Visual mismatch negativity in Parkinson's psychosis and potential for testing treatment mechanisms.

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI:10.1093/braincomms/fcae291
Miriam Vignando, Dominic Ffytche, Ndabezinhle Mazibuko, Giulio Palma, Marcella Montagnese, Sonali Dave, David J Nutt, Anthony S Gabay, Yen F Tai, Lucia Batzu, Valentina Leta, Caroline H Williams Gray, K Ray Chaudhuri, Mitul A Mehta
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引用次数: 0

Abstract

Psychosis and visual hallucinations are a prevalent non-motor symptom of Parkinson's disease, negatively affecting patients' quality of life and constituting a greater risk for dementia. Understanding neural mechanisms associated to these symptoms is instrumental for treatment development. The mismatch negativity is an event-related potential evoked by a violation in a sequence of sensory events. It is widely considered an index of sensory change-detection. Reduced mismatch negativity response is one of the most replicated results in schizophrenia and has been suggested to be a superior psychosis marker. To understand whether this event-related potential component could be a similarly robust marker for Parkinson's psychosis, we used electroencephalography with a change-detection task to study the mismatch negativity in the visual modality in 20 participants with Parkinson's and visual hallucinations and 18 matched Parkinson's participants without hallucinations. We find that visual mismatch negativity is clearly present in participants with Parkinson's disease without hallucinations at both parieto-occipital and frontal sites, whereas participants with Parkinson's and visual hallucinations show reduced or no differences in the two waveforms, confirming the sensitivity of mismatch negativity to psychosis, even within the same diagnostic group. We also explored the relationship between hallucination severity and visual mismatch negativity amplitude, finding a negative correlation between visual hallucinations severity scores and visual mismatch negativity amplitude at a central frontal and a parieto-occipital electrodes, whereby the more severe or complex (illusions, formed visual hallucinations) the symptoms the smaller the amplitude. We have also tested the potential role of the serotonergic 5-HT2A cascade in visual hallucinations in Parkinson's with these symptoms, following the receptor trafficking hypothesis. We did so with a pilot study in healthy controls (N = 18) providing support for the role of the Gi/o-dependent pathway in the psychedelic effect and a case series in participants with Parkinson's and visual hallucinations (N = 5) using a double-blind crossover design. Positive results on psychosis scores and mismatch amplitude add further to the potential role of serotonergic modulation of visual hallucinations in Parkinson's disease.

帕金森氏精神病中的视觉错配负性和测试治疗机制的潜力。
精神错乱和视觉幻觉是帕金森病的一种常见非运动症状,对患者的生活质量造成负面影响,并增加了痴呆症的风险。了解与这些症状相关的神经机制有助于开发治疗方法。错配负性是一种由感觉事件序列中的违规行为诱发的事件相关电位。它被广泛认为是感觉变化检测的指标。错配负性反应的降低是精神分裂症患者中重复率最高的结果之一,并被认为是一种优秀的精神病标志。为了了解这一事件相关电位成分是否同样可以作为帕金森氏症精神病的有力标记,我们使用脑电图和变化检测任务研究了 20 名有视觉幻觉的帕金森氏症患者和 18 名无幻觉的匹配帕金森氏症患者的视觉模式错配负性。我们发现,在没有幻觉的帕金森病患者中,顶枕部和额部都明显存在视觉错配负性,而有幻觉的帕金森病患者在这两种波形上的差异减少或没有差异,这证实了错配负性对精神病的敏感性,即使在同一诊断组中也是如此。我们还探讨了幻觉严重程度与视觉错配负性振幅之间的关系,发现视幻觉严重程度评分与额叶中央电极和顶枕电极的视觉错配负性振幅呈负相关,即症状越严重或复杂(幻觉、形成的视幻觉),振幅越小。根据受体贩运假说,我们还测试了血清素能 5-HT2A 级联在帕金森病患者出现这些症状的视幻觉中的潜在作用。我们在健康对照组(18 人)中进行了试验性研究,证实了 Gi/o 依赖性通路在迷幻效果中的作用,并采用双盲交叉设计,对患有帕金森症并出现视幻觉的患者(5 人)进行了病例系列研究。对精神错乱评分和错配幅度的积极结果进一步证实了血清素能对帕金森病患者视幻觉的潜在调节作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
7.00
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0.00%
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审稿时长
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