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Categorising Visual Hallucinations in Early Parkinson's Disease.
J Parkinsons Dis. 2018; 8(3):447-453.JP

Abstract

BACKGROUND

Visual hallucinations (VHs) are common in Parkinson's disease (PD), with prevalence ranging from 27-50% in cross-sectional cohorts of patients with well-established disease. However, minor hallucinations may occur earlier in the disease process than has been previously reported.

OBJECTIVE

We sought to categorise VHs in a cohort of newly diagnosed PD patients and establish their relationship to other clinical features.

METHODS

Newly diagnosed PD participants (n = 154) were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in PD (ICICLE-PD) study. Participants completed the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS III), Montreal Cognitive Assessment (MoCA) and Parkinson's Disease Questionnaire (PDQ-39) to assess motor severity, cognition and quality of life (QoL), respectively. VHs were classified using the North East Visual Hallucinations Inventory. Hierarchical regression was used to build predictive models of motor severity, QoL and cognition.

RESULTS

22% (n = 34) of participants experienced recurrent VHs with minor VHs being most frequently reported (64.7% of hallucinators). Complex VHs were present in 32.4% of hallucinating participants. Linear regression showed VHs predicted poorer PDQ-39 and MoCA scores (β= 0.201, p = 0.006 and β= - 0.167, p = 0.01, respectively) but not motor severity (p > 0.05).

CONCLUSIONS

Over a fifth of people with newly diagnosed PD reported recurrent VHs; minor hallucinations were the most common, although a small proportion reported complex VHs. Recurrent VHs were found to be a significant independent predictor of cognitive function and QoL but not motor severity. Our findings highlight the importance of screening for VHs at diagnosis.

Authors+Show Affiliations

Institute of Cellular Medicine, Newcastle University, UK.Institute of Neuroscience, Newcastle University, UK. Centre for Clinical Brain Sciences, University of Edinburgh, UK.School of Medicine and Menzies Health Institute Queensland, Griffith University, Australia. School of Medicine, University of Wollongong, New South Wales, Australia.John Van Geest Centre for Brain Repair, University of Cambridge, UK.Faculty of Medical Science, Newcastle University, UK.Institute of Neuroscience, Newcastle University, UK. Newcastle University Institute for Ageing, Newcastle University, UK.Institute of Neuroscience, Newcastle University, UK. Newcastle University Institute for Ageing, Newcastle University, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30040741

Citation

Clegg, Benjamin J., et al. "Categorising Visual Hallucinations in Early Parkinson's Disease." Journal of Parkinson's Disease, vol. 8, no. 3, 2018, pp. 447-453.
Clegg BJ, Duncan GW, Khoo TK, et al. Categorising Visual Hallucinations in Early Parkinson's Disease. J Parkinsons Dis. 2018;8(3):447-453.
Clegg, B. J., Duncan, G. W., Khoo, T. K., Barker, R. A., Burn, D. J., Yarnall, A. J., & Lawson, R. A. (2018). Categorising Visual Hallucinations in Early Parkinson's Disease. Journal of Parkinson's Disease, 8(3), 447-453. https://doi.org/10.3233/JPD-181338
Clegg BJ, et al. Categorising Visual Hallucinations in Early Parkinson's Disease. J Parkinsons Dis. 2018;8(3):447-453. PubMed PMID: 30040741.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Categorising Visual Hallucinations in Early Parkinson's Disease. AU - Clegg,Benjamin J, AU - Duncan,Gordon W, AU - Khoo,Tien K, AU - Barker,Roger A, AU - Burn,David J, AU - Yarnall,Alison J, AU - Lawson,Rachael A, PY - 2018/7/25/pubmed PY - 2019/10/16/medline PY - 2018/7/25/entrez KW - Cognition KW - Parkinson’s disease KW - quality of life KW - visual hallucinations SP - 447 EP - 453 JF - Journal of Parkinson's disease JO - J Parkinsons Dis VL - 8 IS - 3 N2 - BACKGROUND: Visual hallucinations (VHs) are common in Parkinson's disease (PD), with prevalence ranging from 27-50% in cross-sectional cohorts of patients with well-established disease. However, minor hallucinations may occur earlier in the disease process than has been previously reported. OBJECTIVE: We sought to categorise VHs in a cohort of newly diagnosed PD patients and establish their relationship to other clinical features. METHODS: Newly diagnosed PD participants (n = 154) were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in PD (ICICLE-PD) study. Participants completed the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS III), Montreal Cognitive Assessment (MoCA) and Parkinson's Disease Questionnaire (PDQ-39) to assess motor severity, cognition and quality of life (QoL), respectively. VHs were classified using the North East Visual Hallucinations Inventory. Hierarchical regression was used to build predictive models of motor severity, QoL and cognition. RESULTS: 22% (n = 34) of participants experienced recurrent VHs with minor VHs being most frequently reported (64.7% of hallucinators). Complex VHs were present in 32.4% of hallucinating participants. Linear regression showed VHs predicted poorer PDQ-39 and MoCA scores (β= 0.201, p = 0.006 and β= - 0.167, p = 0.01, respectively) but not motor severity (p > 0.05). CONCLUSIONS: Over a fifth of people with newly diagnosed PD reported recurrent VHs; minor hallucinations were the most common, although a small proportion reported complex VHs. Recurrent VHs were found to be a significant independent predictor of cognitive function and QoL but not motor severity. Our findings highlight the importance of screening for VHs at diagnosis. SN - 1877-718X UR - https://www.unboundmedicine.com/medline/citation/30040741/Categorising_Visual_Hallucinations_in_Early_Parkinson's_Disease_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JPD-181338 DB - PRIME DP - Unbound Medicine ER -