Clinical features of minor hallucinations in different phenotypes of Parkinson's disease: A cross-sectional study
Yaxi Wang1, Dongfeng Li1, Yaning Chen1
1Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Background:
Minor hallucinations (MHs) are the most common psychiatric symptom associated with Parkinson's disease (PDPsy), but little is known about their characteristics in different motor phenotypes, especially postural instability gait difficulty (PIGD). The aim of this study was to explore the clinical features of MHs in different subtypes of PD.
Methods:
In this cross-sectional study, 213 patients with Parkinson's disease (PD) were recruited, and the data obtained included comprehensive demographics, motor subtypes, clinical scale scores, and MH contents. Motor subtypes were classified as tremor-dominant (TD), PIGD or indeterminate according to Stebbins' method.
Results:
A total of 213 PD patients were included: 90 (42.3%) TD patients, 98 (46.0%) PIGD patients and 25 (11.7%) indeterminate. In total, 70 (32.9%) patients experienced MHs. Compared to patients with the TD phenotype, we found that patients with the PIGD phenotype had more severe motor and nonmotor symptoms. They also had a higher incidence of visual illusions (VIs) and a shorter MH latency.
Conclusion:
Our study demonstrated that compared to patients with the TD phenotype, patients with the PIGD phenotype had a higher incidence of MHs, especially VIs, which may lead to a higher incidence of visual hallucinations (VHs). They also had a shorter latency of MHs than patients with the TD phenotype, suggesting an earlier onset of MHs and a worse prognosis.
Insights
Patients with the postural instability gait difficulty (PIGD) subtype of Parkinson's disease experience minor hallucinations (MHs) more frequently than tremor-dominant (TD) patients. PIGD patients also show earlier MH onset, suggesting a potentially worse prognosis.
Area of Science:
- Neurology
- Psychiatry
- Clinical Neuroscience
Background:
- Minor hallucinations (MHs) are a common psychiatric symptom in Parkinson's disease (PD).
- Characteristics of MHs in different PD motor phenotypes, particularly postural instability gait difficulty (PIGD), remain under-explored.
- Understanding these differences is crucial for managing PD psychiatric symptoms.
Purpose of the Study:
- To investigate the clinical features of MHs in patients with different Parkinson's disease motor phenotypes.
- To compare MH characteristics between tremor-dominant (TD) and PIGD subtypes.
- To explore the relationship between motor phenotype and the incidence and nature of MHs.
Main Methods:
- A cross-sectional study involving 213 Parkinson's disease patients.
- Classification of motor subtypes into tremor-dominant (TD), PIGD, and indeterminate using Stebbins' method.
- Collection of demographic data, motor subtype, clinical scale scores, and detailed MH content.
Main Results:
- Out of 213 patients, 70 (32.9%) reported MHs.
- Patients with the PIGD phenotype exhibited more severe motor and non-motor symptoms compared to the TD phenotype.
- PIGD patients had a higher incidence of visual illusions (VIs) and a shorter MH latency.
Conclusions:
- The PIGD phenotype is associated with a higher incidence of MHs, particularly VIs, in Parkinson's disease.
- Shorter MH latency in PIGD patients suggests an earlier onset of these symptoms.
- These findings indicate a potentially worse prognosis for psychiatric symptoms in the PIGD subtype of Parkinson's disease.
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