Neuroanatomical and cognitive correlates of visual hallucinations in Parkinson’s disease and dementia with Lewy bodies: Voxel-based morphometry and neuropsychological meta-analysis

Dementia with Lewy bodies (DLB) is the second most prevalent neurodegenerative dementia disorder, after Alzheimer’s disease (AD). DLB is characterised clinically by cognitive fluctuations, visual hallucinations, rapid-eye-movement sleep behaviour disorder, and Parkinsonism. Differentiating DLB from AD and related disorders of Parkinson’s disease (PD) and Parkinson’s disease with dementia (PDD) can be difficult at early disease stages due to overlapping clinical and pathological features. Nevertheless, it has been shown that visuoperceptual, attention and executive deficits, relative to memory impairments, are especially prominent in the early stages of DLB compared with AD or PD. The importance of these impairments is reflected in the recent revision of the diagnostic consensus guidelines of DLB. As the last reviews of cognitive impairments in DLB were conducted over a decade ago (Collerton, Burn, McKeith & O’Brien, 2003; Metzler-Baddeley, 2007; Ralph, 2001), we provide an up-to-date review of the literature into perceptual and attention-executive functions in DLB. There is a need for better controlled studies into cognitive deficits, their neural correlates, and relationships to clinical symptoms in DLB, that go beyond standard clinical assessments. Evidence regarding visuoperception suggests that low-level functions may be relatively preserved while mid- and higher-level functions, that require the recruitment of attention and executive functions are disproportionally affected in DLB. Cognitive fluctuations and visual hallucinations may arise from a desynchronization of top-down attention and bottom-up sensory networks.

Download Full-text

Auditory and visual hallucination prevalence in Parkinson's disease and dementia with Lewy bodies: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291718003161 ◽

2018 ◽

Vol 49 (14) ◽

pp. 2342-2353 ◽

Cited By ~ 4

Author(s):

Charlotte Louise Eversfield ◽

Llwyd David Orton

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dementia With Lewy Bodies ◽

Meta Analysis ◽

Lewy Bodies ◽

Eligibility Criteria ◽

Pooled Prevalence ◽

Prevalence Estimates ◽

Meta Analyses

AbstractBackgroundNon-motor features of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), such as auditory hallucinations (AH), contribute to disease burden but are not well understood.MethodsSystematic review and random-effects meta-analyses of studies reporting AH associated with PD or DLB. Prevalence of visual hallucinations (VH) in identified studies meeting eligibility criteria were included in meta-analyses, facilitating comparison with AH. Synthesis of qualitative descriptions of AH was performed. PubMed, Web of Science and Scopus databases were searched for primary journal articles, written in English, published from 1970 to 2017. Studies reporting AH prevalence in PD or DLB were screened using PRISMA methods.ResultsSearches identified 4542 unique studies for consideration, of which, 26 met inclusion criteria. AH pooled prevalence in PD was estimated to be 8.9% [95% confidence interval (CI) 5.3–14.5], while in DLB was estimated to be 30.8% (±23.4 to 39.3). Verbal hallucinations, perceived as originating outside the head, were the most common form of AH. Non-verbal AH were also common while musical AH were rare. VH were more prevalent, with an estimated pooled prevalence in PD of 28.2% (±19.1 to 39.5), while in DLB they were estimated to be 61.8% (±49.1 to 73.0). Meta-regression determined that the use of validated methodologies to identify hallucinations produced higher prevalence estimates.ConclusionsAH and VH present in a substantial proportion of PD and DLB cases, with VH reported more frequently in both conditions. Both AH and VH are more prevalent in DLB than PD. There is a need for standardised use of validated methods to detect and monitor hallucinations.

Download Full-text

Auditory and visual hallucination prevalence in Parkinson’s disease and dementia with Lewy bodies: a systematic review and meta-analysis

10.31219/osf.io/spjd7 ◽

2018 ◽

Author(s):

Charlotte Louise Eversfield ◽

Llwyd David Orton

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dementia With Lewy Bodies ◽

Psychotic Disorders ◽

Meta Analysis ◽

Lewy Bodies ◽

Eligibility Criteria ◽

Pooled Prevalence ◽

Meta Analyses

Background: Non-motor features of Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) contribute significantly to disease burden yet are less well understood than motor features. Auditory hallucinations (AH) are commonly associated with psychotic disorders, yet their contribution to PD and DLB is not well understood.Methods: We conducted a systematic review and random-effects model meta-analyses of studies reporting AH associated with PD or DLB. Prevalence of visual hallucinations (VH) in identified studies meeting eligibility criteria were included in meta-analyses, facilitating comparison with AH. Synthesis of qualitative descriptions of AH was performed. PubMed, Web of Science and Scopus databases were searched for primary journal articles, written in English, published from 1970 to 2017. Studies reporting AH prevalence in PD or DLB were screened using PRISMA methods. Results: Searches identified 4,542 unique studies for consideration, of which, 26 met inclusion criteria. AH pooled prevalence in PD was estimated to be 8.9% (95% CI=5.3-14.5), while in DLB was estimated to be 30.8% (±23.4-39.3). VH were more common, with an estimated pooled prevalence in PD of 28.2% (±19.1-39.5), while in DLB they were estimated to be 61.8% (±49.1-73.0). Meta-regression determined that the use of validated methodologies to identify hallucinations produced higher prevalence estimates.Conclusions: AH and VH present in a substantial proportion of PD and DLB cases, with VH reported more frequently in both conditions. Both AH and VH are more prevalent in DLB than PD. There is a need for standardised use of validated methods to detect and monitor hallucinations.

Download Full-text

A comparison of gray and white matter density in patients with Parkinson's disease dementia and dementia with Lewy bodies using voxel-based morphometry

Movement Disorders ◽

10.1002/mds.22858 ◽

2009 ◽

Vol 25 (1) ◽

pp. 28-34 ◽

Cited By ~ 38

Author(s):

Ji E. Lee ◽

Bosuk Park ◽

Sook K. Song ◽

Young H. Sohn ◽

Hae-Jeong Park ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

White Matter ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Matter Density ◽

Parkinson’S Disease Dementia ◽

Voxel Based Morphometry

Download Full-text

Frontal and subcortical contribution to visual hallucinations in dementia with Lewy bodies and Parkinson’s disease

Postgraduate Medicine ◽

10.1080/00325481.2019.1656515 ◽

2019 ◽

Vol 131 (7) ◽

pp. 509-522 ◽

Cited By ~ 1

Author(s):

Stefania Pezzoli ◽

Annachiara Cagnin ◽

Angelo Antonini ◽

Annalena Venneri

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Visual Hallucinations

Download Full-text

Visual hallucinations

Practical Neurology ◽

10.1136/practneurol-2021-003016 ◽

2021 ◽

pp. practneurol-2021-003016

Author(s):

Rimona S Weil ◽

A J Lees

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dementia With Lewy Bodies ◽

Visual Loss ◽

Lewy Bodies ◽

Visual Hallucinations ◽

Charles Bonnet Syndrome ◽

Peduncular Hallucinosis ◽

Neurological Conditions ◽

The Brain

Visual hallucinations have intrigued neurologists and physicians for generations due to patients’ vivid and fascinating descriptions. They are most commonly associated with Parkinson’s disease and dementia with Lewy bodies, but also occur in people with visual loss, where they are known as Charles Bonnet syndrome. More rarely, they can develop in other neurological conditions, such as thalamic or midbrain lesions, when they are known as peduncular hallucinosis. This review considers the mechanisms underlying visual hallucinations across diagnoses, including visual loss, network dysfunction across the brain and changes in neurotransmitters. We propose a framework to explain why visual hallucinations occur most commonly in Parkinson’s disease and dementia with Lewy bodies, and discuss treatment approaches to visual hallucinations in these conditions.

Download Full-text