implications instigating extensive research, the precise mechanisms underlying VH remain unclear. Cognitive impairment (CI) is a risk factor and a consistent correlate of VH in LBD. To help shed light on their underlying mechanisms, this study investigates the pattern of CI across the spectrum of VH in LBD.Methods: 30 LBD patients with minor VH (MVH), 13 with complex VH (CVH) and 32 without VH were retrospectively compared on the domains of higher-order visual processing, memory, language and executive functioning. The VH groups were further stratified to investigate whether phenomenological subtypes have distinct cognitive correlates.Results: LBD patients with CVH were impaired on the visuo-spatial and executive functioning domains relative to controls. LBD patients with MVH were also impaired on the visuo-spatial domain. No differences emerged in cognitive domains affected between patient groups endorsing specific hallucinatory phenomena. Conclusion:A pattern of CI indicating fronto-subcortical dysfunction in combination with posterior cortical involvement is implicated in the genesis of CVH. Moreover, this posterior cortical dysfunction may precede the occurrence of CVH as indicated by selective visuo-spatial deficits in LBD patients with MVH.

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Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson’s Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis

Liebermann-Jordanidis

Roheger

Boosfeld

et al. 2022

JPD

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Background: Visuo-cognitive impairment is common in patients with Parkinson’s disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson’s disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking. Objective: To review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD. Methods: MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted. Results: 33 studies were included in the systematic review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages. Conclusion: We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided. Registration: https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244

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Cognitive Correlates of Visual and Minor Hallucinations in Parkinson’s Disease

Cited by 4 publications

References 29 publications

Comprehensive Evaluation of Psychotic Features and Their Clinical Correlates in Early Parkinson’s Disease

Comprehensive Evaluation of Psychotic Features and Their Clinical Correlates in Early Parkinson’s Disease

Neuropsychological correlates of visual hallucinatory phenomena in Lewy body disease

Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson’s Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis

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