Neural correlates of psychotic symptoms in dementia with Lewy bodies
Identifieur interne : 001696 ( Main/Corpus ); précédent : 001695; suivant : 001697Neural correlates of psychotic symptoms in dementia with Lewy bodies
Auteurs : Yasuhiro Nagahama ; Tomoko Okina ; Norio Suzuki ; Minoru MatsudaSource :
- Brain [ 0006-8950 ] ; 2010-02.
Abstract
The aim of this study was to investigate the association between psychotic symptoms in dementia with Lewy bodies and brain perfusion on single photon emission tomography. Based on factor analysis in 145 patients, psychotic symptoms were classified into five symptom domains (factor 1 to 4-related symptoms and delusions). The relationship between each symptom domain and brain perfusion was assessed in 100 patients with dementia with Lewy bodies, while accounting for the effects of age, sex, dementia severity, parkinsonism and dysphoria. Factor 1 symptoms (Capgras syndrome, phantom boarder, reduplication of person and place and misidentification of person) represented misidentifications, and were significantly related to hypoperfusion in the left hippocampus, insula, ventral striatum and bilateral inferior frontal gyri. Factor 3 symptoms (visual hallucination of person and feeling of presence) represented hallucinations of person and were related to hypoperfusion in the left ventral occipital gyrus and bilateral parietal areas. Delusions of theft and persecution were associated with relative hyperperfusion in the right rostral medial frontal cortex, left medial superior frontal gyrus and bilateral dorsolateral frontal cortices. This study revealed that different psychotic symptoms in dementia with Lewy bodies were associated with distinguishable cerebral networks. Visual hallucinations were related to dysfunction of the parietal and occipital association cortices, misidentifications were related to dysfunction of the limbic-paralimbic structures and delusions were related to dysfunction of the frontal cortices. Our findings provide important insights into the pathophysiological mechanisms underlying psychotic symptoms in dementia with Lewy bodies.
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DOI: 10.1093/brain/awp295
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Based on factor analysis in 145 patients, psychotic symptoms were classified into five symptom domains (factor 1 to 4-related symptoms and delusions). The relationship between each symptom domain and brain perfusion was assessed in 100 patients with dementia with Lewy bodies, while accounting for the effects of age, sex, dementia severity, parkinsonism and dysphoria. Factor 1 symptoms (Capgras syndrome, phantom boarder, reduplication of person and place and misidentification of person) represented misidentifications, and were significantly related to hypoperfusion in the left hippocampus, insula, ventral striatum and bilateral inferior frontal gyri. Factor 3 symptoms (visual hallucination of person and feeling of presence) represented hallucinations of person and were related to hypoperfusion in the left ventral occipital gyrus and bilateral parietal areas. Delusions of theft and persecution were associated with relative hyperperfusion in the right rostral medial frontal cortex, left medial superior frontal gyrus and bilateral dorsolateral frontal cortices. This study revealed that different psychotic symptoms in dementia with Lewy bodies were associated with distinguishable cerebral networks. Visual hallucinations were related to dysfunction of the parietal and occipital association cortices, misidentifications were related to dysfunction of the limbic-paralimbic structures and delusions were related to dysfunction of the frontal cortices. Our findings provide important insights into the pathophysiological mechanisms underlying psychotic symptoms in dementia with Lewy bodies.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Yasuhiro Nagahama</name><affiliations><json:string>Department of Geriatric Neurology, Shiga Medical Centre, Japan</json:string><json:string>E-mail: ynaga@pop12.odn.ne.jp</json:string></affiliations></json:item><json:item><name>Tomoko Okina</name><affiliations><json:string>Department of Geriatric Neurology, Shiga Medical Centre, Japan</json:string></affiliations></json:item><json:item><name>Norio Suzuki</name><affiliations><json:string>Department of Geriatric Neurology, Shiga Medical Centre, Japan</json:string></affiliations></json:item><json:item><name>Minoru Matsuda</name><affiliations><json:string>Department of Geriatric Neurology, Shiga Medical Centre, Japan</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>dementia with Lewy bodies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hallucination</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>delusion</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>delusional misidentification syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cerebral blood flow</value></json:item></subject><language><json:string>eng</json:string></language><abstract>The aim of this study was to investigate the association between psychotic symptoms in dementia with Lewy bodies and brain perfusion on single photon emission tomography. Based on factor analysis in 145 patients, psychotic symptoms were classified into five symptom domains (factor 1 to 4-related symptoms and delusions). The relationship between each symptom domain and brain perfusion was assessed in 100 patients with dementia with Lewy bodies, while accounting for the effects of age, sex, dementia severity, parkinsonism and dysphoria. Factor 1 symptoms (Capgras syndrome, phantom boarder, reduplication of person and place and misidentification of person) represented misidentifications, and were significantly related to hypoperfusion in the left hippocampus, insula, ventral striatum and bilateral inferior frontal gyri. Factor 3 symptoms (visual hallucination of person and feeling of presence) represented hallucinations of person and were related to hypoperfusion in the left ventral occipital gyrus and bilateral parietal areas. Delusions of theft and persecution were associated with relative hyperperfusion in the right rostral medial frontal cortex, left medial superior frontal gyrus and bilateral dorsolateral frontal cortices. This study revealed that different psychotic symptoms in dementia with Lewy bodies were associated with distinguishable cerebral networks. Visual hallucinations were related to dysfunction of the parietal and occipital association cortices, misidentifications were related to dysfunction of the limbic-paralimbic structures and delusions were related to dysfunction of the frontal cortices. 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Based on factor analysis in 145 patients, psychotic symptoms were classified into five symptom domains (factor 1 to 4-related symptoms and delusions). The relationship between each symptom domain and brain perfusion was assessed in 100 patients with dementia with Lewy bodies, while accounting for the effects of age, sex, dementia severity, parkinsonism and dysphoria. Factor 1 symptoms (Capgras syndrome, phantom boarder, reduplication of person and place and misidentification of person) represented misidentifications, and were significantly related to hypoperfusion in the left hippocampus, insula, ventral striatum and bilateral inferior frontal gyri. Factor 3 symptoms (visual hallucination of person and feeling of presence) represented hallucinations of person and were related to hypoperfusion in the left ventral occipital gyrus and bilateral parietal areas. Delusions of theft and persecution were associated with relative hyperperfusion in the right rostral medial frontal cortex, left medial superior frontal gyrus and bilateral dorsolateral frontal cortices. This study revealed that different psychotic symptoms in dementia with Lewy bodies were associated with distinguishable cerebral networks. Visual hallucinations were related to dysfunction of the parietal and occipital association cortices, misidentifications were related to dysfunction of the limbic-paralimbic structures and delusions were related to dysfunction of the frontal cortices. Our findings provide important insights into the pathophysiological mechanisms underlying psychotic symptoms in dementia with Lewy bodies.</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>dementia with Lewy bodies</term></item><item><term>hallucination</term></item><item><term>delusion</term></item><item><term>delusional misidentification syndrome</term></item><item><term>cerebral blood flow</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-11-17">Created</change><change when="2010-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/B9F75FEC54C23E67C63FB087E222C0F449D94A02/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/awp295</article-id><article-id pub-id-type="publisher-id">awp295</article-id><article-categories><subj-group><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Neural correlates of psychotic symptoms in dementia with Lewy bodies</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Nagahama</surname><given-names>Yasuhiro</given-names></name></contrib><contrib contrib-type="author"><name><surname>Okina</surname><given-names>Tomoko</given-names></name></contrib><contrib contrib-type="author"><name><surname>Suzuki</surname><given-names>Norio</given-names></name></contrib><contrib contrib-type="author"><name><surname>Matsuda</surname><given-names>Minoru</given-names></name></contrib></contrib-group><aff>Department of Geriatric Neurology, Shiga Medical Centre, Japan</aff><author-notes><corresp>Correspondence to: Yasuhiro Nagahama, Department of Geriatric Neurology, Shiga Medical Centre, 5-4-30 Moriyama, Moriyama-city, Shiga 524-8524, Japan E-mail: <email>ynaga@pop12.odn.ne.jp</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>17</day><month>11</month><year>2009</year></pub-date><volume>133</volume><issue>2</issue><fpage>557</fpage><lpage>567</lpage><history><date date-type="received"><day>24</day><month>7</month><year>2009</year></date><date date-type="rev-recd"><day>18</day><month>9</month><year>2009</year></date><date date-type="accepted"><day>28</day><month>9</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>The aim of this study was to investigate the association between psychotic symptoms in dementia with Lewy bodies and brain perfusion on single photon emission tomography. Based on factor analysis in 145 patients, psychotic symptoms were classified into five symptom domains (factor 1 to 4-related symptoms and delusions). The relationship between each symptom domain and brain perfusion was assessed in 100 patients with dementia with Lewy bodies, while accounting for the effects of age, sex, dementia severity, parkinsonism and dysphoria. Factor 1 symptoms (Capgras syndrome, phantom boarder, reduplication of person and place and misidentification of person) represented misidentifications, and were significantly related to hypoperfusion in the left hippocampus, insula, ventral striatum and bilateral inferior frontal gyri. Factor 3 symptoms (visual hallucination of person and feeling of presence) represented hallucinations of person and were related to hypoperfusion in the left ventral occipital gyrus and bilateral parietal areas. Delusions of theft and persecution were associated with relative hyperperfusion in the right rostral medial frontal cortex, left medial superior frontal gyrus and bilateral dorsolateral frontal cortices. This study revealed that different psychotic symptoms in dementia with Lewy bodies were associated with distinguishable cerebral networks. Visual hallucinations were related to dysfunction of the parietal and occipital association cortices, misidentifications were related to dysfunction of the limbic-paralimbic structures and delusions were related to dysfunction of the frontal cortices. Our findings provide important insights into the pathophysiological mechanisms underlying psychotic symptoms in dementia with Lewy bodies.</p></abstract><kwd-group><kwd>dementia with Lewy bodies</kwd><kwd>hallucination</kwd><kwd>delusion</kwd><kwd>delusional misidentification syndrome</kwd><kwd>cerebral blood flow</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Neural correlates of psychotic symptoms in dementia with Lewy bodies</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Neural correlates of psychotic symptoms in dementia with Lewy bodies</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">Yasuhiro</namePart><namePart type="family">Nagahama</namePart><affiliation>Department of Geriatric Neurology, Shiga Medical Centre, Japan</affiliation><affiliation>E-mail: ynaga@pop12.odn.ne.jp</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tomoko</namePart><namePart type="family">Okina</namePart><affiliation>Department of Geriatric Neurology, Shiga Medical Centre, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Norio</namePart><namePart type="family">Suzuki</namePart><affiliation>Department of Geriatric Neurology, Shiga Medical Centre, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Minoru</namePart><namePart type="family">Matsuda</namePart><affiliation>Department of Geriatric Neurology, Shiga Medical Centre, Japan</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">2010-02</dateIssued><dateCreated encoding="w3cdtf">2009-11-17</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>The aim of this study was to investigate the association between psychotic symptoms in dementia with Lewy bodies and brain perfusion on single photon emission tomography. Based on factor analysis in 145 patients, psychotic symptoms were classified into five symptom domains (factor 1 to 4-related symptoms and delusions). The relationship between each symptom domain and brain perfusion was assessed in 100 patients with dementia with Lewy bodies, while accounting for the effects of age, sex, dementia severity, parkinsonism and dysphoria. Factor 1 symptoms (Capgras syndrome, phantom boarder, reduplication of person and place and misidentification of person) represented misidentifications, and were significantly related to hypoperfusion in the left hippocampus, insula, ventral striatum and bilateral inferior frontal gyri. Factor 3 symptoms (visual hallucination of person and feeling of presence) represented hallucinations of person and were related to hypoperfusion in the left ventral occipital gyrus and bilateral parietal areas. Delusions of theft and persecution were associated with relative hyperperfusion in the right rostral medial frontal cortex, left medial superior frontal gyrus and bilateral dorsolateral frontal cortices. This study revealed that different psychotic symptoms in dementia with Lewy bodies were associated with distinguishable cerebral networks. Visual hallucinations were related to dysfunction of the parietal and occipital association cortices, misidentifications were related to dysfunction of the limbic-paralimbic structures and delusions were related to dysfunction of the frontal cortices. Our findings provide important insights into the pathophysiological mechanisms underlying psychotic symptoms in dementia with Lewy bodies.</abstract><subject><genre>Keywords</genre><topic>dementia with Lewy bodies</topic><topic>hallucination</topic><topic>delusion</topic><topic>delusional misidentification syndrome</topic><topic>cerebral blood flow</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>2010</date><detail type="volume"><caption>vol.</caption><number>133</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>557</start><end>567</end></extent></part></relatedItem><identifier type="istex">B9F75FEC54C23E67C63FB087E222C0F449D94A02</identifier><identifier type="DOI">10.1093/brain/awp295</identifier><identifier type="ArticleID">awp295</identifier><accessCondition type="use and reproduction" contentType="copyright">The Author (2009). 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