Diederich N J, Goetz C G, Raman R, Pappert E J, Leurgans S, Piery V
Department of Neurology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Clin Neuropharmacol. 1998 Sep-Oct;21(5):289-95.
This study examined the relationship between deficits in color and contrast discrimination and visual hallucinations (VH) in patients with Parkinson's disease (PD) and normal visual acuity. Thirty-five nondemented and nonpsychotic PD patients with normal visual acuity and without major ophthalmologic disease were interviewed twice and divided into two groups: hallucinators (n = 14) and non-hallucinating controls (n = 21). The groups were compared for color vision (assessed by Lanthony D-15 [LD] and Farnsworth-Munsell 100 hue [FM] tests), and for contrast sensitivity (tested by Vis tech tables [VT] and monocular and binocular Pelli-Robson test [PR]). There was no difference in age, duration or stage of PD, or dosage or duration of levodopa therapy between the two groups. Parkinson's disease patients showed impairment on all visual tests, with the hallucinators performing worse than the controls on all tests. This difference was significant for the LD (p < 0.007), the VT at 1.5 and 3 cycles per degree (p < 0.037 and 0.043, respectively) and the monocular PR tests (p < 0.049). The results led the authors to conclude that in patients with normal visual acuity, those with VH show added visual deficits of color and contrast discrimination. These ophthalmopathies may therefore be facilitating factors for visual hallucinations in PD and justify more focused research on the pathophysiology of visual hallucinations in Parkinson's disease.
本研究调查了帕金森病（PD）且视力正常的患者中颜色和对比度辨别缺陷与视幻觉（VH）之间的关系。对35名无痴呆、无精神病且视力正常且无重大眼科疾病的PD患者进行了两次访谈，并将其分为两组：幻觉组（n = 14）和无幻觉对照组（n = 21）。比较两组的色觉（通过兰托尼D - 15[LD]和法恩斯沃思 - 芒塞尔100色调[FM]测试评估）和对比度敏感度（通过视技术检查表[VT]以及单眼和双眼佩利 - 罗布森测试[PR]进行测试）。两组在PD的年龄、病程或阶段、左旋多巴治疗的剂量或疗程方面均无差异。帕金森病患者在所有视觉测试中均表现出损害，幻觉组在所有测试中的表现均比对照组差。在LD测试中（p < 0.007）、每度1.5和3周期间的VT测试中（分别为p < 0.037和0.043）以及单眼PR测试中（p < 0.049），这种差异具有统计学意义。这些结果使作者得出结论，在视力正常的患者中，有视幻觉的患者在颜色和对比度辨别方面存在额外的视觉缺陷。因此，这些眼病可能是PD视幻觉的促发因素，并且有理由对帕金森病视幻觉的病理生理学进行更有针对性的研究。
