Division of Neurology, Department of Medicine, Faculty of Health Sciences, University of Stellenbosch, PO Box 19063, Tygerberg 7505, Cape Town, South Africa.
Parkinsonism Relat Disord. 2012 Jul;18(6):742-7. doi: 10.1016/j.parkreldis.2012.03.004. Epub 2012 Apr 11.
Visual processing extends from the retinal level to the ventral temporal lobe, and is modified by top-down and bottom-up processing. Complex visual hallucinations (VH) are commonly a feature of disorders which affect temporal lobe structures, frequently in association with impairment of ascending monoaminergic pathways. When Parkinson's disease (PD) is associated with VH, pathological changes characteristically affect the temporal lobes, a finding which is recapitulated by imaging findings. However, a major association of VH is with cognitive decline, and this is typically linked to deficits in attention and working memory, both of which are modulated by dopamine. Similarly, dopamine plays a crucial role in the function of prefrontal cortex, in addition to controlling access to consciousness via gating mechanisms that are dependent on the basal ganglia.
视觉处理从视网膜延伸到腹侧颞叶，并受到自上而下和自下而上的处理的影响。复杂的视幻觉（VH）通常是影响颞叶结构的疾病的特征，通常与上行单胺能通路的损伤有关。当帕金森病（PD）伴有 VH 时，病理性变化通常会影响颞叶，这一发现与影像学发现相一致。然而，VH 的一个主要关联是与认知能力下降有关，这通常与注意力和工作记忆缺陷有关，而这两者都受多巴胺调节。同样，多巴胺在除了通过依赖基底神经节的门控机制控制意识的获取之外，还在额前皮质的功能中起着至关重要的作用。
