The occipital white matter lesions in Alzheimer's disease patients with visual hallucinations.
OBJECTIVE
Investigators have suggested that lesions responsible for visual hallucinations (VHs) are situated in the visual association cortex. The aim of this study was to assess the relationship between occipital white matter lesions and VHs in Alzheimer's disease (AD) patients.


METHODS
AD patients with a history of VHs (AD+VH) and those without (AD-VH) were retrospectively studied. The two groups of patients were matched by sex and mental state. All subjects underwent brain magnetic resonance image (MRI) scans. The periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWHs) on MRIs were rated by two raters using a semiquantitative scoring method (0=absent; 6=confluent).


RESULTS
Five AD+VH patients and five AD-VH patients were enrolled into this study. The occipital PVH score was higher in the AD+VH patients than in the AD-VH patients. The occipital DWH score was zero in both groups.


CONCLUSIONS
The presence of VHs in AD was associated with increased occipital PVHs and an absence of occipital DWHs on brain MRIs, implying that structural lesions in the geniculocalcarine region and preserved subcortical connections with visual association areas are involved in the genesis of VHs in AD.
Lin
Shu-Han
SH
Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, Tainan 701, Taiwan.
Yu
Chin-Yin
CY
Pai
Ming-Chyi
MC
D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000473:pathology*; D005260:Female; D006212:Hallucinations / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009778:Occipital Lobe / Q000473:pathology*; D014793:Visual Cortex / Q000473:pathology*