High-order visual processing, visual symptoms, and hallucinations: A possible symptomatic progression of Parkinson's disease

Kelsey Barrell, Britta Bureau, Pierpaolo Turcano, Gregory D. Phillips, Jeffrey S. Anderson, Atul Malik, David Shprecher, Meghan Zorn, Edward Zamrini, Rodolfo Savica

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objective: To determine whether Parkinson disease (PD) patients with (VH) have different clinical characteristics and gray-matter volume than those with visual misperceptions (VM) or other visual symptoms (OvS). Background: The spectrum of visual complaints in PD is broad and complex. Methods: We conducted a retrospective chart review of 525 PD patients to identify the frequency of visual symptoms and the association with clinical and radiological features. Brain volumetric MRI data was analyzed using multivariate logistic regression to differentiate cases with and without visual symptoms. Results: Among 525 PD cases, visual complaints were documented in 177 (33.7%). Among these, 83 (46.9%) had VH, 31 (17.5%) had VM, and 63 (35.6%) had OvS (diplopia, blurry vision, photophobia, dry eyes, and eye pain or soreness). When compared to OvS, patients with VH had significantly higher age, duration of disease, rate of REM sleep behavior disorder, and cognitive impairment. Visual hallucinations patients had decreased age-adjusted volumetric averages in 28/30 gray-matter regions when compared to PD without visual symptoms and 30/30 gray-matter regions when compared to VM patients. Conclusions: Visual symptoms in PD may represent a spectrum from OvS to VM to VH, with progression of the latter associated with older age, duration of disease, presence of REM sleep behavior disorder, cognitive impairment, and decreased gray-matter volume.

Original languageEnglish (US)
Article number00999
JournalFrontiers in Neurology
Volume9
Issue numberNOV
DOIs
StatePublished - Nov 27 2018

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Keywords

  • Cognitive impairment
  • Gray-matter volume
  • Parkinson's disease
  • REM sleep behavior disorder
  • Visual hallucinations
  • Visual misperceptions
  • Visual symptoms

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Barrell, K., Bureau, B., Turcano, P., Phillips, G. D., Anderson, J. S., Malik, A., Shprecher, D., Zorn, M., Zamrini, E., & Savica, R. (2018). High-order visual processing, visual symptoms, and hallucinations: A possible symptomatic progression of Parkinson's disease. Frontiers in Neurology, 9(NOV), [00999]. https://doi.org/10.3389/fneur.2018.00999