| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurological Sciences (Dr. Goetz, Leurgans, and Stemer) and Preventive Medicine (Dr. Leurgans and Raman), Rush University, Chicago, IL; and Neurology Associates (Dr. Pappert), Austin, TX.
Address correspondence and reprint requests to Dr. Christopher G. Goetz, Movement Disorders Section, Department of Neurological Sciences, Rush–Presbyterian–St. Luke’s Medical Center, 1725 W. Harrison St., Suite 1106, Chicago, IL 60612.
Objective:— To monitor the evolution of hallucinations over 4 years in a stratified sample of patients with PD.
Methods:— Using a modified version of the Unified PD Rating Scale (UPDRS) Thought Disorder question, the authors stratified patients into five baseline behavioral groups. They recruited up to 20 patients for each group to participate in sequential interviews (Rush Hallucination Inventory) at baseline and 6, 18, and 48 months. UPDRS motor examinations and Mini Mental State Examinations (MMSE) were obtained at baseline and 48 months. Data were analyzed with Wilcoxon rank sum tests, Mantel-Haenszel tests, and Spearman correlations. To determine features that influenced the new development of hallucinations, a cumulative logit regression model of hallucination severity over time was fit using generalized estimating equations.
Results:— Based on the design stratification, 60 patients had no hallucinations at baseline (20 with no behavioral problems, 20 with sleep fragmentation, 20 with altered dream phenomena). Twenty-nine patients had hallucinations (20 with retained insight and 9 with loss of insight). At 48 months, the authors could account for all but two subjects (98% retrieval). In 4 years, the presence of hallucinations increased (33% at baseline, 44% at 18 months, and 63% at 48 months, p < 0.0001). The presence of frequent hallucinations (at least three times weekly) also increased (p = 0.0002). Having hallucinations at baseline or at any given assessment was a strong predictor at all follow-up evaluations of continued hallucinations (p < 0.0001). Hallucinations were not associated with increased mortality (
2 = 0.59, df (1), p = 0.47). Among the 60 subjects without hallucinations at baseline, time was the only significant factor influencing the development of hallucination over 48 months. Baseline age, PD duration, sex, medications, and UPDRS or MMSE scores did not influence the incidence of hallucinations.
Conclusions:— This prospective, longitudinal study documents the persistent and progressive nature of hallucinations in PD patients on chronic dopaminergic therapy. The consistent association of hallucinations with combined levodopa/agonist therapy suggests that these drugs may play a role in the pathophysiology of hallucinations.
This article has been cited by other articles:
|
|
 |
|
  P. Martinez-Martin, C. Rodriguez-Blazquez, K. Abe, K. B. Bhattacharyya, B. R. Bloem, F. J. Carod-Artal, R. Prakash, R.A.J. Esselink, C. Falup-Pecurariu, M. Gallardo, et al. International study on the psychometric attributes of the Non-Motor Symptoms Scale in Parkinson disease Neurology, November 10, 2009; 73(19): 1584 - 1591. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Biglan, R. G. Holloway Jr, M. P. McDermott, I. H. Richard, and The Parkinson Study Group CALM-PD Investigators Risk factors for somnolence, edema, and hallucinations in early Parkinson disease Neurology, July 10, 2007; 69(2): 187 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Fenelon, C. G. Goetz, and A. Karenberg Hallucinations in Parkinson disease in the prelevodopa era Neurology, January 10, 2006; 66(1): 93 - 98. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Oishi, F. Udaka, M. Kameyama, N. Sawamoto, K. Hashikawa, and H. Fukuyama Regional cerebral blood flow in Parkinson disease with nonpsychotic visual hallucinations Neurology, December 13, 2005; 65(11): 1708 - 1715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. G. Goetz, J. Wuu, L. M. Curgian, and S. Leurgans Hallucinations and sleep disorders in PD: Six-year prospective longitudinal study Neurology, January 11, 2005; 64(1): 81 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. T. Stebbins, C. G. Goetz, M. C. Carrillo, K. J. Bangen, D. A. Turner, G. H. Glover, and J. D.E. Gabrieli Altered cortical visual processing in PD with hallucinations: An fMRI study Neurology, October 26, 2004; 63(8): 1409 - 1416. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Wint, M. S. Okun, and H. H. Fernandez Psychosis in Parkinson's Disease J Geriatr Psychiatry Neurol, September 1, 2004; 17(3): 127 - 136. [Abstract] [PDF]
|
|
|
|
 |
|
 J. G. Goldman, C. G. Goetz, E. Berry-Kravis, S. Leurgans, and L. Zhou Genetic Polymorphisms in Parkinson Disease Subjects With and Without Hallucinations: An Analysis of the Cholecystokinin System Arch Neurol, August 1, 2004; 61(8): 1280 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Factor, P. J. Feustel, J. H. Friedman, C. L. Comella, C. G. Goetz, R. Kurlan, M. Parsa, R. Pfeiffer, and the Parkinson Study Group Longitudinal outcome of Parkinson's disease patients with psychosis Neurology, June 10, 2003; 60(11): 1756 - 1761. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Levy, M.-X. Tang, E.D. Louis, L.J. Cote, B. Alfaro, H. Mejia, Y. Stern, and K. Marder The association of incident dementia with mortality in PD Neurology, December 10, 2002; 59(11): 1708 - 1713. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Learning About Hallucinations in Parkinson's Disease Journal Watch Psychiatry, January 24, 2002; 2002(124): 7 - 7. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
