Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease
Identifieur interne : 000856 ( Main/Corpus ); précédent : 000855; suivant : 000857Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease
Auteurs : Gisela Llebaria ; Javier Pagonabarraga ; Mercè Martínez-Corral ; Carmen García-Sánchez ; Berta Pascual-Sedano ; Alexandre Gironell ; Jaime KulisevskySource :
- Movement Disorders [ 0885-3185 ] ; 2010-12-15.
English descriptors
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.
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DOI: 10.1002/mds.23411
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-12-15">2010-12-15</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">16</biblScope><biblScope unit="page" from="2785">2785</biblScope><biblScope unit="page" to="2791">2791</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">7D520AE687E13B7E4A1CB7C5D29D91709E2F28F9</idno><idno type="DOI">10.1002/mds.23411</idno><idno type="ArticleID">MDS23411</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>dementia</term><term>hallucinations</term><term>insight</term><term>posterior cortical dysfunction</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><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></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Gisela Llebaria BSc</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Javier Pagonabarraga MD, PhD</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Mercè Martínez‐Corral MD</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Carmen García‐Sánchez BSc, PhD</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Berta Pascual‐Sedano MD, PhD</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Alexandre Gironell MD, PhD</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item><json:item><name>Jaime Kulisevsky MD, PhD</name><affiliations><json:string>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hallucinations</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dementia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>insight</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>posterior cortical dysfunction</value></json:item></subject><articleId><json:string>MDS23411</json:string></articleId><language><json:string>eng</json:string></language><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. 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Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation></author><author><persName><forename type="first">Carmen</forename><surname>García‐Sánchez</surname></persName><roleName type="degree">BSc, PhD</roleName><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation></author><author><persName><forename type="first">Berta</forename><surname>Pascual‐Sedano</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation></author><author><persName><forename type="first">Alexandre</forename><surname>Gironell</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation></author><author><persName><forename type="first">Jaime</forename><surname>Kulisevsky</surname></persName><roleName type="degree">MD, PhD</roleName><note type="correspondence"><p>Correspondence: Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Sant Antoni M. Claret 167, 08025 Barcelona, Spain</p></note><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-12-15"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">16</biblScope><biblScope unit="page" from="2785">2785</biblScope><biblScope unit="page" to="2791">2791</biblScope></imprint></monogr><idno type="istex">7D520AE687E13B7E4A1CB7C5D29D91709E2F28F9</idno><idno type="DOI">10.1002/mds.23411</idno><idno type="ArticleID">MDS23411</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>hallucinations</term></item><item><term>dementia</term></item><item><term>insight</term></item><item><term>posterior cortical dysfunction</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-03-08">Received</change><change when="2010-07-27">Registration</change><change when="2010-12-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/7D520AE687E13B7E4A1CB7C5D29D91709E2F28F9/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="160"><doi origin="wiley" registered="yes">10.1002/mds.v25.16</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">16</numbering></numberingGroup><coverDate startDate="2010-12-15">15 December 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="130" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23411</doi><idGroup><id type="unit" value="MDS23411"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2010-03-08"></event><event type="manuscriptRevised" date="2010-06-19"></event><event type="manuscriptAccepted" date="2010-07-27"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.4 mode:FullText" date="2010-12-16"></event><event type="publishedOnlineEarlyUnpaginated" date="2010-10-19"></event><event type="firstOnline" date="2010-10-19"></event><event type="publishedOnlineFinalForm" date="2010-12-16"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">2785</numbering><numbering type="pageLast">2791</numbering></numberingGroup><correspondenceTo>Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Sant Antoni M. Claret 167, 08025 Barcelona, Spain</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23411.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="4"></count><count type="referenceTotal" number="35"></count><count type="wordTotal" number="5642"></count></countGroup><titleGroup><title type="main" xml:lang="en">Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease<link href="#fn7"></link></title><title type="short" xml:lang="en">Neuropsychology of VH in Parkinson's Disease</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Gisela</givenNames><familyName>Llebaria</familyName><degrees>BSc</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Javier</givenNames><familyName>Pagonabarraga</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Mercè</givenNames><familyName>Martínez‐Corral</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Carmen</givenNames><familyName>García‐Sánchez</familyName><degrees>BSc, PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Berta</givenNames><familyName>Pascual‐Sedano</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alexandre</givenNames><familyName>Gironell</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Jaime</givenNames><familyName>Kulisevsky</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>jkulisevsky@santpau.cat</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">hallucinations</keyword><keyword xml:id="kwd3">dementia</keyword><keyword xml:id="kwd4">insight</keyword><keyword xml:id="kwd5">posterior cortical dysfunction</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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 (<i>P</i> < 0.04), and patients with VH and loss of insight showed a greater impairment on the PD‐CRS posterior cortical score (<i>P</i> = 0.021) and the clock copying item (<i>P</i> = 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.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn7"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Neuropsychology of VH in Parkinson's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Gisela</namePart><namePart type="family">Llebaria</namePart><namePart type="termsOfAddress">BSc</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Javier</namePart><namePart type="family">Pagonabarraga</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mercè</namePart><namePart type="family">Martínez‐Corral</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carmen</namePart><namePart type="family">García‐Sánchez</namePart><namePart type="termsOfAddress">BSc, PhD</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Berta</namePart><namePart type="family">Pascual‐Sedano</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alexandre</namePart><namePart type="family">Gironell</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jaime</namePart><namePart type="family">Kulisevsky</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Movement Disorders Unit, Neurology Department, Sant Pau Hospital (Sant Pau Institute of Biomedical Research), Autonomous University of Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain</affiliation><description>Correspondence: Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Sant Antoni M. Claret 167, 08025 Barcelona, Spain</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-12-15</dateIssued><dateCaptured encoding="w3cdtf">2010-03-08</dateCaptured><dateValid encoding="w3cdtf">2010-07-27</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">4</extent><extent unit="references">35</extent><extent unit="words">5642</extent></physicalDescription><abstract 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.</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>hallucinations</topic><topic>dementia</topic><topic>insight</topic><topic>posterior cortical dysfunction</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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