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Related Experiment Videos

Visual hallucinations in posterior cortical atrophy.

Keith A Josephs1, Jennifer L Whitwell, Bradley F Boeve

  • 1Divisions of Movement Disorders and Behavioral Neurology, Department of Neurology, Mayo Clinic, Rochester, Minn, USA. josephs.keith@mayo.edu

Archives of Neurology
|October 13, 2006
PubMed
Summary
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Visual hallucinations in posterior cortical atrophy (PCA) are linked to parkinsonism and REM sleep behavior disorder. Brain imaging reveals greater atrophy in specific structures, suggesting a broader neural circuit involvement.

Area of Science:

  • Neuroscience
  • Neurology
  • Clinical Neuroimaging

Background:

  • Posterior cortical atrophy (PCA) affects visual processing, with visual hallucinations reported in up to 25% of patients.
  • The clinical and imaging distinctions between PCA patients with and without hallucinations remain unclear.

Purpose of the Study:

  • To compare clinical and neuroimaging characteristics of patients with PCA, differentiating between those experiencing visual hallucinations and those who do not.

Main Methods:

  • A retrospective case-control study was conducted at a tertiary care center.
  • Fifty-nine patients meeting PCA criteria were analyzed, divided into groups with (n=13) and without (n=46) visual hallucinations.
  • Voxel-based morphometry was employed to identify significant imaging differences.

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Main Results:

  • Patients with PCA and hallucinations more frequently exhibited parkinsonism, REM sleep behavior disorder, and myoclonic jerks (P<.001).
  • Voxel-based morphometry indicated more substantial atrophy in the primary visual cortex, basal ganglia (lentiform nuclei), thalamus, basal forebrain, and midbrain in hallucinating patients.

Conclusions:

  • Hallucinations in PCA are associated with a distinct clinical profile including parkinsonism, REM sleep behavior disorder, and myoclonic jerks.
  • Neuroimaging findings suggest that hallucinations in PCA involve a thalamocortical circuit, extending beyond posterior association cortex atrophy.