Objective: The aim of this study is to identify frequency and clinical (motor and nonmotor) correlates of VH predictors of their development after a follow-up period of four years in our Parkinson’s disease (PD) cohort.
Background: Longitudinal studies show that 74% of patients with PD develop visual hallucinations (VH)after 20 years of disease duration and that VH are associated with worse quality of life, dementia development and moving to nursing homes. Neurobiological basis of VH in PD remains unclear and clinical correlates are insufficiently defined.
Method: In this longitudinal study, 130 patients with PD were followed for four years. At zero visit and after two and four years of follow – up, patients underwent a detailed clinical assessment of motor and non – motor symptoms and a neuropsychological evaluation. The presence of VH was assessed using the appropriate question of the UPDRS scale. Binary logistic regression was used to define clinical predictors of VH development after four years of follow-up.
Results: 42% of patients had VH, of which 9,30% with loss of insight. VH were associated with greater motor disability including bradykinesia, axial motor symptoms , postural disability and freezing. VH occurred more frequently in patients with cognitive impairment . Hallucinators expressed symptoms of autonomic disfunction and sleep disorders more frequently. Depression, anxiety and apathy were more severe in patients with VH.
As predictors of VH, regardless of age and PD duration, the presence of freezing and visuo-spatial impairment at zero visit were singled out. Among the non-motor symptoms, the presence of orthostatic hypotension and depression carried the greatest risk for VH development.
Conclusion: Our results confirm that VH in PD is accompanied by a more severe clinical phenotype, more pronounced motor disability, autonomic dysfunction, sleep disorders, neuropsychiatric symptoms, falls. VH should be expected in patients with cognitive impairment in the visual-spatial domain and axial motor impairment
To cite this abstract in AMA style:
G. Mandic Stojmenovic, T. Stojkovic, E. Stefanova, V. Markovic, I. Stankovic Tutus, I. Petrovic, N. Dragasevic Miskovic, M. Svetel, V. Kostic. Clinical correlates of visual hallucinations in Parkinson’s disease [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/clinical-correlates-of-visual-hallucinations-in-parkinsons-disease/. Accessed May 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-correlates-of-visual-hallucinations-in-parkinsons-disease/