Plaques and tangles as well as Lewy-type alpha synucleinopathy are associated with formed visual hallucinations

Sandra A. Jacobson, Trisha Morshed, Brittany N. Dugger, Thomas G. Beach, Joseph G. Hentz, Charles Howard Adler, Holly A. Shill, Marwan N. Sabbagh, Christine M. Belden, Lucia I. Sue, John Nathaniel Caviness, Chengcheng Hu

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: Previous research has linked complex or formed visual hallucinations (VH) to Lewy-type alpha-synucleinopathy (LTS) in neocortical and limbic areas. As Alzheimer's disease pathology often co-occurs with LTS, we questioned whether this pathology - amyloid plaques and neurofibrillary tangles - might also be linked to VH. Methods: We performed a semi-quantitative neuropathological study across brainstem, limbic, and cortical structures in subjects with a documented clinical history of VH and a clinicopathological diagnosis of Parkinson's disease (PD), Alzheimer's disease (AD), or dementia with Lewy bodies (DLB). 173 subjects - including 50 with VH and 123 without VH - were selected from the Arizona Study of Aging and Neurodegenerative Disorders. Clinical variables examined included the Mini-mental State Exam, Hoehn & Yahr stage, and total dopaminergic medication dose. Neuropathological variables examined included total and regional LTS and plaque and tangle densities. Results: A significant relationship was found between the density of LTS and the presence of VH in PD, AD, and DLB. Plaque and tangle densities also were associated with VH in PD (p=.003 for plaque and p=.004 for tangles) but not in AD, where densities were high regardless of the presence of hallucinations. Furthermore, with DLB cases excluded, comorbidity of PD and AD was significantly more prevalent among subjects+VH than subjects-VH (p<.001). Conclusion: These findings suggest that both AD and PD neuropathology contribute to the pathogenesis of VH. Incident VH could be predictive of concomitant AD/PD pathology even when criteria are not met for a second diagnosis.

Original languageEnglish (US)
Pages (from-to)1009-1014
Number of pages6
JournalParkinsonism and Related Disorders
Volume20
Issue number9
DOIs
StatePublished - 2014

Fingerprint

Hallucinations
Alzheimer Disease
Parkinson Disease
Lewy Bodies
Pathology
Lewy Body Disease
Neurofibrillary Tangles
Amyloid Plaques
Neurodegenerative Diseases
Brain Stem
Comorbidity

Keywords

  • Alzheimer's disease
  • Hallucinations
  • Parkinson's disease
  • Psychosis
  • Visual hallucinations

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

Plaques and tangles as well as Lewy-type alpha synucleinopathy are associated with formed visual hallucinations. / Jacobson, Sandra A.; Morshed, Trisha; Dugger, Brittany N.; Beach, Thomas G.; Hentz, Joseph G.; Adler, Charles Howard; Shill, Holly A.; Sabbagh, Marwan N.; Belden, Christine M.; Sue, Lucia I.; Caviness, John Nathaniel; Hu, Chengcheng.

In: Parkinsonism and Related Disorders, Vol. 20, No. 9, 2014, p. 1009-1014.

Research output: Contribution to journalArticle

Jacobson, SA, Morshed, T, Dugger, BN, Beach, TG, Hentz, JG, Adler, CH, Shill, HA, Sabbagh, MN, Belden, CM, Sue, LI, Caviness, JN & Hu, C 2014, 'Plaques and tangles as well as Lewy-type alpha synucleinopathy are associated with formed visual hallucinations', Parkinsonism and Related Disorders, vol. 20, no. 9, pp. 1009-1014. https://doi.org/10.1016/j.parkreldis.2014.06.018
Jacobson, Sandra A. ; Morshed, Trisha ; Dugger, Brittany N. ; Beach, Thomas G. ; Hentz, Joseph G. ; Adler, Charles Howard ; Shill, Holly A. ; Sabbagh, Marwan N. ; Belden, Christine M. ; Sue, Lucia I. ; Caviness, John Nathaniel ; Hu, Chengcheng. / Plaques and tangles as well as Lewy-type alpha synucleinopathy are associated with formed visual hallucinations. In: Parkinsonism and Related Disorders. 2014 ; Vol. 20, No. 9. pp. 1009-1014.
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abstract = "Objective: Previous research has linked complex or formed visual hallucinations (VH) to Lewy-type alpha-synucleinopathy (LTS) in neocortical and limbic areas. As Alzheimer's disease pathology often co-occurs with LTS, we questioned whether this pathology - amyloid plaques and neurofibrillary tangles - might also be linked to VH. Methods: We performed a semi-quantitative neuropathological study across brainstem, limbic, and cortical structures in subjects with a documented clinical history of VH and a clinicopathological diagnosis of Parkinson's disease (PD), Alzheimer's disease (AD), or dementia with Lewy bodies (DLB). 173 subjects - including 50 with VH and 123 without VH - were selected from the Arizona Study of Aging and Neurodegenerative Disorders. Clinical variables examined included the Mini-mental State Exam, Hoehn & Yahr stage, and total dopaminergic medication dose. Neuropathological variables examined included total and regional LTS and plaque and tangle densities. Results: A significant relationship was found between the density of LTS and the presence of VH in PD, AD, and DLB. Plaque and tangle densities also were associated with VH in PD (p=.003 for plaque and p=.004 for tangles) but not in AD, where densities were high regardless of the presence of hallucinations. Furthermore, with DLB cases excluded, comorbidity of PD and AD was significantly more prevalent among subjects+VH than subjects-VH (p<.001). Conclusion: These findings suggest that both AD and PD neuropathology contribute to the pathogenesis of VH. Incident VH could be predictive of concomitant AD/PD pathology even when criteria are not met for a second diagnosis.",
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T1 - Plaques and tangles as well as Lewy-type alpha synucleinopathy are associated with formed visual hallucinations

AU - Jacobson, Sandra A.

AU - Morshed, Trisha

AU - Dugger, Brittany N.

AU - Beach, Thomas G.

AU - Hentz, Joseph G.

AU - Adler, Charles Howard

AU - Shill, Holly A.

AU - Sabbagh, Marwan N.

AU - Belden, Christine M.

AU - Sue, Lucia I.

AU - Caviness, John Nathaniel

AU - Hu, Chengcheng

PY - 2014

Y1 - 2014

N2 - Objective: Previous research has linked complex or formed visual hallucinations (VH) to Lewy-type alpha-synucleinopathy (LTS) in neocortical and limbic areas. As Alzheimer's disease pathology often co-occurs with LTS, we questioned whether this pathology - amyloid plaques and neurofibrillary tangles - might also be linked to VH. Methods: We performed a semi-quantitative neuropathological study across brainstem, limbic, and cortical structures in subjects with a documented clinical history of VH and a clinicopathological diagnosis of Parkinson's disease (PD), Alzheimer's disease (AD), or dementia with Lewy bodies (DLB). 173 subjects - including 50 with VH and 123 without VH - were selected from the Arizona Study of Aging and Neurodegenerative Disorders. Clinical variables examined included the Mini-mental State Exam, Hoehn & Yahr stage, and total dopaminergic medication dose. Neuropathological variables examined included total and regional LTS and plaque and tangle densities. Results: A significant relationship was found between the density of LTS and the presence of VH in PD, AD, and DLB. Plaque and tangle densities also were associated with VH in PD (p=.003 for plaque and p=.004 for tangles) but not in AD, where densities were high regardless of the presence of hallucinations. Furthermore, with DLB cases excluded, comorbidity of PD and AD was significantly more prevalent among subjects+VH than subjects-VH (p<.001). Conclusion: These findings suggest that both AD and PD neuropathology contribute to the pathogenesis of VH. Incident VH could be predictive of concomitant AD/PD pathology even when criteria are not met for a second diagnosis.

AB - Objective: Previous research has linked complex or formed visual hallucinations (VH) to Lewy-type alpha-synucleinopathy (LTS) in neocortical and limbic areas. As Alzheimer's disease pathology often co-occurs with LTS, we questioned whether this pathology - amyloid plaques and neurofibrillary tangles - might also be linked to VH. Methods: We performed a semi-quantitative neuropathological study across brainstem, limbic, and cortical structures in subjects with a documented clinical history of VH and a clinicopathological diagnosis of Parkinson's disease (PD), Alzheimer's disease (AD), or dementia with Lewy bodies (DLB). 173 subjects - including 50 with VH and 123 without VH - were selected from the Arizona Study of Aging and Neurodegenerative Disorders. Clinical variables examined included the Mini-mental State Exam, Hoehn & Yahr stage, and total dopaminergic medication dose. Neuropathological variables examined included total and regional LTS and plaque and tangle densities. Results: A significant relationship was found between the density of LTS and the presence of VH in PD, AD, and DLB. Plaque and tangle densities also were associated with VH in PD (p=.003 for plaque and p=.004 for tangles) but not in AD, where densities were high regardless of the presence of hallucinations. Furthermore, with DLB cases excluded, comorbidity of PD and AD was significantly more prevalent among subjects+VH than subjects-VH (p<.001). Conclusion: These findings suggest that both AD and PD neuropathology contribute to the pathogenesis of VH. Incident VH could be predictive of concomitant AD/PD pathology even when criteria are not met for a second diagnosis.

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KW - Hallucinations

KW - Parkinson's disease

KW - Psychosis

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