Thalamic Hyperperfusion in Verbal Hallucination of Parkinsonian Patients

Matsui, Hirokazu; Nishinaka, Kazuto; Miyoshi, Takafumi; Hara, Narihiro; Oda, Masaya; Kubori, Tamotsu; Udaka, Fukashi

doi:10.2169/internalmedicine.46.0191

Cited by 11 publications

(3 citation statements)

References 33 publications

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“…Furthermore, we identified added factors of interest to modality-specific hallucinations, where visual hallucinations were identified as a significant risk factor for sensed presence, and female sex and visual or auditory hallucinations were identified as significant risk factors for olfactory hallucinations. Yet caution must be exercised when focusing on findings relating to non-visual hallucinations owing to: (i) limited number of studies, (ii) small subgroup sizes [ 40 , 41 ], and (iii) comorbid visual hallucinations in those subgroups [ 34 , 41 ]. Further replicative efforts are thus essential.…”

Section: Discussionmentioning

confidence: 99%

Non-visual hallucinations in Parkinson’s disease: a systematic review

et al. 2023

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Background Non-visual hallucinations in Parkinson’s disease (PD) can be prevalent and distressing. Most existing research has however, focused on visual hallucinations as well as related risk factors. The current study thus conducted a systematic review to collate existing evidence on non-visual hallucinations in PD, focusing on their prevalence, phenomenology, and clinical-cognitive correlates. Methods Ninety-one relevant studies were included from a systematic search across PsycINFO APA, PubMed, and Web of Science, for peer-reviewed publications in the English language, from 1970 to the present. These comprised a mix of case (30 studies; n = 56) and group design (62 studies; n = 7346) studies, divided into three somewhat overlapping collections to address our three research foci. Results Prevalence estimates for hallucinations were: auditory 1.5–72.0%, olfactory 1.6–21.0%, somatic-tactile 0.4–22.5%, gustatory 1.0–15.0%, and sensed presence 0.9–73.3%. Phenomenological inquiries revealed descriptions of vivid, consuming events replete with elaborate detail, adversely affecting PD patients in different ways. Overt experiences of multisensory hallucinations were also highly variable (0.4–80%) but exceedingly common, reported by almost half of the 45 included prevalence studies. There was some evidence for modality-specific hallucination predictors, but this was largely tentative, pending robust replication. Conclusions Marked prevalence figures coupled with phenomenological descriptions implicating distress denote that non-visual and multisensory hallucinations in PD are of clinical significance. More direct research and clinical attention need to be devoted to the study and management of such hallucinatory experiences.

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Section: Discussionmentioning

confidence: 99%

Non-visual hallucinations in Parkinson’s disease: a systematic review

et al. 2023

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“…Cognitive decline in PD has been associated with specific patterns of LB density in the entorhinal cortex and anterior cingulate cortex [36], which plays a role in autonomic nervous system (ANS) control, including the higher centers of autonomic regulations [37]. Involvement of the anterior cingulate cortex might simultaneously cause cognitive impairment and cardiovascular sympathetic failure.…”

Section: Several Pathogeneses Have Been Suggested For the Associationmentioning

confidence: 99%

Cardiovascular dysautonomia and cognitive impairment in Lewy body disease

Oka

Umehara²,

Nakahara³

et al. 2019

Preprint

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Background Cognitive impairment may be correlated with cardiovascular dysautonomia, including blood pressure (BP) dysregulation, in Parkinson’s disease (PD), but the association between these factors in dementia with Lewy bodies (DLB) is uncertain. This study aimed to clarify whether cardiovascular dysautonomia had an influence on cognitive function in Lewy body disease or not. Methods 99 patients with de novo PD (n=75) and DLB (n=24) were evaluated using the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphy, orthostatic hypotension (OH), supine hypertension (SH), postprandial hypotension (PPH), nocturnal BP fall in 24-hour ambulatory blood pressure monitoring (ABPM) and constipation were estimated. Associations of these factors with cognitive and executive dysfunction were examined. Results In DLB, MIBG uptake was reduced and OH, PPH and SH were severely disturbed, compared to PD. The nocturnal BP fall in ABPM was lower in DLB, and the failure of nocturnal BP fall in PD was associated with MMSE, after adjustment for other clinical features. FAB was significantly associated nocturnal BP fall, age and SH in PD, but no significant correlations among factors were found for DLB. Conclusion The significant association between nocturnal BP dysregulation and cognitive or executive decline in PD might be due to impaired microvascular circulation or invasion of α-synuclein in the CNS. The lack of a correlation of BP insufficiency with cognitive impairment in DLB suggests initial involvement of Lewy body pathology in the neocortex, regardless of Lewy body invasion of the autonomic nervous system.

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“…In regard to clinical conditions, AVHs are frequently found in neurological or neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, dementia, hearing impairment and epilepsy [13, 30, 31], substance abuse [32], and in psychiatric conditions such as dissociative disorders, mood disorders, and borderline personality disorder [14, 33, 34]. In particular focusing on dementia, the presence of behavioral symptoms (mostly delusions and hallucinations) is significant, in particular in Alzheimer's disease and vascular dementia [35]: specifically, the prevalence of AVHs ranges between 1% and 29% [13].…”

Section: Auditory Verbal Hallucinations (Avh) In Other Disordersmentioning

confidence: 99%

Transcranial Magnetic Stimulation for the Treatment of Pharmacoresistant Nondelusional Auditory Verbal Hallucinations in Dementia

Marras

Pallanti

2013

Case Reports in Psychiatry

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Auditory verbal hallucinations (AVHs) are known as a core symptom of schizophrenia, but also occur in a number of other conditions, not least in neurodegenerative disorders such as dementia. In the last decades, Transcranial Magnetic Stimulation (TMS) emerged as a valuable therapeutic approach towards several neurological and psychiatric diseases, including AVHs. Herein we report a case of a seventy-six-years-old woman with vascular-degenerative brain disease, complaining of threatening AVHs. The patient was treated with a high-frequency temporoparietal (T3P3) rTMS protocol for fifteen days. A considerable reduction of AVHs in frequency and content (no more threatening) was observed. Although further research is needed, this seems an encouraging result.

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Thalamic Hyperperfusion in Verbal Hallucination of Parkinsonian Patients

Cited by 11 publications

References 33 publications

Non-visual hallucinations in Parkinson’s disease: a systematic review

Non-visual hallucinations in Parkinson’s disease: a systematic review

Cardiovascular dysautonomia and cognitive impairment in Lewy body disease

Transcranial Magnetic Stimulation for the Treatment of Pharmacoresistant Nondelusional Auditory Verbal Hallucinations in Dementia

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