Abstract
The presence of visual hallucinations (VH) is a significant predictor of dementia
in Parkinson's disease (PD) and it is associated with a more rapid cognitive decline.
Non-demented PD patients with VH present greater neuropsychological impairment than
those without VH in domains such as verbal and visual memory, language comprehension,
and visuospatial and visuoperceptive functions. Frontal dysfunction has also been
described in PD with VH, including deficits in verbal fluency, sustained attention,
and inhibition. In PD with VH, structural and functional abnormalities within the
primary visual system and visual association areas, including ventral and dorsal pathways,
have been reported. Structural MRI studies have shown that non-demented PD patients
with VH present grey matter reduction in parieto-occipital areas and the hippocampal
head. A follow-up study performed at a mean of 30 months revealed that unlike PD patients without VH, PD patients with VH frequently
develop dementia associated with progressive atrophy in limbic, paralimbic and neocortical
areas. Functional MRI (fMRI) studies have revealed altered activation in occipito-temporal
and frontal areas in response to simple and complex visual stimuli in PD patients
with VH, suggesting a marked impairment in bottom-up visual processing, as well as
an attentional deficit in the pathophysiology of VH in PD.
Keywords
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Article info
Publication history
Published online: June 27, 2011
Accepted:
June 8,
2011
Received in revised form:
June 5,
2011
Received:
April 1,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
