Significance of visual hallucinations and cerebral hypometabolism in the risk of dementia in Parkinson's disease patients with mild cognitive impairment

Gasca‐Salas, Carmen; Clavero, Pedro; García‐García, David; Obeso, José A.; Rodríguez‐Oroz, María C.

doi:10.1002/hbm.23080

Cited by 42 publications

(42 citation statements)

References 44 publications

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“…Eleven studies were excluded for the following reasons: seven [11–17] provided no critical outcomes or did not have the minimum sample size, two [18, 19] did not include the target population (i.e. PD patients without cognitive impairment), in one [20] the index investigation was proton magnetic resonance spectroscopy, and one [21] focused on cognitive impairment and cerebral hypometabolism in PD patients with mild cognitive impairment (PD-MCI) with and without visual hallucinations. The table showing the full data extraction is available at: https://drive.google.com/file/d/0B0_JB3wzTvbpUHRSZ2NfSVZfVkE/view?usp=sharing.…”

Section: Resultsmentioning

confidence: 99%

Clinical utility of FDG PET in Parkinson’s disease and atypical parkinsonism associated with dementia

Walker

Gandolfo

Orini

et al. 2018

Eur J Nucl Med Mol Imaging

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PurposeThere are no comprehensive guidelines for the use of FDG PET in the following three clinical scenarios: (1) diagnostic work-up of patients with idiopathic Parkinson’s disease (PD) at risk of future cognitive decline, (2) discriminating idiopathic PD from progressive supranuclear palsy, and (3) identifying the underlying neuropathology in corticobasal syndrome.MethodsWe therefore performed three literature searches and evaluated the selected studies for quality of design, risk of bias, inconsistency, imprecision, indirectness and effect size. Critical outcomes were the sensitivity, specificity, accuracy, positive/negative predictive value, area under the receiving operating characteristic curve, and positive/negative likelihood ratio of FDG PET in detecting the target condition. Using the Delphi method, a panel of seven experts voted for or against the use of FDG PET based on published evidence and expert opinion.ResultsOf 91 studies selected from the three literature searches, only four included an adequate quantitative assessment of the performance of FDG PET. The majority of studies lacked robust methodology due to lack of critical outcomes, inadequate gold standard and no head-to-head comparison with an appropriate reference standard. The panel recommended the use of FDG PET for all three clinical scenarios based on nonquantitative evidence of clinical utility.ConclusionDespite widespread use of FDG PET in clinical practice and extensive research, there is still very limited good quality evidence for the use of FDG PET. However, in the opinion of the majority of the panellists, FDG PET is a clinically useful imaging biomarker for idiopathic PD and atypical parkinsonism associated with dementia.

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Section: Resultsmentioning

confidence: 99%

Clinical utility of FDG PET in Parkinson’s disease and atypical parkinsonism associated with dementia

Walker

Gandolfo

Orini

et al. 2018

Eur J Nucl Med Mol Imaging

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“…Occipital hypometabolism is associated with visual hallucinations, which are common in DLB but may also occur in PD. PD patients with visual hallucinations indeed also show occipital hypometabolism and have a higher risk of developing dementia than patients without visual hallucinations (25).…”

Section: Pd and Cognitive Impairmentmentioning

confidence: 94%

Metabolic Imaging in Parkinson Disease

et al. 2016

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This review focuses on recent human 18 F-FDG PET studies in Parkinson disease. First, an overview is given of the current analytic approaches to metabolic brain imaging data. Next, we discuss how 18 F-FDG PET studies have advanced understanding of the relation between distinct brain regions and associated symptoms in Parkinson disease, including cognitive decline. In addition, the value of 18 F-FDG PET studies in differential diagnosis, identifying prodromal patients, and the evaluation of treatment effects are reviewed. Finally, anticipated developments in the field are addressed.

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“…Areas of reduced posterior cortical metabolism 40 overlap with areas of reduced activation in functional MRI (fMRI) studies 125 , so might reflect similar underlying functional alterations or a causal link (for example, an area of reduced metabolism might result in a reduced blood oxygen level-dependent (BOLD) signal). Likewise, regions of increased metabolic activity in the frontal cortex 118 , as identified in some studies, may relate to regions of increased frontal fMRI activation 125 .…”

Section: Phenomenology and Diagnosismentioning

confidence: 99%

“…A significant group × time interaction was found, with a steeper decline across a range of cognitive domains and an increased risk of dementia at follow-up in patients with visual hallucinations. A recent metabolic imaging study of PD-associated mild cognitive impairment (PD-MCI) has also found elevated rates of dementia at 30-month follow-up in patients with visual hallucinations 40 .…”

Section: Frequency and Clinical Consequencesmentioning

confidence: 99%

The psychosis spectrum in Parkinson disease

et al. 2017

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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.

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Significance of visual hallucinations and cerebral hypometabolism in the risk of dementia in Parkinson's disease patients with mild cognitive impairment

Cited by 42 publications

References 44 publications

Clinical utility of FDG PET in Parkinson’s disease and atypical parkinsonism associated with dementia

Clinical utility of FDG PET in Parkinson’s disease and atypical parkinsonism associated with dementia

Metabolic Imaging in Parkinson Disease

The psychosis spectrum in Parkinson disease

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