Department of Neurology, Jikei University School of Medicine, Kashiwa Hospital, Tokyo, Japan.
Mov Disord. 2010 Jan 30;25(2):167-71. doi: 10.1002/mds.22919.
Visual hallucinations (VHs) are common in dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD), while auditory hallucinations are rare. To neurophysiologically investigate the pathophysiology of VHs in these disorders, we studied event-related potentials (ERPs) of DLB, PDD, and Alzheimer's disease (AD) patients. We compared visual and auditory ERP latencies among PDD patients with and without VHs (PDD-H: 11, PDD-N: 6), DLB patients (24), and AD patients (21). To elicit visual and auditory ERPs, a facial discrimination paradigm and a conventional auditory odd-ball paradigm, respectively, were used. The mean visual P3 latencies in the PDD-H and DLB groups were significantly longer than that in the AD group, while the mean auditory P3 latencies in all four patient groups were comparable. The mean visual P2 latencies in the PDD-N, PDD-H, and DLB groups were significantly longer than that in the control group. Our findings suggest that visual cognitive functions are selectively impaired in hallucinatory patients with DLB and PDD. VHs may be associated in part with predominant visual cognitive impairments attributable to PDD and DLB pathologies. Our findings also suggest that the impairments occur at the early stage of facial information processing.
视觉幻觉(VH)在路易体痴呆(DLB)和帕金森病伴痴呆(PDD)中很常见,而听觉幻觉则很少见。为了从神经生理学角度研究这些疾病中 VH 的病理生理学,我们研究了 DLB、PDD 和阿尔茨海默病(AD)患者的事件相关电位(ERP)。我们比较了有和无 VH 的 PDD 患者(PDD-H:11 例,PDD-N:6 例)、DLB 患者(24 例)和 AD 患者(21 例)的视觉和听觉 ERP 潜伏期。为了引出视觉和听觉 ERP,分别使用面部辨别范式和传统听觉odd-ball 范式。PDD-H 和 DLB 组的平均视觉 P3 潜伏期明显长于 AD 组,而所有 4 组患者的平均听觉 P3 潜伏期相当。PDD-N、PDD-H 和 DLB 组的平均视觉 P2 潜伏期明显长于对照组。我们的发现表明,DLB 和 PDD 有幻觉的患者的视觉认知功能受到选择性损害。VH 可能部分与 PDD 和 DLB 病理导致的占主导地位的视觉认知障碍有关。我们的发现还表明,损伤发生在面部信息处理的早期阶段。