Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Speech, Language and Hearing Sciences, Niigata University of Health and Welfare, Niigata, Japan.
Parkinsonism Relat Disord. 2023 Aug;113:105513. doi: 10.1016/j.parkreldis.2023.105513. Epub 2023 Jul 8.
Pareidolia, a form of visual illusions phenomenologically similar to complex visual hallucinations, is a phenomenon that is associated with visual hallucinations in dementia with Lewy bodies (DLB). This study aimed to identify commonalities and differences in behavioral and neural correlates between pareidolic illusions and visual hallucinations in DLB.
Forty-three patients with DLB underwent the scene pareidolia test, which evokes and measures pareidolic illusions, and standardized neuropsychological and behavioral assessments. Regional cerebral blood flow (rCBF) was measured by single-photon emission computed tomography. Factor analysis was performed to assess the relationships among pareidolic illusions, cognitive functions, and behavioral symptoms. Partial least squares correlation analysis was used to investigate the relationship between these symptoms and rCBF.
Factor analysis yielded three behavior factors: the first factor (hallucinations/fluctuations) consisted of pareidolic illusions, visual hallucinations, and fluctuating cognition; the second factor (general cognitive function) consisted of general cognitive function and working memory; and the third factor (visual processing) consisted of visual processing and pareidolic illusions. Partial least squares correlation analysis identified two brain-behavior correlation patterns: (1) rCBF reduction in the frontal and perisylvian/periventricular regions was associated with lower general cognitive function and lower visual processing; and (2) rCBF reduction in the bilateral occipitotemporal cortex was associated with more severe hallucinations/fluctuations and lower visual processing.
At the behavioral level, pareidolic illusions are associated with visual hallucinations, fluctuating cognition, and visual processing in DLB. At the neural level, pareidolic illusions may arise from the synergistic effects of global neuropathological changes and occipitotemporal cortical dysfunctions.
空想性错视是一种与路易体痴呆（DLB）中的复杂视幻觉在现象学上相似的视错觉形式。本研究旨在确定 DLB 患者的空想性错视与视幻觉在行为和神经相关方面的异同。
43 例 DLB 患者接受了场景空想性错视测试，该测试可诱发和测量空想性错视，并进行了标准化的神经心理学和行为评估。采用单光子发射计算机断层扫描测量局部脑血流（rCBF）。采用因子分析评估空想性错视、认知功能和行为症状之间的关系。采用偏最小二乘相关分析探讨这些症状与 rCBF 的关系。
因子分析得出三个行为因素：第一个因素（幻觉/波动）包括空想性错视、视幻觉和波动认知；第二个因素（一般认知功能）包括一般认知功能和工作记忆；第三个因素（视觉处理）包括视觉处理和空想性错视。偏最小二乘相关分析确定了两种脑-行为相关模式：（1）额叶和侧脑室周围/脑室周围区域的 rCBF 减少与一般认知功能和视觉处理能力降低有关；（2）双侧枕颞叶皮质的 rCBF 减少与更严重的幻觉/波动和视觉处理能力降低有关。
在行为水平上，空想性错视与 DLB 中的视幻觉、波动认知和视觉处理有关。在神经水平上，空想性错视可能是由广泛的神经病理学改变和枕颞叶皮质功能障碍的协同作用引起的。
