Visual Dysfunction in Parkinson's Disease

Bódis-Wollner, Iván; Marx, Marcia S.; Mitra, Sunanda; Bobak, Phyllis; Mylin, L.; Yahr, Melvin D.

doi:10.1093/brain/110.6.1675

Cited by 264 publications

(69 citation statements)

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“…15,16 These findings suggest abnormal function of visual cortical areas. Additional retinal changes cannot be excluded, since some visual abnormalities, such as impaired contrast vision, are mediated by disruption of dopaminergic processes in the retina 35,36 and are unlikely to be discovered during routine neurologic examination or by ordinary high contrast visual acuity testing.…”

mentioning

confidence: 99%

Visual perception in Parkinson disease dementia and dementia with Lewy bodies

Mosimann

Mather²,

Wesnes³

et al. 2004

Neurology

259

176

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Abstract-Objective:To quantify visual discrimination, space-motion, and object-form perception in patients with Parkinson disease dementia (PDD), dementia with Lewy bodies (DLB), and Alzheimer disease (AD). Methods: The authors used a cross-sectional study to compare three demented groups matched for overall dementia severity (PDD: n ϭ 24; DLB: n ϭ 20; AD: n ϭ 23) and two age-, sex-, and education-matched control groups (PD: n ϭ 24, normal controls [NC]: n ϭ 25). Results: Visual perception was globally more impaired in PDD than in nondemented controls (NC, PD), but was not different from DLB. Compared to AD, PDD patients tended to perform worse in all perceptual scores. Visual perception of patients with PDD/DLB and visual hallucinations was significantly worse than in patients without hallucinations. Conclusions: Parkinson disease dementia (PDD) is associated with profound visuoperceptual impairments similar to dementia with Lewy bodies (DLB) but different from Alzheimer disease. These findings are consistent with previous neuroimaging studies reporting hypoactivity in cortical areas involved in visual processing in PDD and DLB. NEUROLOGY 2004;63:2091-2096 Parkinson disease (PD) is associated with a higher risk of developing dementia compared to healthy elderly controls; longitudinal studies suggest that up to 78% of PD patients will develop dementia after nearly two decades of motor symptoms.1 Once dementia is established, clinical symptoms of PD dementia (PDD) may show, apart from a longer duration of motor features, considerable overlap with dementia with Lewy bodies (DLB). The postural instability-gait type of parkinsonism is overrepresented in PDD and DLB 2 and both disorders show similar fluctuation of attention 3 and response to cholinergic therapy. 4,5 Studies comparing visual perception and visual construction of PDD with Alzheimer disease (AD) have revealed contradictory results. Some studies report PDD to be more impaired, 6,7 whereas other studies found no differences. 8,9 Similar inconsistencies have been found when perception of PD patients was compared with healthy controls.10 Since operationalized criteria to define the clinical boundaries between PD and PDD or PDD and DLB require refinement, these inconsistencies may be partly due to diagnostic heterogeneity. When DLB was compared with AD, studies consistently reported greater visual impairment in DLB 11 and a recent study found similar impairments in pentagon copying in DLB and PDD.12 Some of these studies used construction tasks as evidence, but this may not be legitimate given the motor impairments in these patients. Studies quantifying visual perception of DLB and PDD using tasks without motor requirements are lacking.Peripheral structures such as the retina, the optic nerve and tract, and primary visual cortex are multimodal in their function, whereas the visual association cortex is more specialized.13 Low-level visual discrimination is mainly processed in visual area V1/ V2, whereas high-level visual functions require additional activati...

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mentioning

confidence: 99%

Visual perception in Parkinson disease dementia and dementia with Lewy bodies

Mosimann

Mather²,

Wesnes³

et al. 2004

Neurology

259

176

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“…2,45,46 Pattern electroretinogram studies in PD subjects have shown significant loss at midspatial frequencies of 4 cyc/deg, corroborating our findings. 47 With the addition of motion, both PD and control subjects improved their contrast sensitivity at low spatial frequencies. This ''motion gain'' was previously demonstrated in healthy subjects, who exhibited selectively increased contrast sensitivity at a spatial frequency of 1 cyc/deg with moving stimuli of up to 4.38/s.…”

Section: Discussionmentioning

confidence: 95%

Visual Contrast Sensitivity in Early-Stage Parkinson's Disease

Ming

Palidis

Spering

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Visual impairments are frequent in Parkinson's disease (PD) and impact normal functioning in daily activities. Visual contrast sensitivity is a powerful nonmotor sign for discriminating PD patients from controls. However, it is usually assessed with static visual stimuli. Here we examined the interaction between perception and eye movements in static and dynamic contrast sensitivity tasks in a cohort of mildly impaired, early-stage PD patients. METHODS.Patients (n ¼ 13) and healthy age-matched controls (n ¼ 12) viewed stimuli of various spatial frequencies (0-8 cyc/deg) and speeds (08/s, 108/s, 308/s) on a computer monitor. Detection thresholds were determined by asking participants to adjust luminance contrast until they could just barely see the stimulus. Eye position was recorded with a videobased eye tracker. RESULTS.Patients' static contrast sensitivity was impaired in the intermediate spatial-frequency range and this impairment correlated with fixational instability. However, dynamic contrast sensitivity and patients' smooth pursuit were relatively normal. An independent component analysis revealed contrast sensitivity profiles differentiating patients and controls.CONCLUSIONS. Our study simultaneously assesses perceptual contrast sensitivity and eye movements in PD, revealing a possible link between fixational instability and perceptual deficits. Spatiotemporal contrast sensitivity profiles may represent an easily measurable metric as a component of a broader combined biometric for nonmotor features observed in PD.

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“…Dopamine deficiency and dopaminergic neuronal degeneration in retina leading to abnormal perception of colour and motion reduced contrast sensitivity in PD [8,9,10,11,12] Impaired vision in PD was first shown by psychophysical and visual evoked potential (VEP) measurements [13,14] Post-Mortem Studies: The DA content of the retina as measured at post-mortem, is low in PD. Dopaminergic neuronal cells have been identified in the inner nuclear and inner plexiform layers , there is concurrent retinal dopamine neurons loss in PD [15] PD and the role of retina as a model of neurodegeneration Thinning of the retinal nerve fibre layer (RNFL), the inner retinal layer (IRL), and macular thickness have been Documented in few studies, and it has been proposed that this may correlate with loss of these dopaminergic cells and progression of functional visual abnormalities in PD patients [16,17] OCT scan OCT is a new non-invasive, imaging technology which provides very high resolution, cross sectional images retina and measure anatomic layers of the retina.…”

Section: Jmscr Vol||05||issue||06||page 24166-24171||june 2017mentioning

confidence: 99%

Study of Correlation of Retinal Layer Thickness with Duration and Severity of Parkinson’s Disease

Jadhav¹

2017

jmscr

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Visual Dysfunction in Parkinson's Disease

Cited by 264 publications

References 0 publications

Visual perception in Parkinson disease dementia and dementia with Lewy bodies

Visual perception in Parkinson disease dementia and dementia with Lewy bodies

Visual Contrast Sensitivity in Early-Stage Parkinson's Disease

Study of Correlation of Retinal Layer Thickness with Duration and Severity of Parkinson’s Disease

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