Reality monitoring and visual hallucinations in Parkinson’s disease

Barnes, Jim; Boubert, Laura; Harris, Judy; Lee, A.; David, Anthony S.

doi:10.1016/s0028-3932(02)00182-3

Cited by 168 publications

(141 citation statements)

References 64 publications

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“…Until recently, object recognition has not been well studied in PD. Studies using measures such as the Vision Object and Space Perception battery have shown inconsistent findings 36, 37. Recognition of embedded figures may be affected,13 and emotion recognition, a specialized form of object recognition, is impaired 14.…”

Section: Discussionmentioning

confidence: 99%

Assessing cognitive dysfunction in Parkinson's disease: An online tool to detect visuo‐perceptual deficits

et al. 2018

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Background: People with Parkinson's disease (PD) who develop visuo‐perceptual deficits are at higher risk of dementia, but we lack tests that detect subtle visuo‐perceptual deficits and can be performed by untrained personnel. Hallucinations are associated with cognitive impairment and typically involve perception of complex objects. Changes in object perception may therefore be a sensitive marker of visuo‐perceptual deficits in PD. Objective: We developed an online platform to test visuo‐perceptual function. We hypothesised that (1) visuo‐perceptual deficits in PD could be detected using online tests, (2) object perception would be preferentially affected, and (3) these deficits would be caused by changes in perception rather than response bias. Methods: We assessed 91 people with PD and 275 controls. Performance was compared using classical frequentist statistics. We then fitted a hierarchical Bayesian signal detection theory model to a subset of tasks. Results: People with PD were worse than controls at object recognition, showing no deficits in other visuo‐perceptual tests. Specifically, they were worse at identifying skewed images (P < .0001); at detecting hidden objects (P = .0039); at identifying objects in peripheral vision (P < .0001); and at detecting biological motion (P = .0065). In contrast, people with PD were not worse at mental rotation or subjective size perception. Using signal detection modelling, we found this effect was driven by change in perceptual sensitivity rather than response bias. Conclusions: Online tests can detect visuo‐perceptual deficits in people with PD, with object recognition particularly affected. Ultimately, visuo‐perceptual tests may be developed to identify at‐risk patients for clinical trials to slow PD dementia. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionmentioning

confidence: 99%

Assessing cognitive dysfunction in Parkinson's disease: An online tool to detect visuo‐perceptual deficits

et al. 2018

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“…Overall, studies have found greater impairment in visuospatial and visuoperceptual function in PD patients with hallucinations. 24,[29][30][31][32][33] In addition to visual processing impairment, PD patients with visual hallucinations have reduced visual acuity compared with those without psychosis. 10,34 Altogether, impairments in visual acuity and visual processing in PD with hallucinations indicate that visual deficits contribute to the generation of visual hallucinations.…”

Section: Cognitive and Visual Impairmentmentioning

confidence: 99%

Risk Factors for Psychosis in Parkinson’s Disease

Barrett

2017

US Endocrinology

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Psychosis is a characteristic neuropsychiatric symptom of Parkinson's disease (PD) that is common and associated with worse outcomes. The purpose of this article is to review identified risk factors for visual hallucinations in PD, the most common manifestation of psychosis. With the possible exception of dopamine agonists, antiparkinsonian medications are only considered modifiers of psychosis in PD. Dementia in PD has consistently been shown to be associated with psychosis, and executive dysfunction and impairment in visual processing appear to play a role in its pathogenesis. The association of psychosis with disorders of sleep-wake dysregulation and autonomic dysfunction supports the involvement of brainstem dysfunction in PD psychosis. Despite many studies evaluating genetic risk factors for hallucinations, GBA mutations are the only variants consistently reported to be associated with an increased risk of hallucinations in PD. Lastly, psychosis in PD is associated with a more severe disease burden, both related and unrelated to PD pathology. Any explanatory model of psychosis in PD must incorporate pharmacological, neuroanatomic, pathological, and genetic factors before there can be a complete understanding of this common and disabling neuropsychiatric symptom. KeywordsParkinson's disease, psychosis, hallucinations, risk factor, dementia, rapid eye movement (REM) sleep behavior disorder Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. had minor hallucinations prior to PD motor symptom onset.3 In addition to being common, psychosis is also associated with worse outcomes: increased institutionalization, 4 decreased quality of life, 5 and increased mortality. Considering its prevalence and association with worse outcomes, many studies have sought to identify risk factors for psychosis, specifically visual hallucinations. These efforts have contributed to an improved understanding of this disabling neuropsychiatric symptom. Some risk factors, i.e. cognitive impairment and rapid eye movement (REM) sleep behavior disorder (RBD), may be integral to the mechanism by which psychotic symptoms emerge and have contributed to development of explanatory models of psychotic symptoms in PD. Other risk factors likely represent correlations arising from concomitant pathology in areas not involved in psychosis but occurring at a similar disease stage. Lastly, multiple studies have helped to clarify the relationship between antiparkinsonian medications, especially dopaminergic medications, and psychosis in PD.The purpose of this article is to review risk factors fo...

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“…Yra iškelta keletas galimų priežasčių, kodėl vystosi regos haliucinacijos: ilgalaikio dopamino agonistų ir levodopos sukeltas šalutinis poveikis, neuronų, sekretuojančių acetilcholiną, hipofunkcija, serotoninerginių neuronų disfunkcijos (12). Regos haliucinacijos taip pat gali vystytis pagal štai tokią schemą: 1) sumažinamas ir supaprastinamas informacijos apie esamą aplinką kiekis, 2) sutrikęs vidinis gebėjimas stebėti aplinką, 3) silpstanti atmintis, 4) panaudojamos schemos ir vaizdai iš vis dar egzistuojančių prisiminimų ir atminties, kurie tariamai galė-tų užpildyti matomų, tačiau nesuvokiamų dalykų spragas, todėl ligoniams sunku diferencijuoti, ar vaizdas kilo esant aplinkos, ar vidiniam dirginimui (13). Sergant Parkinsono liga haliucinacijos būna sudėtingos.…”

Section: Darbo Uždaviniai Ir Metodikaunclassified