Prevalence and Risk Factors for Minor Hallucinations in Patients with Parkinson's Disease
Min Zhong1, Ruxin Gu1, Sha Zhu1
1Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Purpose:
As the most frequent and earliest type of psychotic phenomenon in Parkinson's disease (PD), minor hallucination (MH) can occur before the onset of motor symptoms. This sensation may be an early predictor of severe psychotic and cognitive states and is often overlooked in clinics. This study was aimed at providing a comprehensive and in-depth understanding of MHs. Patients and Methods. Demographic information was obtained from 262 patients with PD, and a series of clinical assessment questionnaires were provided. According to the result of the Movement Disorders Society Unified Parkinson's Disease Rating Scale Part I, the patients were classified into the MH and nonhallucination (NH) groups.
Results:
MHs were the most common psychotic symptom with 38.9% prevalence. The most frequent MH was visual illusion, especially object misidentification. Three minor phenomena were somewhat consistent in terms of external factors, temporal factors, and content. Disease duration, daily levodopa equivalent dose, and percentage of levodopa and dopamine-receptor agonist use were remarkably greater in the MH group than in the NH group. After covariate control, the MH group had worse life quality and more severe nonmotor symptoms, including poor sleep quality and rapid eye movement sleep behavior disorder (RBD), than the NH group. The binary logistic regression model showed that RBD, sleep quality, and health-related life quality were associated with MHs.
Conclusion:
A high prevalence of MHs was observed in patients with PD. Further studies are needed to confirm and expand the identified clinical factors related to MH, which have potential prognostic and therapeutic implication.
Insights
Minor hallucinations (MHs) are common in Parkinson's disease (PD), affecting nearly 40% of patients. These early symptoms are linked to worse quality of life, sleep issues, and rapid eye movement sleep behavior disorder (RBD).
Area of Science:
- Neurology
- Psychiatry
Background:
- Minor hallucinations (MHs) are the earliest and most frequent psychotic symptom in Parkinson's disease (PD).
- MHs can precede motor symptom onset and may predict severe cognitive and psychotic states.
- These symptoms are often underdiagnosed in clinical settings.
Purpose of the Study:
- To comprehensively understand the prevalence and clinical characteristics of MHs in Parkinson's disease.
- To identify factors associated with the occurrence of MHs in PD patients.
Main Methods:
- Demographic and clinical data were collected from 262 PD patients.
- Patients were categorized into MH and non-hallucination (NH) groups based on the Movement Disorders Society Unified Parkinson's Disease Rating Scale Part I.
- Clinical assessments included questionnaires on quality of life and nonmotor symptoms.
Main Results:
- MHs were prevalent in 38.9% of PD patients, with visual illusions (object misidentification) being the most common.
- Patients with MHs had longer disease duration, higher levodopa equivalent doses, and greater use of dopamine agonists.
- The MH group exhibited poorer quality of life, worse sleep quality, and a higher prevalence of rapid eye movement sleep behavior disorder (RBD).
Conclusions:
- Minor hallucinations are highly prevalent in Parkinson's disease.
- Rapid eye movement sleep behavior disorder, poor sleep quality, and reduced health-related quality of life are significantly associated with MHs.
- Further research is warranted to validate these findings and explore their prognostic and therapeutic implications.
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