Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease
Identifieur interne : 001B54 ( Main/Exploration ); précédent : 001B53; suivant : 001B55Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease
Auteurs : Gisela Llebaria [Espagne] ; Javier Pagonabarraga [Espagne] ; Mercè Martínez-Corral [Espagne] ; Carmen García-Sánchez [Espagne] ; Berta Pascual-Sedano [Espagne] ; Alexandre Gironell [Espagne] ; Jaime Kulisevsky [Espagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2010-12-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Analysis of Variance, Cognition, Cognition Disorders (etiology), Cognition Disorders (psychology), Dementia, Dysfunction, Hallucination, Hallucinations (complications), Hallucinations (psychology), Humans, Nervous system diseases, Neuropsychological Tests, Parkinson Disease (complications), Parkinson Disease (psychology), Parkinson disease, Parkinson's disease, Prospective Studies, Quality of Life, Risk Factors, dementia, hallucinations, insight, posterior cortical dysfunction.
- MESH :
- complications : Hallucinations, Parkinson Disease.
- etiology : Cognition Disorders.
- psychology : Cognition Disorders, Hallucinations, Parkinson Disease.
- Aged, Aged, 80 and over, Analysis of Variance, Cognition, Humans, Neuropsychological Tests, Prospective Studies, Quality of Life, Risk Factors.
Abstract
The development of visual hallucinations (VH) is a frequent complication of Parkinson's disease (PD). Presence of hallucinations is one of the main risk factors associated with dementia, and severity progression of VH mainly contributes to impaired quality of life in PD. The neuropsychological features associated with severity progression of VH are unknown and might help to detect patients at risk of a more severe outcome. We aimed to explore the neuropsychological deficits associated with the different types of VH observed in PD, from minor hallucinations to well‐formed VH with loss of insight. Prospective study of 57 PD patients with (n = 29) and without VH (n = 28) matched for age, education, antiparkinsonian medications, and disease duration. Description of VH was assessed by the Hallucinations and Psychosis item of the MDS‐UPDRS. Cognition was assessed with the Parkinson's Disease‐Cognitive Rating Scale (PD‐CRS) and the Mattis Dementia Rating Scale (MDRS). Patients with minor VH did not differ from patients without VH in any cognitive domain. PD patients with major VH and insight retained performed worse on the action verbal fluency task (P < 0.04), and patients with VH and loss of insight showed a greater impairment on the PD‐CRS posterior cortical score (P = 0.021) and the clock copying item (P = 0.01). A double dissociation was found in the neuropsychological profile of patients with VH with and without loss of insight. While the presence of major VH with insight retained appeared related to a predominant frontal‐striatal impairment, loss of insight was characterized by further impairment of cognitive functions related to posterior cortical areas. A comprehensible continuum pattern of clinical relationships emerged among VH and cognitive functioning in PD. © 2010 Movement Disorder Society.
Url:
DOI: 10.1002/mds.23411
Affiliations:
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<front><div type="abstract" xml:lang="en">The development of visual hallucinations (VH) is a frequent complication of Parkinson's disease (PD). Presence of hallucinations is one of the main risk factors associated with dementia, and severity progression of VH mainly contributes to impaired quality of life in PD. The neuropsychological features associated with severity progression of VH are unknown and might help to detect patients at risk of a more severe outcome. We aimed to explore the neuropsychological deficits associated with the different types of VH observed in PD, from minor hallucinations to well‐formed VH with loss of insight. Prospective study of 57 PD patients with (n = 29) and without VH (n = 28) matched for age, education, antiparkinsonian medications, and disease duration. Description of VH was assessed by the Hallucinations and Psychosis item of the MDS‐UPDRS. Cognition was assessed with the Parkinson's Disease‐Cognitive Rating Scale (PD‐CRS) and the Mattis Dementia Rating Scale (MDRS). Patients with minor VH did not differ from patients without VH in any cognitive domain. PD patients with major VH and insight retained performed worse on the action verbal fluency task (P < 0.04), and patients with VH and loss of insight showed a greater impairment on the PD‐CRS posterior cortical score (P = 0.021) and the clock copying item (P = 0.01). A double dissociation was found in the neuropsychological profile of patients with VH with and without loss of insight. While the presence of major VH with insight retained appeared related to a predominant frontal‐striatal impairment, loss of insight was characterized by further impairment of cognitive functions related to posterior cortical areas. A comprehensible continuum pattern of clinical relationships emerged among VH and cognitive functioning in PD. © 2010 Movement Disorder Society.</div>
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<name sortKey="Pascual Edano, Berta" sort="Pascual Edano, Berta" uniqKey="Pascual Edano B" first="Berta" last="Pascual-Sedano">Berta Pascual-Sedano</name>
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