Clinical Features of Auditory Hallucinations in Patients With Dementia With Lewy Bodies

Tsunoda, Naoko; Hashimoto, Mamoru; Ishikawa, Tomohisa; Fukuhara, Ryuji; Yuki, Seiji; Tanaka, Hibiki; Hatada, Yutaka; Miyagawa, Yusuke; Ikeda, Manabu

doi:10.4088/jcp.17m11623

Cited by 23 publications

(24 citation statements)

References 9 publications

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“…In contrast, women experienced significantly auditory hallucination (39.8%) more than men (21.2%), similar to initial symptoms. Similar findings were reported by Tsunoda et al ., 38 who reported that auditory hallucination was observed in 33.5% of patients, and the rate was significantly higher in women. In psychiatric practice, auditory hallucinations indicating late‐onset schizophrenia are often observed in elderly age, and this occurs predominantly in women 39,40 .…”

Section: Discussionsupporting

confidence: 91%

Characteristics of initial symptoms and symptoms at diagnosis in probable dementia with Lewy body disease: incidence of symptoms and gender differences

et al. 2020

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Aim: Although dementia with Lewy bodies (DLB) is characterized by a variety of initial symptoms, there are almost no reports of the initial symptoms of DLB assessed in a large number of cases. We retrospectively evaluated the initial symptoms of 234 participants with DLB and DLB-related symptoms at diagnosis and characterized any gender differences in the symptom profiles. Methods: This study consisted of 234 participants with probable DLB who met the diagnostic criteria outlined in the Fourth Consensus Report of the DLB Consortium (2017). DLB was confirmed based on several characteristic biomarkers for dopamine transporter imaging with 123 IN -omegafluoropropyl-2-beta-carbomethoxy-3-beta (4-iodophenyl) nortropane singlephoton emission computed tomography, 123 I-metaiodobenzylguanidine myocardial scintigraphy, and brain perfusion measured with single photon emission computed tomography. In addition, core and supportive clinical features were considered in the diagnosis. Results: Initial symptoms included cognitive impairment (41.9%) and psychiatric symptoms (i.e. visual and auditory hallucinations, delusions, and depression) (42.3%). Almost half of the women initially presented with psychiatric symptoms, with significantly more women than men presenting with auditory hallucinations. In contrast, men had a significantly higher rate of rapid eye movement sleep behaviour disorder (RBD) than women did. At diagnosis, DLB-related symptoms differed between men and women, with male patients exhibiting significantly more RBD, parkinsonism, hyposmia, and syncope than female patients. Moreover women presented significantly more often with auditory hallucinations than did men. Conclusions: Our results indicate that there are gender differences in the initial symptoms of DLB, as well as in the presentation of subsequent symptoms observed at diagnosis. There was a higher incidence of RBD in men, whereas women had a higher incidence of psychotic symptoms.

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Section: Discussionsupporting

confidence: 91%

Characteristics of initial symptoms and symptoms at diagnosis in probable dementia with Lewy body disease: incidence of symptoms and gender differences

et al. 2020

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“…On the other hand, systematized delusions have been identified as one of the supportive clinical features [3]. In our recent study, the frequency of delusion in DLB patients was 54.8% (68/124), top three of delusions were phantom boarder delusion, delusion of theft and persecution, and there was no case of delusional parasitosis [10]. Delusional parasitosis is rare in DLB, and there is only one case report [11].…”

Section: Discussionmentioning

confidence: 99%

Delusional parasitosis in dementia with Lewy bodies: a case report

et al. 2019

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BackgroundDementia with Lewy bodies (DLB) is characterized by fluctuating cognitive impairments, recurrent visual hallucinations, the motor symptoms of parkinsonism and REM sleep behavior disorder. Various neuropsychiatric symptoms including hallucination and delusions occur frequently; however, delusional parasitosis is rare in DLB. Here, we report a case of DLB patient with delusional parasitosis.Case presentationThe patient was an 89-year-old woman. At the age of 88, she began to complain her oral cenesthopathy, and developed cognitive decline, delusional parasitosis and parkinsonism. As a result of examination, she was diagnosed as DLB and treated with combination of donepezil 5 mg/day and aripiprazole 1.5 mg/day, and her complaint was disappeared.ConclusionsFurther studies are needed to investigate the association between delusional parasitosis and underlying pathophysiology of DLB, and the utility of antipsychotics for delusional parasitosis in DLB has to be examined through more cases.

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“…Auditory hallucinations are also frequent in DLB, being described in about 30% of patients, and they may be verbal or nonverbal, but only rarely of musical type [11]. The presence of auditory hallucinations in patients with DLB is associated with hearing loss [12].…”

Section: Discussionmentioning

confidence: 99%

Shift of musical hallucinations to visual hallucinations after correction of the hearing deficit in a patient with Lewy body dementia: a case report

Montalvo

Azevedo

2021

J Med Case Reports

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Background Musical hallucinations are a particular type of auditory hallucination in which the patient perceives instrumental music, musical sounds, or songs. Musical hallucinations are associated with acquired hearing loss, particularly within the elderly. Under conditions of reduced auditory sensory input, perception-bearing circuits are disinhibited and perceptual traces released, implying an interaction between peripheral sensory deficits and central factors related to brain dysfunction. Case presentation A 71-year-old Caucasian man with hearing loss complained of memory difficulties and resting tremor of the right upper limb in the previous 2 years. He already had difficulties in instrumental activities of daily life. Neurological examination showed Parkinsonian signs and hypoacusia. Neuropsychological examination identified deficits in executive functions and memory tests. Brain computerized tomography and nuclear magnetic resonance scans showed mild cortical and subcortical atrophy. The clinical diagnosis of possible dementia with Lewy bodies was established. Five years later, the patient began complaining of musical hallucinations. There had been no previous change in medication. An otorhinolaryngologist diagnosed age-related hearing loss and prescribed bilateral hearing aids. After using the hearing aids, the patient did not hear the songs any longer, only some tinnitus, described as a whistle. However, at the same time, the patient started experiencing visual hallucinations he never had before. Discussion To our knowledge, the immediate shift of hallucinations from one sensory modality to another sensory modality when perception is improved has not been previously described. This report emphasizes the interaction between brain pathology and sensory deficits for the genesis of hallucinations, and reinforces the theory that attention and control networks must couple properly to the default mode network, as well as integrate and select adequately peripheral signals to the somatosensory cortices, in order to keep a clear state of mind. Conclusion The clinician should bear in mind and let the patient know that improving one sensory modality to ameliorate hallucinations may sometimes paradoxically lead to hallucinations in a different sensory modality.

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Clinical Features of Auditory Hallucinations in Patients With Dementia With Lewy Bodies

Cited by 23 publications

References 9 publications

Characteristics of initial symptoms and symptoms at diagnosis in probable dementia with Lewy body disease: incidence of symptoms and gender differences

Characteristics of initial symptoms and symptoms at diagnosis in probable dementia with Lewy body disease: incidence of symptoms and gender differences

Delusional parasitosis in dementia with Lewy bodies: a case report

Shift of musical hallucinations to visual hallucinations after correction of the hearing deficit in a patient with Lewy body dementia: a case report

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