Visual hallucinations in Parkinson's disease: The critical role of intermediate nucleus basalis of Meynert

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders Pub Date : 2025-06-23 DOI:10.1016/j.parkreldis.2025.107935

Hiroyuki Hatsuta , Masashi Mizutani , Kaoru Yagita , Terunori Sano , Masaki Takao

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Abstract

Background and objective

Patients with Parkinson's disease (PD) often experience visual hallucinations (VH) and delusions. PD patients with VH reportedly have a higher incidence of dementia than PD patients without VH. The nucleus basalis of Meynert (nbM) comprises acetylcholine-releasing neurons that are critical for memory, attention, and arousal. Notably, the nbM also exhibits pathological α-synuclein accumulation, which is a hallmark of Lewy body diseases, including PD. In the present study, we investigated the distribution of abnormal α-synuclein accumulation in the nbM.

Methods

nbM sections of PD 28 autopsy patients were prepared and analyzed via immunohistochemistry using antibodies against phosphorylated α-synuclein and Choline acetyltransferase. The analysis included quantitative assessments of Choline acetyltransferase or α-synuclein positive neurons.

Results

Immunohistochemical analyses of the nbM sections revealed significant cholinergic neuron loss in the intermediate nbM of patients with VH compared with those without VH (137 vs. 191, p = 0.04). Moreover, the ratio of α-synuclein-positive cells to choline acetyltransferase-positive cells was significantly higher in patients with VH than in those without VH (p = 0.03).

Conclusions

Pathological changes in nbM—particularly cholinergic deficits in the intermediate part—were therefore identified as potential contributors to VH in PD. These findings add to our understanding of the neuropathological basis of VH in PD and may inform future therapeutic strategies.

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帕金森病的视幻觉：Meynert中间基底核的关键作用

背景与目的帕金森病（PD）患者常出现视幻觉（VH）和妄想。据报道，有VH的PD患者比没有VH的PD患者有更高的痴呆发生率。Meynert基底核（nbM）由乙酰胆碱释放神经元组成，这些神经元对记忆、注意力和觉醒至关重要。值得注意的是，nbM也表现出病理性α-突触核蛋白积累，这是路易体疾病（包括PD）的标志。在本研究中，我们研究了异常α-突触核蛋白在脑脊液中的分布。方法制备PD 28尸检患者的snbm切片，采用抗磷酸化α-突触核蛋白和胆碱乙酰转移酶抗体免疫组化分析。分析包括定量评估胆碱乙酰转移酶或α-突触核蛋白阳性神经元。结果免疫组织化学分析显示，VH患者与无VH患者相比，中间nbM中胆碱能神经元损失显著（137 vs. 191, p = 0.04）。VH组α-突触核蛋白阳性细胞与胆碱乙酰转移酶阳性细胞的比例显著高于无VH组（p = 0.03）。结论npm的病理改变，特别是中间部分的胆碱能缺陷，因此被确定为PD中VH的潜在因素。这些发现增加了我们对PD中VH的神经病理学基础的理解，并可能为未来的治疗策略提供信息。

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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来源期刊

Parkinsonism & related disorders 医学-临床神经学

CiteScore

6.20

自引率

4.90%

发文量

292

审稿时长

39 days

期刊介绍： Parkinsonism & Related Disorders publishes the results of basic and clinical research contributing to the understanding, diagnosis and treatment of all neurodegenerative syndromes in which Parkinsonism, Essential Tremor or related movement disorders may be a feature. Regular features will include: Review Articles, Point of View articles, Full-length Articles, Short Communications, Case Reports and Letter to the Editor.