Visual Hallucinations and the Role of Medications in Parkinson’s Disease: Triggers, Pathophysiology, and Management

Powell, Alice; Ireland, Catriona; Lewis, Simon J.G.

doi:10.1176/appi.neuropsych.19110316

Cited by 22 publications

(27 citation statements)

References 99 publications

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“…Recently, a role for serotonergic dysfunction in VH has been suggested 27 , linked to alterations of 5-HT2 A receptor density 28 , 29 (for a review, see ref. 30 ).…”

Section: Introductionmentioning

confidence: 99%

Mapping brain structural differences and neuroreceptor correlates in Parkinson’s disease visual hallucinations

et al. 2022

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Parkinson’s psychosis (PDP) describes a spectrum of symptoms that may arise in Parkinson’s disease (PD) including visual hallucinations (VH). Imaging studies investigating the neural correlates of PDP have been inconsistent in their findings, due to differences in study design and limitations of scale. Here we use empirical Bayes harmonisation to pool together structural imaging data from multiple research groups into a large-scale mega-analysis, allowing us to identify cortical regions and networks involved in VH and their relation to receptor binding. Differences of morphometrics analysed show a wider cortical involvement underlying VH than previously recognised, including primary visual cortex and surrounding regions, and the hippocampus, independent of its role in cognitive decline. Structural covariance analyses point to the involvement of the attentional control networks in PD-VH, while associations with receptor density maps suggest neurotransmitter loss may be linked to the cortical changes.

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“…Recently, a role for serotonergic dysfunction in VH has been suggested 27 , linked to alterations of 5-HT2 A receptor density 28 , 29 (for a review, see ref. 30 ).…”

Section: Introductionmentioning

confidence: 99%

Mapping brain structural differences and neuroreceptor correlates in Parkinson’s disease visual hallucinations

et al. 2022

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“…Janzen et al, 2012; Collerton et al, 2005), with neurodegeneration in brainstem and forebrain cholinergic nuclei (Janzen et al, 2012) and electrophysiological measures of cholinergic function reduced in patients with VH (Manganelli et al 2009). Recently, a role for serotonergic dysfunction in VH has been suggested (Ballanger et al, 2010), linked to alterations of 5-HT 2A receptor density (Yasue et al, 2016; Huot et al, 2010) (for a review Powell et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Mapping brain structural differences and neuroreceptor correlates in Parkinson’s disease visual hallucinations: a mega-analysis

Vignando

ffytche

Lewis

et al. 2021

Preprint

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Parkinson's psychosis (PDP) describes a spectrum of symptoms that may arise in Parkinson's disease (PD) including visual hallucinations (VH). Imaging studies investigating the neural correlates of PDP have been inconsistent in their findings, due to differences in study design and limitations of scale. Here we use empirical Bayes harmonisation to pool together structural imaging data from multiple research groups into a large-scale mega-analysis, allowing us to apply new methodological approaches to identify cortical regions and networks involved in VH and their relation to receptor binding. Differences of cortical thickness and surface area show a wider cortical involvement underlying VH than previously recognised, including primary visual cortex and its surrounds, and the hippocampus, independent of its role in cognitive decline. Structural covariance analyses point to a strong involvement of the attentional control networks in PD-VH, while associations with receptor density maps suggest neurotransmitter loss may drive the cortical changes.

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“…The less functional allele of the 5-HTTLPR protects against VH and later in the disease course also against dyskinesia. This indicates that selective serotonin reuptake inhibitors could possibily be used to treat or prevent these AE [8,50,51]. Additionally, HTR1A rs6295 affected the occurrence of VH and motor complications, but in an opposite manner.…”

Section: Discussionmentioning

confidence: 99%

Serotonin-Related Functional Genetic Variants Affect the Occurrence of Psychiatric and Motor Adverse Events of Dopaminergic Treatment in Parkinson’s Disease: A Retrospective Cohort Study

Redenšek

Blagus

Trošt

et al. 2022

JPM

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The serotonergic system is important in Parkinson’s disease (PD) pathogenesis as it can take over dopamine production after a large portion of dopaminergic neurons is lost through neurodegeneration. The aim of this study was to evaluate the effect of genetic variability of serotonergic genes on the occurrence of motor complications and psychiatric adverse events (AE) due to dopaminergic treatment. We enrolled 231 patients and their clinical data were collected. Genotyping was performed for eight genetic variants. Logistic regression was used for analysis. Carriers of the HTR1A rs6295 GC genotype (OR = 2.58; 95% CI = 1.15–5.78; p = 0.021), TPH2 rs4290270 AA genotype (OR = 2.78; 95% CI = 1.08–7.03; p = 0.034), and at least one TPH2 rs4570625 T allele (OR = 1.86; 95% CI = 1.00–3.44; p = 0.047) had increased risk for visual hallucinations (VH). Additionally, carriers of at least one SLC6A4 5-HTTPLR rs25531 S (OR = 0.52; 95% CI = 0.28–0.96; p = 0.037) or at least one LG allele (OR = 0.37; 95% CI = 0.14–0.97; p = 0.044) had a decreased chance for VH. Constructed haplotypes of the TPH2 showed increased risk for VH (OR = 1.94; 95% CI = 1.06–3.55; p = 0.032) and impulse control disorders (OR = 5.20; 95% CI = 1.86–14.50; p = 0.002). Finally, individual gene–gene interactions showed decreased odds for the development of motor AE. Our findings suggest that the serotonergic pathway may play an important role in the development of AE resulting from dopaminergic treatment.

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Visual Hallucinations and the Role of Medications in Parkinson’s Disease: Triggers, Pathophysiology, and Management

Cited by 22 publications

References 99 publications

Mapping brain structural differences and neuroreceptor correlates in Parkinson’s disease visual hallucinations

Mapping brain structural differences and neuroreceptor correlates in Parkinson’s disease visual hallucinations

Mapping brain structural differences and neuroreceptor correlates in Parkinson’s disease visual hallucinations: a mega-analysis

Serotonin-Related Functional Genetic Variants Affect the Occurrence of Psychiatric and Motor Adverse Events of Dopaminergic Treatment in Parkinson’s Disease: A Retrospective Cohort Study

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