Hanoglu Lütfü, Yildiz Sultan, Cakir Tansel, Hanoglu Taha, Yulug Burak
Department of Neurology, Istanbul, Medipol University, Istanbul, Turkey.
Regeneration and Restoration Center, Istanbul Medipol University, Istanbul, Turkey.
Endocr Metab Immune Disord Drug Targets. 2019;19(1):84-89. doi: 10.2174/1871530318666180830112709.
Charles Bonnet Syndrome (CBS) has been defined as complex visual hallucinations (CVH) due to visual loss. The underlying mechanism of CBS is not clear and the underlying pathophysiology of the visual hallucinations in CBS patients and pure visually impaired patients is still not clear.
In our study, we have scanned three patients with eye disease and CBS (VH+) and three patients with eye disease without CBS (VH-) using FDG-PET.
Our results showed underactivity in the pons and overactivity in primary right left visual cortex and inferior parietal cortex in VH- patients and underactivity in left Broca, left inf frontal primary visual cortex and anterior and posterior cingulate cortex in VH+ patients relative to the normative 18FFDG PET data that was taken from the database consisting of 50 age-matched healthy adults without neuropsychiatric disorders.
From this distributed pattern of activity changes, we conclude that the generation of visual hallucination in CBS is associated with bottom-up and top-down mechanism rather than the generally accepted visual deafferentation-related hyperexcitability theory.
查尔斯·博内综合征（CBS）被定义为因视力丧失导致的复杂视幻觉（CVH）。CBS的潜在机制尚不清楚，CBS患者和单纯视力受损患者视幻觉的潜在病理生理学仍不明确。
在我们的研究中，我们使用FDG-PET对3例患有眼部疾病且伴有CBS（VH+）的患者和3例患有眼部疾病但无CBS（VH-）的患者进行了扫描。
我们的结果显示，相对于从由50名无神经精神疾病的年龄匹配健康成年人组成的数据库中获取的标准18F-FDG PET数据，VH-患者脑桥活动不足，右侧和左侧初级视觉皮层以及顶下叶皮层活动过度，而VH+患者左侧布洛卡区、左侧额下回初级视觉皮层以及前扣带回和后扣带回皮层活动不足。
从这种活动变化的分布模式来看，我们得出结论，CBS中视幻觉的产生与自下而上和自上而下的机制有关，而不是与普遍接受的与视觉传入缺失相关的过度兴奋理论有关。
