Seeing Visual Hallucinations with Functional Magnetic Resonance Imaging

Howard, Robert; David, Anthony S.; Woodruff, Peter; Mellers, John D. C.; Wright, I.G.; Brammer, Mick; Bullmore, Edward T.; Williams, Steven

doi:10.1159/000106610

Cited by 30 publications

(20 citation statements)

References 20 publications

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“…28 However, in the current study, DLB subjects without hallucinations, although few in number, had a similar pattern of occipital hypoperfusion as those who had hallucinations. Changes in occipital regions have been associated with hallucinations using functional MRI.…”

supporting

confidence: 39%

Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD

Lobotesis

Fenwick²,

Phipps³

et al. 2001

Neurology

374

219

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supporting

confidence: 39%

Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD

Lobotesis

Fenwick²,

Phipps³

et al. 2001

Neurology

374

219

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“…Other relevant methodological factors include the relative modest sample size and the possibility that the measures of psychopathology were too insensitive for an association to be detected. The findings suggest that functional neuroimaging linked to more sensitive measures of psychopathology might have a more incisive role in the detection of brainbehaviour relationships in dementia, as demonstrated in the study of visual hallucinations [38].…”

Section: Discussionmentioning

confidence: 90%

A Comparison of Medial and Lateral Temporal Lobe Atrophy in Dementia with Lewy Bodies and Alzheimer’s Disease: Magnetic Resonance Imaging Volumetric Study

Barber¹,

McKeith²,

Ballard³

et al. 2001

Dement Geriatr Cogn Disord

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Objectives: To compare medial and lateral temporal lobe atrophy on magnetic resonance imaging (MRI) in dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD), and to examine the relationship between volumetric indices and cognitive and non-cognitive symptoms. Methods: T₁-weighted 1.0-tesla MRI scans were acquired in elderly subjects with DLB (n = 26; mean age = 75.8 years) and AD (n = 22; 77.3 years) and normal controls (n = 26; 76.2 years). MRI-based volume measurements of the hippocampus, parahippocampus, fusiform gyrus, combined inferior and middle temporal gyri, and superior temporal gyrus were acquired. Results: Hippocampal and parahippocampal volumes were significantly larger in subjects with DLB compared to AD. Differences in hippocampal volumes between DLB and AD were observed across the entire length, and in all subjects with dementia there was a loss of hippocampal asymmetry compared to normal controls. Atrophy of temporal lobe structures correlated with memory impairment in both groups, and with age in DLB. There was no association between atrophy and psychotic symptoms in either group. Conclusions: Subjects with DLB and AD have a different pattern of temporal lobe atrophy with the most striking differences relating to medial rather than lateral temporal lobe structures. These structural differences could explain the relative preservation of memory function in DLB compared to AD.

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“…This findings could imply that a “disease” free occipital lobe, presumably with abnormalities located in other brain regions, is necessary to develop psychosis, and that disruption of neural circuits involving visual association areas might prevent hallucinations. Using functional MRI Howard et al 58have suggested that visual hallucinations are, at least in part, located in the primary visual cortex, raising the possibility that strategically located lesions in white matter may disrupt this process. Whether occipital WMHs might suppress visual hallucinations is clearly an area which requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging

Barber

Scheltens²,

Gholkar

et al. 1999

Journal of Neurology, Neurosurgery & Psychiatry

377

279

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Objectives-Alzheimer's disease and vascular dementia are associated with an increase in changes in white matter on MRI. The aims were to investigate whether white matter changes also occur in dementia with Lewy bodies and to examine the relation between white matter lesions and the cognitive and noncognitive features of dementia with Lewy bodies, Alzheimer's disease, and vascular dementia. Methods-Proton density and T2 weighted images were obtained on a 1.0 Tesla MRI scanner in patients with dementia with Lewy bodies (consensus criteria; n=27, mean age=75.9 years), Alzheimer's disease (NINCDS/ADRDA; n=28, mean age=77.4 years), vascular dementia (NINDS/AIREN; n=25, mean age=76.8 years), and normal controls (n=26, mean age=76.2 years). Cognitive function, depressive symptoms, and psychotic features were assessed using a standardised protocol. Periventricular hyperintensities (PVHs), white matter hyperintensities (WMHs) and basal ganglia hyperintensities (BGHs) were visually rated blind to diagnosis using a semiquantitative scale. Results-Periventricular hyperintensities were positively correlated with age and were more severe in all dementia groups than controls. Total deep hyperintensities scores (WMHs plus BGHs) were significantly higher in all dementia groups than controls and higher in patients with vascular dementia than those with dementia with Lewy bodies or Alzheimer's disease. In all patients with dementia, frontal WMHs were associated with higher depression scores and occipital WMHs were associated with an absence of visual hallucinations and delusions. Conclusion-In common with Alzheimer's disease and vascular dementia, PVHs and WMHs were significantly more extensive in dementia with Lewy bodies than in controls. This overlap between diVerent dementias may reflect shared pathological mechanisms. The link between frontal WMHs and depression and the absence of occipital WMHs and psychotic symptoms has important implications for understanding the neurobiological basis of these symptoms. (J Neurol Neurosurg Psychiatry 1999;67:66-72)

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Seeing Visual Hallucinations with Functional Magnetic Resonance Imaging

Cited by 30 publications

References 20 publications

Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD

Occipital hypoperfusion on SPECT in dementia with Lewy bodies but not AD

A Comparison of Medial and Lateral Temporal Lobe Atrophy in Dementia with Lewy Bodies and Alzheimer’s Disease: Magnetic Resonance Imaging Volumetric Study

White matter lesions on magnetic resonance imaging in dementia with Lewy bodies, Alzheimer's disease, vascular dementia, and normal aging

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