Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations
Identifieur interne : 001517 ( Main/Corpus ); précédent : 001516; suivant : 001518Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations
Auteurs : Anne Marthe Meppelink ; Bauke M. De Jong ; Remco Renken ; Klaus L. Leenders ; Frans W. Cornelissen ; Teus Van LaarSource :
- Brain [ 0006-8950 ] ; 2009-11.
Abstract
Impaired visual processing may play a role in the pathophysiology of visual hallucinations in Parkinson's disease. In order to study involved neuronal circuitry, we assessed cerebral activation patterns both before and during recognition of gradually revealed images in Parkinson's disease patients with visual hallucinations (PDwithVHs), Parkinson's disease patients without visual hallucinations (PDnonVHs) and healthy controls. We hypothesized that, before image recognition, PDwithVHs would show reduced bottom-up visual activation in occipital-temporal areas and increased (pre)frontal activation, reflecting increased top-down demand. Overshoot of the latter has been proposed to play a role in generating visual hallucinations. Nine non-demented PDwithVHs, 14 PDnonVHs and 13 healthy controls were scanned on a 3 Tesla magnetic resonance imaging scanner. Static images of animals and objects gradually appearing out of random visual noise were used in an event-related design paradigm. Analyses were time-locked on the moment of image recognition, indicated by the subjects button-press. Subjects were asked to press an additional button on a colour-changing fixation dot, to keep attention and motor action constant and to assess reaction times. Data pre-processing and statistical analysis were performed with statistical parametric mapping-5 software. Bilateral activation of the fusiform and lingual gyri was seen during image recognition in all groups (P < 0.001). Several seconds before image recognition, PDwithVHs showed reduced activation of the lateral occipital cortex, compared with both PDnonVHs and healthy controls. In addition, reduced activation of extrastriate temporal visual cortices was seen just before image recognition in PDwithVHs. The association between increased vulnerability for visual hallucintions in Parkinson's disease and impaired visual object processing in occipital and temporal extrastriate visual cortices supported the hypothesis of impaired bottom-up visual processing in PDwithVHs. Support for the hypothesized increased top-down frontal activation was not obtained. The finding of activation reductions in ventral/lateral visual association cortices in PDwithVHs before image recognition further helps to explain functional mechanisms underlying visual hallucinations in Parkinson's disease.
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DOI: 10.1093/brain/awp223
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De Jong</name><affiliation><mods:affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Renken, Remco" sort="Renken, Remco" uniqKey="Renken R" first="Remco" last="Renken">Remco Renken</name><affiliation><mods:affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Leenders, Klaus L" sort="Leenders, Klaus L" uniqKey="Leenders K" first="Klaus L." last="Leenders">Klaus L. Leenders</name><affiliation><mods:affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Cornelissen, Frans W" sort="Cornelissen, Frans W" uniqKey="Cornelissen F" first="Frans W." last="Cornelissen">Frans W. Cornelissen</name><affiliation><mods:affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>4 Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Van Laar, Teus" sort="Van Laar, Teus" uniqKey="Van Laar T" first="Teus" last="Van Laar">Teus Van Laar</name><affiliation><mods:affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-11">2009-11</date><biblScope unit="volume">132</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="2980">2980</biblScope><biblScope unit="page" to="2993">2993</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">795973AF8B7E6006413527193CA897EDF805B978</idno><idno type="DOI">10.1093/brain/awp223</idno><idno type="ArticleID">awp223</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Impaired visual processing may play a role in the pathophysiology of visual hallucinations in Parkinson's disease. In order to study involved neuronal circuitry, we assessed cerebral activation patterns both before and during recognition of gradually revealed images in Parkinson's disease patients with visual hallucinations (PDwithVHs), Parkinson's disease patients without visual hallucinations (PDnonVHs) and healthy controls. We hypothesized that, before image recognition, PDwithVHs would show reduced bottom-up visual activation in occipital-temporal areas and increased (pre)frontal activation, reflecting increased top-down demand. Overshoot of the latter has been proposed to play a role in generating visual hallucinations. Nine non-demented PDwithVHs, 14 PDnonVHs and 13 healthy controls were scanned on a 3 Tesla magnetic resonance imaging scanner. Static images of animals and objects gradually appearing out of random visual noise were used in an event-related design paradigm. Analyses were time-locked on the moment of image recognition, indicated by the subjects button-press. Subjects were asked to press an additional button on a colour-changing fixation dot, to keep attention and motor action constant and to assess reaction times. Data pre-processing and statistical analysis were performed with statistical parametric mapping-5 software. Bilateral activation of the fusiform and lingual gyri was seen during image recognition in all groups (P < 0.001). Several seconds before image recognition, PDwithVHs showed reduced activation of the lateral occipital cortex, compared with both PDnonVHs and healthy controls. In addition, reduced activation of extrastriate temporal visual cortices was seen just before image recognition in PDwithVHs. The association between increased vulnerability for visual hallucintions in Parkinson's disease and impaired visual object processing in occipital and temporal extrastriate visual cortices supported the hypothesis of impaired bottom-up visual processing in PDwithVHs. Support for the hypothesized increased top-down frontal activation was not obtained. The finding of activation reductions in ventral/lateral visual association cortices in PDwithVHs before image recognition further helps to explain functional mechanisms underlying visual hallucinations in Parkinson's disease.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Anne Marthe Meppelink</name><affiliations><json:string>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</json:string><json:string>E-mail: a.m.meppelink@neuro.umcg.nl</json:string></affiliations></json:item><json:item><name>Bauke M. de Jong</name><affiliations><json:string>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</json:string></affiliations></json:item><json:item><name>Remco Renken</name><affiliations><json:string>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</json:string></affiliations></json:item><json:item><name>Klaus L. Leenders</name><affiliations><json:string>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</json:string></affiliations></json:item><json:item><name>Frans W. Cornelissen</name><affiliations><json:string>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</json:string><json:string>4 Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</json:string></affiliations></json:item><json:item><name>Teus van Laar</name><affiliations><json:string>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</json:string><json:string>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Original Articles</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>fMRI</value></json:item><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>visual hallucinations</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Impaired visual processing may play a role in the pathophysiology of visual hallucinations in Parkinson's disease. In order to study involved neuronal circuitry, we assessed cerebral activation patterns both before and during recognition of gradually revealed images in Parkinson's disease patients with visual hallucinations (PDwithVHs), Parkinson's disease patients without visual hallucinations (PDnonVHs) and healthy controls. We hypothesized that, before image recognition, PDwithVHs would show reduced bottom-up visual activation in occipital-temporal areas and increased (pre)frontal activation, reflecting increased top-down demand. Overshoot of the latter has been proposed to play a role in generating visual hallucinations. Nine non-demented PDwithVHs, 14 PDnonVHs and 13 healthy controls were scanned on a 3 Tesla magnetic resonance imaging scanner. Static images of animals and objects gradually appearing out of random visual noise were used in an event-related design paradigm. Analyses were time-locked on the moment of image recognition, indicated by the subjects button-press. Subjects were asked to press an additional button on a colour-changing fixation dot, to keep attention and motor action constant and to assess reaction times. Data pre-processing and statistical analysis were performed with statistical parametric mapping-5 software. Bilateral activation of the fusiform and lingual gyri was seen during image recognition in all groups (P > 0.001). Several seconds before image recognition, PDwithVHs showed reduced activation of the lateral occipital cortex, compared with both PDnonVHs and healthy controls. In addition, reduced activation of extrastriate temporal visual cortices was seen just before image recognition in PDwithVHs. The association between increased vulnerability for visual hallucintions in Parkinson's disease and impaired visual object processing in occipital and temporal extrastriate visual cortices supported the hypothesis of impaired bottom-up visual processing in PDwithVHs. Support for the hypothesized increased top-down frontal activation was not obtained. The finding of activation reductions in ventral/lateral visual association cortices in PDwithVHs before image recognition further helps to explain functional mechanisms underlying visual hallucinations in Parkinson's disease.</abstract><qualityIndicators><score>8.5</score><pdfVersion>1.4</pdfVersion><pdfPageSize>612.68 x 790.866 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>2342</abstractCharCount><pdfWordCount>8224</pdfWordCount><pdfCharCount>53819</pdfCharCount><pdfPageCount>14</pdfPageCount><abstractWordCount>312</abstractWordCount></qualityIndicators><title>Impaired visual processing preceding image recognition in Parkinson's disease patients with visual 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NEUROLOGY</json:string><json:string>NEUROSCIENCES</json:string></wos></categories><publicationDate>2009</publicationDate><copyrightDate>2009</copyrightDate><doi><json:string>10.1093/brain/awp223</json:string></doi><id>795973AF8B7E6006413527193CA897EDF805B978</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/795973AF8B7E6006413527193CA897EDF805B978/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/795973AF8B7E6006413527193CA897EDF805B978/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/795973AF8B7E6006413527193CA897EDF805B978/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>OUP</p></availability><date>2009-09-15</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations</title><author corresp="yes"><persName><forename type="first">Anne Marthe</forename><surname>Meppelink</surname></persName><email>a.m.meppelink@neuro.umcg.nl</email><affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation></author><author><persName><forename type="first">Bauke M.</forename><surname>de Jong</surname></persName><affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation></author><author><persName><forename type="first">Remco</forename><surname>Renken</surname></persName><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation></author><author><persName><forename type="first">Klaus L.</forename><surname>Leenders</surname></persName><affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation></author><author><persName><forename type="first">Frans W.</forename><surname>Cornelissen</surname></persName><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>4 Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation></author><author><persName><forename type="first">Teus</forename><surname>van Laar</surname></persName><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation></author></analytic><monogr><title level="j">Brain</title><idno type="pISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-11"></date><biblScope unit="volume">132</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="2980">2980</biblScope><biblScope unit="page" to="2993">2993</biblScope></imprint></monogr><idno type="istex">795973AF8B7E6006413527193CA897EDF805B978</idno><idno type="DOI">10.1093/brain/awp223</idno><idno type="ArticleID">awp223</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2009-09-15</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Impaired visual processing may play a role in the pathophysiology of visual hallucinations in Parkinson's disease. In order to study involved neuronal circuitry, we assessed cerebral activation patterns both before and during recognition of gradually revealed images in Parkinson's disease patients with visual hallucinations (PDwithVHs), Parkinson's disease patients without visual hallucinations (PDnonVHs) and healthy controls. We hypothesized that, before image recognition, PDwithVHs would show reduced bottom-up visual activation in occipital-temporal areas and increased (pre)frontal activation, reflecting increased top-down demand. Overshoot of the latter has been proposed to play a role in generating visual hallucinations. Nine non-demented PDwithVHs, 14 PDnonVHs and 13 healthy controls were scanned on a 3 Tesla magnetic resonance imaging scanner. Static images of animals and objects gradually appearing out of random visual noise were used in an event-related design paradigm. Analyses were time-locked on the moment of image recognition, indicated by the subjects button-press. Subjects were asked to press an additional button on a colour-changing fixation dot, to keep attention and motor action constant and to assess reaction times. Data pre-processing and statistical analysis were performed with statistical parametric mapping-5 software. Bilateral activation of the fusiform and lingual gyri was seen during image recognition in all groups (P < 0.001). Several seconds before image recognition, PDwithVHs showed reduced activation of the lateral occipital cortex, compared with both PDnonVHs and healthy controls. In addition, reduced activation of extrastriate temporal visual cortices was seen just before image recognition in PDwithVHs. The association between increased vulnerability for visual hallucintions in Parkinson's disease and impaired visual object processing in occipital and temporal extrastriate visual cortices supported the hypothesis of impaired bottom-up visual processing in PDwithVHs. Support for the hypothesized increased top-down frontal activation was not obtained. The finding of activation reductions in ventral/lateral visual association cortices in PDwithVHs before image recognition further helps to explain functional mechanisms underlying visual hallucinations in Parkinson's disease.</p></abstract><textClass><keywords scheme="keyword"><list><item><term>Original Articles</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>fMRI</term></item><item><term>Parkinson's disease</term></item><item><term>visual hallucinations</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-09-15">Created</change><change when="2009-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/795973AF8B7E6006413527193CA897EDF805B978/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">brain</journal-id><journal-id journal-id-type="publisher-id">brainj</journal-id><journal-title>Brain</journal-title><issn pub-type="ppub">0006-8950</issn><issn pub-type="epub">1460-2156</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/brain/awp223</article-id><article-id pub-id-type="publisher-id">awp223</article-id><article-categories><subj-group><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Meppelink</surname><given-names>Anne Marthe</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref><xref ref-type="aff" rid="AFF3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>de Jong</surname><given-names>Bauke M.</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref><xref ref-type="aff" rid="AFF3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Renken</surname><given-names>Remco</given-names></name><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Leenders</surname><given-names>Klaus L.</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref><xref ref-type="aff" rid="AFF3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Cornelissen</surname><given-names>Frans W.</given-names></name><xref ref-type="aff" rid="AFF3"><sup>3</sup></xref><xref ref-type="aff" rid="AFF4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>van Laar</surname><given-names>Teus</given-names></name><xref ref-type="aff" rid="AFF2"><sup>1</sup></xref><xref ref-type="aff" rid="AFF2"><sup>2</sup></xref><xref ref-type="aff" rid="AFF3"><sup>3</sup></xref></contrib></contrib-group><aff id="AFF1">1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</aff><aff id="AFF2">2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</aff><aff id="AFF3">3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</aff><aff id="AFF4">4 Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</aff><author-notes><corresp>Correspondence to: Anne Marthe Meppelink, MD, Department of Neurology, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands E-mail: <email>a.m.meppelink@neuro.umcg.nl</email></corresp></author-notes><pub-date pub-type="ppub"><month>11</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>15</day><month>9</month><year>2009</year></pub-date><volume>132</volume><issue>11</issue><fpage>2980</fpage><lpage>2993</lpage><history><date date-type="received"><day>23</day><month>3</month><year>2009</year></date><date date-type="rev-recd"><day>14</day><month>7</month><year>2009</year></date><date date-type="accepted"><day>15</day><month>7</month><year>2009</year></date></history><permissions><copyright-statement>© The Author (2009). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</copyright-statement><copyright-year>2009</copyright-year></permissions><abstract><p>Impaired visual processing may play a role in the pathophysiology of visual hallucinations in Parkinson's disease. In order to study involved neuronal circuitry, we assessed cerebral activation patterns both before and during recognition of gradually revealed images in Parkinson's disease patients with visual hallucinations (PDwithVHs), Parkinson's disease patients without visual hallucinations (PDnonVHs) and healthy controls. We hypothesized that, before image recognition, PDwithVHs would show reduced bottom-up visual activation in occipital-temporal areas and increased (pre)frontal activation, reflecting increased top-down demand. Overshoot of the latter has been proposed to play a role in generating visual hallucinations. Nine non-demented PDwithVHs, 14 PDnonVHs and 13 healthy controls were scanned on a 3 Tesla magnetic resonance imaging scanner. Static images of animals and objects gradually appearing out of random visual noise were used in an event-related design paradigm. Analyses were time-locked on the moment of image recognition, indicated by the subjects’ button-press. Subjects were asked to press an additional button on a colour-changing fixation dot, to keep attention and motor action constant and to assess reaction times. Data pre-processing and statistical analysis were performed with statistical parametric mapping-5 software. Bilateral activation of the fusiform and lingual gyri was seen during image recognition in all groups (<italic>P</italic> < 0.001). Several seconds before image recognition, PDwithVHs showed reduced activation of the lateral occipital cortex, compared with both PDnonVHs and healthy controls. In addition, reduced activation of extrastriate temporal visual cortices was seen just before image recognition in PDwithVHs. The association between increased vulnerability for visual hallucintions in Parkinson's disease and impaired visual object processing in occipital and temporal extrastriate visual cortices supported the hypothesis of impaired bottom-up visual processing in PDwithVHs. Support for the hypothesized increased top-down frontal activation was not obtained. The finding of activation reductions in ventral/lateral visual association cortices in PDwithVHs <italic>before</italic> image recognition further helps to explain functional mechanisms underlying visual hallucinations in Parkinson's disease.</p></abstract><kwd-group><kwd>fMRI</kwd><kwd>Parkinson's disease</kwd><kwd>visual hallucinations</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Impaired visual processing preceding image recognition in Parkinson's disease patients with visual hallucinations</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">Anne Marthe</namePart><namePart type="family">Meppelink</namePart><affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>E-mail: a.m.meppelink@neuro.umcg.nl</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bauke M.</namePart><namePart type="family">de Jong</namePart><affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Remco</namePart><namePart type="family">Renken</namePart><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Klaus L.</namePart><namePart type="family">Leenders</namePart><affiliation>1 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frans W.</namePart><namePart type="family">Cornelissen</namePart><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>4 Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Teus</namePart><namePart type="family">van Laar</namePart><affiliation>2 Neuro Imaging Center (NIC) Groningen, University of Groningen, Groningen, The Netherlands</affiliation><affiliation>3 School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><topic>Original Articles</topic></subject><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2009-11</dateIssued><dateCreated encoding="w3cdtf">2009-09-15</dateCreated><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Impaired visual processing may play a role in the pathophysiology of visual hallucinations in Parkinson's disease. In order to study involved neuronal circuitry, we assessed cerebral activation patterns both before and during recognition of gradually revealed images in Parkinson's disease patients with visual hallucinations (PDwithVHs), Parkinson's disease patients without visual hallucinations (PDnonVHs) and healthy controls. We hypothesized that, before image recognition, PDwithVHs would show reduced bottom-up visual activation in occipital-temporal areas and increased (pre)frontal activation, reflecting increased top-down demand. Overshoot of the latter has been proposed to play a role in generating visual hallucinations. Nine non-demented PDwithVHs, 14 PDnonVHs and 13 healthy controls were scanned on a 3 Tesla magnetic resonance imaging scanner. Static images of animals and objects gradually appearing out of random visual noise were used in an event-related design paradigm. Analyses were time-locked on the moment of image recognition, indicated by the subjects button-press. Subjects were asked to press an additional button on a colour-changing fixation dot, to keep attention and motor action constant and to assess reaction times. Data pre-processing and statistical analysis were performed with statistical parametric mapping-5 software. Bilateral activation of the fusiform and lingual gyri was seen during image recognition in all groups (P < 0.001). Several seconds before image recognition, PDwithVHs showed reduced activation of the lateral occipital cortex, compared with both PDnonVHs and healthy controls. In addition, reduced activation of extrastriate temporal visual cortices was seen just before image recognition in PDwithVHs. The association between increased vulnerability for visual hallucintions in Parkinson's disease and impaired visual object processing in occipital and temporal extrastriate visual cortices supported the hypothesis of impaired bottom-up visual processing in PDwithVHs. Support for the hypothesized increased top-down frontal activation was not obtained. The finding of activation reductions in ventral/lateral visual association cortices in PDwithVHs before image recognition further helps to explain functional mechanisms underlying visual hallucinations in Parkinson's disease.</abstract><subject><genre>Keywords</genre><topic>fMRI</topic><topic>Parkinson's disease</topic><topic>visual hallucinations</topic></subject><relatedItem type="host"><titleInfo><title>Brain</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0006-8950</identifier><identifier type="eISSN">1460-2156</identifier><identifier type="PublisherID">brainj</identifier><identifier type="PublisherID-hwp">brain</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>132</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>2980</start><end>2993</end></extent></part></relatedItem><identifier type="istex">795973AF8B7E6006413527193CA897EDF805B978</identifier><identifier type="DOI">10.1093/brain/awp223</identifier><identifier type="ArticleID">awp223</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author (2009). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. 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