scholarly journals 060 Impaired color discrimination is associated with hallucinations in dementia with lewy bodies

2019 ◽  
Vol 90 (e7) ◽  
pp. A19.3-A20
Author(s):  
Elie Matar ◽  
Joseph R Phillips ◽  
Kaylena A Ehgoetz Martens ◽  
Glenda M Halliday ◽  
Simon JG Lewis
Keyword(s):  
Color Vision ◽  
Lewy Body ◽  
Dementia With Lewy Bodies ◽  
Strong Association ◽  
Lewy Bodies ◽  
Color Discrimination ◽  
Visual Hallucinations ◽  
Vision Deficits ◽  
First Time ◽  
The Relationship

IntroductionEmerging evidence indicates that color discrimination impairments can predict the development of dementia across a range of prodromal Lewy body conditions. However, color vision deficits are not seen uniformly in patients with Dementia with Lewy Bodies (DLB), suggesting a more nuanced association. Visual hallucinations(VH) represent a discriminating feature of DLB, and recent evidence implicates visual pathway dysfunction as a significant contributor to this phenomenon. We therefore hypothesized that color impairment will more closely associate with VH in DLB rather than general cognition.MethodsIn this study, we examined the relationship between color vision impairment and VH, along with other clinical and neuropsychological features in 24 patients with DLB alongside 25 age-matched controls. Color discrimination was assessed using the Farnsworth-Munsell-100 Hue (FM-100) test.ResultsColor discrimination impairment was seen in 16/24 DLB participants (67%) with a higher error score relative to controls(p=0.001). We demonstrate for the first time a strong association between color discrimination errors and both the presence and severity of VH in DLB based on clinician-derived(p=0.008) and questionnaire-derived(p=0.03) measures. Correlation with clinical and neuropsychological variables revealed that color discrimination is significantly related to visuospatial impairment(p=0.02) but not to global measures of cognition, motor severity, age or disease duration. Factor analysis confirmed a unique relationship between color discrimination, visual hallucinations and visuospatial function.ConclusionOur results suggest that color impairments may be a specific biomarker of visual hallucinations and associated visuoperceptual deficits in evolving Lewy body disorders rather than dementia per se and thus providing insight into a shared pathophysiological substrate.

scholarly journals Impaired Color Discrimination—A Specific Marker of Hallucinations in Lewy Body Disorders

2019 ◽  
Vol 32 (5) ◽  
pp. 257-264 ◽  
Author(s):  
Elie Matar ◽  
Joseph R. Phillips ◽  
Kaylena A. Ehgoetz Martens ◽  
Glenda M. Halliday ◽  
Simon J. G. Lewis
Keyword(s):  
Color Vision ◽  
Lewy Body ◽  
Strong Association ◽  
Lewy Bodies ◽  
Behavior Disorder ◽  
Lewy Body Dementia ◽  
Color Discrimination ◽  
Specific Marker ◽  
Visual Hallucinations ◽  
Sleep Behavior

There is emerging evidence indicating that color discrimination impairments can predict the development of Lewy body dementia in patients with rapid eye movement sleep behavior disorder, Parkinson disease, and in patients with mild cognitive impairment. Despite this clear relationship, color vision deficits are not seen uniformly in patients with dementia with Lewy bodies (DLB), suggesting a more nuanced association with the underlying neuropathology. Visual hallucinations represent a discriminating feature of DLB, and recent evidence implicates visual pathway dysfunction as a significant contributor to this phenomenon. In this study, we examined the relationship between color vision impairment and visual hallucinations, along with other clinical and neuropsychological features in 24 well-characterized patients with DLB alongside 25 healthy controls. Color discrimination impairment was seen in 16 (67%) of 24 DLB participants with a higher error score relative to controls ( P = .001). We demonstrate for the first time a strong association between color discrimination errors on the Farnsworth-Munsell 100 hue test and both the presence and severity of hallucinatory symptoms in DLB based on clinician-derived ( P = .008) and questionnaire-derived ( P = .03) measures. Correlation with clinical and neuropsychological variables revealed that color discrimination is significantly related to visuospatial difficulties measured by the clock-drawing task ( P = .02) but not to global measures of cognition, motor severity, age, or disease duration in our cohort. Factor analysis confirmed a unique relationship between color discrimination, visual hallucinations, and visuospatial function. Our results suggest that color discrimination does not simply relate to dementia but rather indexes higher order perceptual deficits that may predict visual hallucinations in Lewy body disorders and share a common pathophysiological substrate.

scholarly journals Visual cortical excitability in dementia with Lewy bodies

2016 ◽  
Vol 208 (5) ◽  
pp. 497-498 ◽  
Author(s):  
John-Paul Taylor ◽  
Michael Firbank ◽  
John T. O'Brien
Keyword(s):  
Visual System ◽  
Dementia With Lewy Bodies ◽  
Cortical Excitability ◽  
Lewy Bodies ◽  
Visual Hallucinations ◽  
Double Dissociation ◽  
Visual Areas ◽  
Phosphene Threshold ◽  
Visual Cortical ◽  
The Relationship

SummaryAlterations in the visual system may underlie visual hallucinations in dementia with Lewy bodies (DLB). However, cortical excitability as measured by transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) activation of lower visual areas (V1–3) to visual stimuli appear normal in DLB. We explored the relationship between TMS-determined phosphene threshold and fMRI-related visual activation and found a positive relationship between the two in controls but a negative one in DLB. This double dissociation suggests a loss of inhibition in the visual system in DLB, which may predispose individuals to visual dysfunction and visual hallucinations.

Delirium prior to dementia as a clinical phenotype of Lewy body disease: an autopsied case report

2016 ◽  
Vol 29 (4) ◽  
pp. 687-689 ◽  
Author(s):  
Hiroshige Fujishiro ◽  
Ito Kawakami ◽  
Kenichi Oshima ◽  
Kazuhiro Niizato ◽  
Shuji Iritani
Keyword(s):  
Lewy Body ◽  
Clinical Phenotype ◽  
Lewy Bodies ◽  
Lewy Body Disease ◽  
Japanese Woman ◽  
Visual Hallucinations ◽  
Limited Information ◽  
Lewy Body Pathology ◽  
Old Japanese ◽  
The Relationship

ABSTRACTAlthough delirium shares clinical characteristics with dementia with Lewy bodies (DLB), there is limited information regarding the relationship between delirium and Lewy body pathology. Here, we report an 89-year-old Japanese woman with an episode of delirium who was pathologically confirmed to have limbic-type Lewy body disease (LBD). Although she exhibited transient visual hallucinations during the delirium, she had no overt dementia. She developed no core clinical features of DLB and died of pneumonia at the age of 90 years. This autopsied case suggests that delirium may be one of the clinical phenotypes of LBD prior to the onset of dementia.

scholarly journals Visual hallucinations in dementia with Lewy bodies: transcranial magnetic stimulation study

2011 ◽  
Vol 199 (6) ◽  
pp. 492-500 ◽  
Author(s):  
John-Paul Taylor ◽  
Michael Firbank ◽  
Nicola Barnett ◽  
Sarah Pearce ◽  
Anthea Livingstone ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Dementia With Lewy Bodies ◽  
Cortical Excitability ◽  
Lewy Bodies ◽  
Visual Hallucinations ◽  
Visual Responses ◽  
People With Dementia ◽  
Visual Cortical ◽  
The Relationship

BackgroundThe aetiology of visual hallucinations is poorly understood in dementia with Lewy bodies. Pathological alterations in visual cortical excitability may be one contributory mechanism.AimsTo determine visual cortical excitability in people with dementia with Lewy bodies compared with aged-matched controls and also the relationship between visual cortical excitability and visual hallucinations in dementia with Lewy bodies.MethodVisual cortical excitability was determined by using transcranial magnetic stimulation (TMS) applied to the occiput to elicit phosphenes (transient subjective visual responses) in 21 patients with dementia with Lewy bodies and 19 age-matched controls.ResultsPhosphene parameters were similar between both groups. However, in the patients with dementia with Lewy bodies, TMS measures of visual cortical excitability correlated strongly with the severity of visual hallucinations (P = 0.005). Six patients with dementia with Lewy bodies experienced visual hallucination-like phosphenes (for example, seeing people or figures on stimulation) compared with none of the controls (P = 0.02).ConclusionsIncreased visual cortical excitability in dementia with Lewy bodies does not appear to explain visual hallucinations but it may be a marker for their severity.

Characterization of dementia with Lewy bodies (DLB) and mild cognitive impairment using the Lewy body dementia module (LBD‐MOD)

2021 ◽  
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Iris Cohen ◽  
Keri K. Greenfield ◽  
Michael J. Kleiman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lewy Body ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Lewy Body Dementia

Cognitive correlates and baseline predictors of future development of visual hallucinations in dementia with Lewy bodies

Cortex ◽  
2021 ◽  
Author(s):  
Stefania Pezzoli ◽  
Annachiara Cagnin ◽  
Cinzia Bussè ◽  
Giovanni Zorzi ◽  
Federica Fragiacomo ◽  
...  
Keyword(s):  
Future Development ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Visual Hallucinations ◽  
Cognitive Correlates

scholarly journals Evaluating a novel behavioral paradigm for visual hallucinations in Dementia with Lewy bodies

Aging Brain ◽  
2021 ◽  
Vol 1 ◽  
pp. 100011
Author(s):  
Joseph R. Phillips ◽  
Elie Matar ◽  
Kaylena A. Ehgoetz Martens ◽  
Ahmed A. Moustafa ◽  
Glenda M. Halliday ◽  
...  
Keyword(s):  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Visual Hallucinations ◽  
Behavioral Paradigm

A Detailed Phenomenological Comparison of Complex Visual Hallucinations in Dementia With Lewy Bodies and Alzheimer's Disease

1997 ◽  
Vol 9 (4) ◽  
pp. 381-388 ◽  
Author(s):  
Clive Ballard ◽  
Ian McKeith ◽  
Richard Harrison ◽  
John O'Brien ◽  
Peter Thompson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Time Of Day ◽  
Visual Hallucinations ◽  
Dementia Patients ◽  
Core Feature ◽  
Definition Of

Visual hallucinations (VH) are a core feature of dementia with Lewy bodies (DLB), but little is known about their phenomenology. A total of 73 dementia patients (42 DLB, 30 Alzheimer's disease [AD], 1 undiagnosed) in contact with clinical services were assessed with a detailed standardized inventory. DLB was diagnosed according to the criteria of McKeith and colleagues, AD was diagnosed using the NINCDS-ADRDA criteria. Autopsy confirmation has been obtained when possible. VH were defined using the definition of Burns and colleagues. Detailed descriptions of hallucinatory experiences were recorded. Annual follow-up interviews were undertaken. The clinical diagnosis has been confirmed in 18 of the 19 cases that have come to autopsy. A total of 93% of DLB patients and 27% of AD patients experienced VH. DLB patients were significantly more likely to experience multiple VH that persisted over follow-up. They were significantly more likely to hear their VH speak but there were no significant differences in the other phenomenological characteristics including whether the hallucinations moved, the time of day that they were experienced, their size, the degree of insight, and whether they were complete. VH may be more likely to be multiple, to speak, and to be persistent in DLB patients. These characteristics could potentially aid accurate diagnosis.

scholarly journals The relationship between non-motor features and weight-loss in the premanifest stage of Huntington’s disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253817
Author(s):  
Wasiq Khan ◽  
Sundus Alusi ◽  
Hissam Tawfik ◽  
Abir Hussain
Keyword(s):  
Weight Loss ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Expert Knowledge ◽  
Strong Association ◽  
Machine Intelligence ◽  
Rule Mining ◽  
First Time ◽  
The Relationship ◽  
Relevant Factors

Weight-loss is an integral part of Huntington’s disease (HD) that can start before the onset of motor symptoms. Investigating the underlying pathological processes may help in the understanding of this devastating disease as well as contribute to its management. However, the complex behavior and associations of multiple biological factors is impractical to be interpreted by the conventional statistics or human experts. For the first time, we combine a clinical dataset, expert knowledge and machine intelligence to model the multi-dimensional associations between the potentially relevant factors and weight-loss activity in HD, specifically at the premanifest stage. The HD dataset is standardized and transformed into required knowledge base with the help of clinical HD experts, which is then processed by the class rule mining and self-organising maps to identify the significant associations. Statistical results and experts’ report indicate a strong association between severe weight-loss in HD at the premanifest stage and measures of certain cognitive, psychiatric functional ability factors. These results suggest that the mechanism underlying weight-loss in HD is, at least partly related to dysfunction of certain areas of the brain, a finding that may have not been apparent otherwise. These associations will aid the understanding of the pathophysiology of the disease and its progression and may in turn help in HD treatment trials.

Sign in / Sign up

Export Citation Format

Share Document