title: Visual complaints and visual hallucinations in Parkinson's disease.
abstract: BACKGROUND
  Visual symptoms are common in Parkinson's disease (PD) and are frequently under-diagnosed. The detection of visual symptoms is important for differential diagnosis and patient management.
  
  
  OBJECTIVE
  To establish the prevalence of recurrent visual complaints (RVC) and recurrent visual hallucinations (RVH) and to investigate their interaction in PD patients and controls.
  
  
  METHODS
  This cross-sectional study included 88 PD patients and 90 controls. RVC and RVH were assessed with a visual symptom questionnaire and the North-East-Visual-Hallucinations-Interview (NEVHI).
  
  
  RESULTS
  Double vision (PD vs.
  
  
  METHODS
  18.2% vs. 1.3%; p < 0.001), misjudging objects when walking (PD vs.
  
  
  METHODS
  12.5% vs. 1.3%; p < 0.01), words moving whilst reading (PD vs.
  
  
  METHODS
  17.0% vs. 1.3%; p < 0.001) and freezing in narrow spaces (PD vs.
  
  
  METHODS
  30.7% vs. 0%; p < 0.001) were almost exclusively found in PD patients. The same was true for recurrent complex visual hallucinations and illusions (PD vs.
  
  
  METHODS
  both 17.0% vs. 0%; p < 0.001). Multiple RVC (43.2% vs. 15.8%) and multiple RVH (29.5% vs. 5.6%) were also more common in PD patients (both p < 0.001). RVC did not predict recurrent complex visual hallucinations; but double vision (p = 0.018, R(2) = 0.302) and misjudging objects (p = 0.002, R(2) = 0.302) predicted passage hallucinations. Misjudging objects also predicted the feeling of presence (p = 0.010, R(2) = 0.321).
  
  
  CONCLUSIONS
  Multiple and recurrent visual symptoms are common in PD. RVC emerged as risk factors predictive of the minor forms of hallucinations, but not recurrent complex visual hallucinations.
authors.affiliation: Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.
authors.forename: Prabitha
authors.initials: P
authors.lastname: Urwyler
authors.affiliation: Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Nef
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Killen
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom; Northumberland, Tyne & Wear NHS Foundation Trust, Bensham Hospital, Gateshead, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Collerton
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom; Northumberland, Tyne & Wear NHS Foundation Trust, Bensham Hospital, Gateshead, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Burn
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: McKeith
authors.affiliation: Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland; Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Old Age Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland. Electronic address: urs.mosimann@gef.be.ch.
authors.forename: Urs Peter
authors.initials: UP
authors.lastname: Mosimann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004172:Diplopia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006212:Hallucinations / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D014786:Vision Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology
keywords: Parkinson's disease; Visual complaints; Visual hallucinations