Ozawa Masakazu, Shiraishi Tomotaka, Murakami Hidetomo, Yoshimaru Daisuke, Onda Asako, Matsuno Hiromasa, Komatsu Teppei, Sakuta Kenichi, Sakai Kenichiro, Umehara Tadashi, Mitsumura Hidetaka, Okano Hirotaka James, Iguchi Yasuyuki
Department of Neurology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Division of Regenerative Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Sci Rep. 2024 Dec 28;14(1):31293. doi: 10.1038/s41598-024-82707-x.
Visual hallucinations (VH) and pareidolia, a type of minor hallucination, share common underlying mechanisms. However, the similarities and differences in their brain regions remain poorly understood in Parkinson's disease (PD). A total of 104 drug-naïve PD patients underwent structural MRI and were assessed for pareidolia using the Noise Pareidolia Test (NPT) were enrolled. Subcortical gray matter volume and cortical surface volume were analyzed using the FreeSurfer software. Structural analyses revealed associations between NPT scores and atrophy in the right thalamus, right hippocampus, right temporal cortex, and right orbitofrontal cortex in all PD participants. These results were almost the same after adjusting for right-handed 97 patients with PD. It is considered that hallucinations in patients with PD are related to altered integration of sensory input (bottom-up) and prior knowledge (top-down) within the visual system. Our findings indicate that pareidolia in PD involves both bottom-up (thalamus and temporal cortex) and top-down (orbitofrontal cortex) processing disturbances; in contrast, VH predominantly involves bottom-up but not top-down regions. Understanding these distinctions could aid in the development of targeted interventions for hallucinations in patients with PD.
视幻觉（VH）和空想性错视（一种轻微幻觉）具有共同的潜在机制。然而，在帕金森病（PD）中，它们在脑区的异同仍知之甚少。共有104例未服用过药物的PD患者接受了结构磁共振成像检查，并使用噪声空想性错视测试（NPT）评估空想性错视情况。使用FreeSurfer软件分析皮层下灰质体积和皮层表面体积。结构分析显示，在所有PD参与者中，NPT评分与右侧丘脑、右侧海马体、右侧颞叶皮质和右侧眶额皮质的萎缩之间存在关联。在对97例右利手PD患者进行校正后，这些结果几乎相同。据认为，PD患者的幻觉与视觉系统内感觉输入（自下而上）和先验知识（自上而下）的整合改变有关。我们的研究结果表明，PD中的空想性错视涉及自下而上（丘脑和颞叶皮质）和自上而下（眶额皮质）的加工障碍；相比之下，视幻觉主要涉及自下而上而非自上而下的脑区。了解这些差异有助于开发针对PD患者幻觉的靶向干预措施。
