Visual hallucinations, white matter lesions and disease severity in Parkinson's disease.
OBJECTIVE
To determine if visual hallucinations in patients with Parkinson's disease are associated with an increased prevalence of white matter lesions.


METHODS
Fifteen patients with (group 1) and 15 patients without (group 2) a history of visual hallucinations were studied. Both groups were matched for age. Magnetic resonance imaging was performed in all patients using standard T2 weighted Fast-Spin-Echo sequences. Assessment of cerebral white matter changes was performed using a modification of established criteria, with semiquantitative evaluation of periventricular and deep white matter changes.


RESULTS
There was no significant group difference with regard to the total amount of white matter changes, nor was a group difference found between the amount or extent of periventricular hyperintensities or deep white matter lesions. Group 1 was significantly (P = 0.001) more disabled as evaluated by Hoehn/Yahr stage controlling for age and duration of disease. Mean increases in Hoehn/Yahr stage were not significantly greater in group 1 compared with group 2 at a 2-year follow-up examination (0.6 vs. 0.3, P = 0.166).


CONCLUSIONS
Our data suggest that visual hallucinations are an indicator of a more aggressive course of the disease, but are not associated with a higher prevalence of global or occipital white matter lesions.
Kraft
E
E
Max Planck Institute of Psychiatry, Munich, Germany.
Winkelmann
J
J
Trenkwalder
C
C
Auer
D P
DP
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001284:Atrophy; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D010300:Parkinson Disease / Q000145:classification / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D011618:Psychotic Disorders / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index; D014785:Vision, Ocular / Q000502:physiology