Factors associated with drug–induced visual hallucinations in Parkinson's disease

Papapetropoulos, Spiridon; Argyriou, Andreas A.; Ellul, John

doi:10.1007/s00415-005-0840-x

Cited by 67 publications

(49 citation statements)

References 37 publications

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“…VH were thus initially considered to be a druginduced phenomenon,and were classified as "dopaminomimetic psychosis" or "levodopa psychosis" [3,4,[6][7][8][9][10][11], despite earlier reports showing that VH may occur as a consequence of anticholinergic treatments [12].…”

Section: Introductionmentioning

confidence: 99%

Visual Hallucinations in PD and Lewy Body Dementias: Old and New Hypotheses

Onofrj

Taylor

Monaco

et al. 2013

Behavioural Neurology

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Abstract. Visual Hallucinations (VH) are a common non-motor symptom of Parkinson's Disease (PD) and the Lewy body dementias (LBD) of Parkinson's disease with dementia (PDD) and Dementia with Lewy Bodies (DLB). The origin of VH in PD and LBD is debated: earlier studies considered a number of different possible mechanisms underlying VH including visual disorders, Rapid Eye Movement (REM) Sleep Intrusions, dysfunctions of top down or bottom up visual pathways, and neurotransmitter imbalance. More recently newer hypotheses introduce, among the possible mechanisms of VH, the role of attention networks (ventral and dorsal) and of the Default Mode Network (DMN) a network that is inhibited during attentional tasks and becomes active during rest and self referential imagery. Persistent DMN activity during active tasks with dysfunctional imbalance of dorsal and ventral attentional networks represents a new hypothesis on the mechanism of VH. We review the different methods used to classify VH and discuss reports supporting or challenging the different hypothetical mechanisms of VH.

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Section: Introductionmentioning

confidence: 99%

Visual Hallucinations in PD and Lewy Body Dementias: Old and New Hypotheses

Onofrj

Taylor

Monaco

et al. 2013

Behavioural Neurology

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“…Psychosis is consistently more common in PD patients with dementia, 7,9,11,[19][20][21] and cognitive impairment is a risk factor for later developing hallucinations. 9,22,23 Based on this, many studies have evaluated whether certain cognitive domains are preferentially impaired in PD patients with visual hallucinations.…”

Section: Cognitive and Visual Impairmentmentioning

confidence: 99%

“…7,11,12,15 Studies have also found that greater disease severity, as measured by the Activities of Daily Living subscale of the Unified Parkinson Disease Rating Scale (UPDRS Part II), is an independent risk factor for hallucinations in PD. 8,10,12,13 Papapetropoulos et al found that the total UPDRS score was an independent predictor of visual hallucinations in PD.…”

Section: Age Duration Of Disease and Disease Severitymentioning

confidence: 99%

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Risk Factors for Psychosis in Parkinson’s Disease

Barrett

2017

US Endocrinology

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Psychosis is a characteristic neuropsychiatric symptom of Parkinson's disease (PD) that is common and associated with worse outcomes. The purpose of this article is to review identified risk factors for visual hallucinations in PD, the most common manifestation of psychosis. With the possible exception of dopamine agonists, antiparkinsonian medications are only considered modifiers of psychosis in PD. Dementia in PD has consistently been shown to be associated with psychosis, and executive dysfunction and impairment in visual processing appear to play a role in its pathogenesis. The association of psychosis with disorders of sleep-wake dysregulation and autonomic dysfunction supports the involvement of brainstem dysfunction in PD psychosis. Despite many studies evaluating genetic risk factors for hallucinations, GBA mutations are the only variants consistently reported to be associated with an increased risk of hallucinations in PD. Lastly, psychosis in PD is associated with a more severe disease burden, both related and unrelated to PD pathology. Any explanatory model of psychosis in PD must incorporate pharmacological, neuroanatomic, pathological, and genetic factors before there can be a complete understanding of this common and disabling neuropsychiatric symptom. KeywordsParkinson's disease, psychosis, hallucinations, risk factor, dementia, rapid eye movement (REM) sleep behavior disorder Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. had minor hallucinations prior to PD motor symptom onset.3 In addition to being common, psychosis is also associated with worse outcomes: increased institutionalization, 4 decreased quality of life, 5 and increased mortality. Considering its prevalence and association with worse outcomes, many studies have sought to identify risk factors for psychosis, specifically visual hallucinations. These efforts have contributed to an improved understanding of this disabling neuropsychiatric symptom. Some risk factors, i.e. cognitive impairment and rapid eye movement (REM) sleep behavior disorder (RBD), may be integral to the mechanism by which psychotic symptoms emerge and have contributed to development of explanatory models of psychotic symptoms in PD. Other risk factors likely represent correlations arising from concomitant pathology in areas not involved in psychosis but occurring at a similar disease stage. Lastly, multiple studies have helped to clarify the relationship between antiparkinsonian medications, especially dopaminergic medications, and psychosis in PD.The purpose of this article is to review risk factors fo...

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“…[2][3][4] Neurodegenerative disease, psychotropic medications, and psychological factors may all manifest with or exacerbate symptoms of visual dysfunction. [5][6][7][8][9][10][11][12][13][14] Such multifactorial visual complaints are difficult to diagnose, and may be best approached by a multidisciplinary team. 3 The Visual Perception Clinic in the Newcastle Eye Centre provides such a multidisciplinary service.…”

Section: Introductionmentioning

confidence: 99%

A novel, multidisciplinary clinic for complex visual problems in older people

Han

Jefferis

Archibald

et al. 2012

Eye

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Background Visual symptoms in older people can be complex and inadequately explained by eye pathology alone. Psychological and neurodegenerative processes may manifest as complex visual symptoms, and thus some patients may be poorly served by a purely ophthalmic approach. We have developed a novel multidisciplinary clinic with input from neurology, ophthalmology, and psychiatric specialists. Here, we describe the patient population, disease prevalence, and potential impact of this new clinic. Methods A retrospective audit of paper and electronic records from June 2010 to February 2012 and selected case reports. Results Between June 2010 and February 2012 48 patients attended the clinic. Notes were available for 47 (98%). Mean age was 76.2 (range 48-92). The main presenting complaints were hallucinations, followed by nonspecific visual deficit, double vision, blurred vision, and visuospatial deficit. Cognitive impairment was noted in 68% (32/47) of patients, of which 16/32 (50%) were new diagnoses. We were able to give a diagnosis to 98% (46/47) of patients; of these, 74% (35/46) were new diagnoses. A total of 6% (3/47) were felt to have presentations attributable to eye pathology alone, whereas 89% (42/47) were felt to have a neuropsychiatric component. Management included referral to other clinics for continuing care in 43% (20/47) and initiation of therapy in 36% (17/47). The three case reports demonstrate cases, where our multidisciplinary approach aided diagnosis and management of patients with complex visual symptoms. Conclusion A combined clinic with neurological, ophthalmic, and psychiatric

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Factors associated with drug–induced visual hallucinations in Parkinson's disease

Cited by 67 publications

References 37 publications

Visual Hallucinations in PD and Lewy Body Dementias: Old and New Hypotheses

Visual Hallucinations in PD and Lewy Body Dementias: Old and New Hypotheses

Risk Factors for Psychosis in Parkinson’s Disease

A novel, multidisciplinary clinic for complex visual problems in older people

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