Frontiers in Neurology (Jan 2021)

Exploring Bottom-Up Visual Processing and Visual Hallucinations in Parkinson's Disease With Dementia

  • Nicholas Murphy,
  • Nicholas Murphy,
  • Alison Killen,
  • Rajnish Kumar Gupta,
  • Sara Graziadio,
  • Lynn Rochester,
  • Michael Firbank,
  • Mark R. Baker,
  • Charlotte Allan,
  • Daniel Collerton,
  • John-Paul Taylor,
  • Prabitha Urwyler,
  • Prabitha Urwyler,
  • Prabitha Urwyler,
  • Prabitha Urwyler

DOI
https://doi.org/10.3389/fneur.2020.579113
Journal volume & issue
Vol. 11

Abstract

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Visual hallucinations (VH) are a common symptom of Parkinson's disease with dementia (PDD), affecting up to 65% of cases. Integrative models of their etiology posit that a decline in executive control of the visuo-perceptual system is a primary mechanism of VH generation. The role of bottom-up processing in the manifestation of VH in this condition is still not clear although visual evoked potential (VEP) differences have been associated with VH at an earlier stage of PD. Here we compared the amplitude and latency pattern reversal VEPs in healthy controls (n = 21) and PDD patients (n = 34) with a range of VH severities. PDD patients showed increased N2 latency relative to controls, but no significant differences in VEP measures were found for patients reporting complex VH (CVH) (n = 17) compared to those without VH. Our VEP findings support previous reports of declining visual system physiology in PDD and some evidence of visual system differences between patients with and without VH. However, we did not replicate previous findings of a major relationships between the integrity of the visual pathway and VH.

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