Department of Neurology, Inje University Ilsan-Paik Hospital, Goyang Department of Neurology, University of Ulsan College of Medicine Department of Neurology, College of Medicine, Hanyang University.
Can J Neurol Sci. 2013 Sep;40(5):657-62. doi: 10.1017/s0317167100014888.
Visual hallucination (VH) is a common psychotic symptom in patients with Parkinson's disease (PD) and may be a significant predictor of cognitive impairment (CI) in such patients.
This study aimed to investigate the pattern of glucose metabolism of VH and the relationship between VH and CI in PD.
We studied 28 PD patients, including 15 with VH (PD-VH) and 13 without VH (PD-NVH). Of the 15 PD-VH patients, 8 patients had cognitive impairment (PD-VHCI) whereas 7 did not (PD-VHNCI). All patients underwent [18F] fluorodeoxyglucose positron emission tomography ([18F] FDG PET) followed by statistical parametric mapping (SPM) analyses.
Compared to the patients with PDNVH, PD-VHNCI patients showed glucose hypometabolism in the inferior and middle temporal cortices, fusiform gyri, and frontal areas, suggesting the involvement of the ventral visual pathway. Compared to the patients with PDNVH, PD-VHCI patients showed glucose hypometabolism in the temporoparietal association cortices with scattered frontal areas.
Dysfunction of ventral visual pathway involving the temporal lobe may play a key role in VH development in PD patients. The evolving distribution from the ventral visual pathway to more extensive posterior cortices in PD-VHCI patients suggests that VH may be a prodromal symptom occurring prior to CI in PD patients.
视幻觉（VH）是帕金森病（PD）患者常见的精神病症状，可能是此类患者认知障碍（CI）的重要预测指标。
本研究旨在探讨 VH 的葡萄糖代谢模式以及 PD 中 VH 与 CI 的关系。
我们研究了 28 例 PD 患者，包括 15 例 VH 患者（PD-VH）和 13 例无 VH 患者（PD-NVH）。在 15 例 PD-VH 患者中，8 例有认知障碍（PD-VHCI），7 例没有（PD-VHNCI）。所有患者均接受 [18F]氟脱氧葡萄糖正电子发射断层扫描（[18F] FDG PET），并进行统计参数映射（SPM）分析。
与 PD-NVH 患者相比，PD-VHNCI 患者的中下颞叶、梭状回和额叶出现葡萄糖代谢低下，提示腹侧视觉通路受累。与 PD-NVH 患者相比，PD-VHCI 患者的颞顶叶联合皮质及散在的额叶出现葡萄糖代谢低下。
颞叶腹侧视觉通路功能障碍可能在 PD 患者 VH 的发生发展中起关键作用。PD-VHCI 患者从腹侧视觉通路向更广泛的后皮质的病变分布提示 VH 可能是 PD 患者 CI 发生前的前驱症状。
