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Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors.
Brain 2000; 123 (Pt 4):733-45B

Abstract

Hallucinations, mainly of a visual nature, are considered to affect about one-quarter of patients with Parkinson's disease. They are commonly viewed as a side-effect of antiparkinsonian treatment, but other factors may be involved. The aim of this study was to determine the phenomenology, prevalence and risk factors of hallucinations in Parkinson's disease. Two-hundred and sixteen consecutive patients fulfilling clinical criteria for Parkinson's disease were studied. Demographic and clinical variables were recorded, including motor and cognitive status, depressive symptoms and sleep-wake disturbances. Patients with and without hallucinations were compared using non-parametric tests, and logistic regression was applied to significant data. Hallucinations had been present during the previous 3 months in 39.8% of the patients, and fell into three categories: minor forms, consisting of a sensation of a presence (person), a sideways passage (commonly of an animal) or illusions were present in 25.5% of the patients (an isolated occurrence in 14.3%), formed visual hallucinations were present in 22.2% (isolated in 9.3%) and auditory hallucinations were present in 9.7% (isolated in 2.3%). Patients with minor hallucinations had a higher depression score than non-hallucinators but did not differ in other respects. Logistic regression analysis identified three factors independently predictive of formed visual hallucinations: severe cognitive disorders, daytime somnolence and a long duration of Parkinson's disease. These findings indicate that, when minor hallucinations are included, the total prevalence is much higher than previously reported. A simple side-effect of dopaminergic treatment is not sufficient to explain the occurrence of all visual hallucinations. The main risk factor in treated patients is cognitive impairment, although sleep-wake cycle disturbances, and possibly other factors related to the duration of the disease, act as cofactors.

Authors+Show Affiliations

Department of Neurology, Hôpital Tenon, Paris, France. gilles.fenelon@tnn.ap-hop-paris.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

10734005

Citation

Fénelon, G, et al. "Hallucinations in Parkinson's Disease: Prevalence, Phenomenology and Risk Factors." Brain : a Journal of Neurology, vol. 123 (Pt 4), 2000, pp. 733-45.
Fénelon G, Mahieux F, Huon R, et al. Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors. Brain. 2000;123 (Pt 4):733-45.
Fénelon, G., Mahieux, F., Huon, R., & Ziégler, M. (2000). Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors. Brain : a Journal of Neurology, 123 (Pt 4), pp. 733-45.
Fénelon G, et al. Hallucinations in Parkinson's Disease: Prevalence, Phenomenology and Risk Factors. Brain. 2000;123 (Pt 4):733-45. PubMed PMID: 10734005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors. AU - Fénelon,G, AU - Mahieux,F, AU - Huon,R, AU - Ziégler,M, PY - 2000/3/29/pubmed PY - 2000/5/8/medline PY - 2000/3/29/entrez SP - 733 EP - 45 JF - Brain : a journal of neurology JO - Brain VL - 123 (Pt 4) N2 - Hallucinations, mainly of a visual nature, are considered to affect about one-quarter of patients with Parkinson's disease. They are commonly viewed as a side-effect of antiparkinsonian treatment, but other factors may be involved. The aim of this study was to determine the phenomenology, prevalence and risk factors of hallucinations in Parkinson's disease. Two-hundred and sixteen consecutive patients fulfilling clinical criteria for Parkinson's disease were studied. Demographic and clinical variables were recorded, including motor and cognitive status, depressive symptoms and sleep-wake disturbances. Patients with and without hallucinations were compared using non-parametric tests, and logistic regression was applied to significant data. Hallucinations had been present during the previous 3 months in 39.8% of the patients, and fell into three categories: minor forms, consisting of a sensation of a presence (person), a sideways passage (commonly of an animal) or illusions were present in 25.5% of the patients (an isolated occurrence in 14.3%), formed visual hallucinations were present in 22.2% (isolated in 9.3%) and auditory hallucinations were present in 9.7% (isolated in 2.3%). Patients with minor hallucinations had a higher depression score than non-hallucinators but did not differ in other respects. Logistic regression analysis identified three factors independently predictive of formed visual hallucinations: severe cognitive disorders, daytime somnolence and a long duration of Parkinson's disease. These findings indicate that, when minor hallucinations are included, the total prevalence is much higher than previously reported. A simple side-effect of dopaminergic treatment is not sufficient to explain the occurrence of all visual hallucinations. The main risk factor in treated patients is cognitive impairment, although sleep-wake cycle disturbances, and possibly other factors related to the duration of the disease, act as cofactors. SN - 0006-8950 UR - https://www.unboundmedicine.com/medline/citation/10734005/full_citation L2 - https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/123.4.733 DB - PRIME DP - Unbound Medicine ER -