Enhanced visual illusions in Parkinson's disease with cardiovascular autonomic failure.

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Autonomic Research Pub Date : 2025-07-05 DOI:10.1007/s10286-025-01142-8

Tadashi Umehara, Masahiro Mimori, Tatsushi Kokubu, Masakazu Ozawa, Tomotaka Shiraishi, Asako Onda, Hiromasa Matsuno, Shusaku Omoto, Hidetomo Murakami, Yasuyuki Iguchi

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引用次数: 0

Abstract

Purpose: Few studies have examined the association between cardiovascular autonomic failure and minor hallucinations in patients with Parkinson's disease (PD). The aim of this study was to clarify this association.

Methods: The subjects were 133 patients with PD without well-structured visual hallucinations. Visual illusory responses were evaluated using the noise pareidolia test. Cardiac ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) uptake and neurogenic orthostatic hypotension (nOH) and supine hypertension (nSH) on head-up tilt-table testing were examined in association with the incidence of pareidolia.

Results: Fifty-one (38%) patients had pareidolia. nOH (β = 0.220, p = 0.008), cognitive impairment (β = -0.228, p = 0.028), and longer symptom duration (β = 0.273, p = 0.006) were associated with an increased incidence of pareidolia independently of age, sex, motor severity, levodopa-equivalent dose, and anticholinergic and cholinesterase inhibitor use. An increased incidence of pareidolia was also associated with nSH (β = 0.214, p = 0.009), while no such association was found with cardiac ¹²³I-MIBG uptake. Patients with severe nOH or nSH tended to have a higher incidence of pareidolia than those with mild nOH (p = 0.063) or nSH (p < 0.003), respectively.

Conclusion: nOH and nSH were associated with the severity of pareidolia in early PD patients without well-structured visual hallucinations. Further studies are required to clarify whether this association is attributable to widespread central pathological changes related to cardiovascular autonomic failure, or to degeneration of the sympathetic nervous system.

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帕金森病伴心血管自主神经衰竭的视错觉增强。

目的：很少有研究探讨帕金森病（PD）患者心血管自主神经衰竭与轻微幻觉之间的关系。本研究的目的是澄清这种联系。方法：以133例无结构良好幻觉的PD患者为研究对象。用噪声性视错觉试验评价视错觉反应。研究了心脏123I-metaiodobenzylguanidine （123I-MIBG）摄取、神经源性直立性低血压（nOH）和仰卧位高血压（nSH）与斜视发生率的关系。结果：51例（38%）患者存在空想性视错觉。nOH （β = 0.220, p = 0.008）、认知障碍（β = -0.228, p = 0.028）和较长的症状持续时间（β = 0.273, p = 0.006）与空想性视斜视发生率增加相关，与年龄、性别、运动严重程度、左旋多巴当量剂量、抗胆碱能和胆碱酯酶抑制剂的使用无关。斜视发生率的增加也与nSH相关（β = 0.214, p = 0.009），而与心脏123I-MIBG摄取没有这种关联。重度nOH和nSH患者的空想性视错觉发生率高于轻度nOH和nSH患者（p = 0.063）。结论：无结构良好幻觉的早期PD患者，nOH和nSH与空想性视错觉严重程度相关。需要进一步的研究来阐明这种关联是否归因于与心血管自主神经衰竭相关的广泛中枢病理改变，还是交感神经系统的变性。

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

Clinical Autonomic Research 医学-临床神经学

CiteScore

7.40

自引率

6.90%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.