The metabolic correlate of visual hallucinations in Parkinson's disease
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Backgound: Visual hallucinations (VH) occur in about 25% of patients with Parkinson's disease (PD). However, the pathophysiological mechanisms of VH in PD are not well understood.Keywords:
Pathophysiology
Parkinson’s disease one of the most complex neurological disorder. The disease risk and progression are due to common genetic variants. Approximately 6.2 million cases are reported each year according to the statistics published in 2015 whereas it is expected that this number will be twice by 2040. There are two types of Parkinson’s disease, familial Parkinson’s disease, and sporadic Parkinson’s disease. The disease is characterized by the presence of Lewy bodies. Adult age increases the risk of Parkinson’s disease. In this review, we provide an overview of the disease pathology of Lewy bodies in the occurrence of Parkinson’s disease, in vitro studies to determine the role of iPSCs in treatment of Parkinson’s disease, in vivo studies to determine the role of animal model in studying disease modeling, and future prospective how single-cell RNA sequencing technology is a major advancement in studying and find the treatment for Parkinson’s disease.
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Objective To investigate the prevalence and characteristics of visual hallucination among patients with Parkinson's disease(PD),and analyse the potential risk factors.Methods One hundred and twenty-eight patients with PD were administered self-prepared visual hallucination questionnaires,and prevalence of visual hallucination was surveyed.The differences in sex,age,disease duration,Mini Mental State Exam(MMSE) scores,Hoehn Yahr stage,types of medicine used and levodopa equivalent doses(LDE) were compared between the patients with visual hallucination and those without visual hallucination.The prevalence of rapid eye movement sleep behavior disorder(RBD) was investigated in patients with visual hallucination.Results Eighteen patients(14.06%) experienced visual hallucination,among whom 10(55.56%) experienced visual hallucination no less than one time per day,11(61.11%) saw the shadow of human figure and 15(83.33%)were complicated with RBD.There were significant differences in MMSE scores,Hoehn Yahr stage,female proportion and usage of dopamine agonists between patients with visual hallucination and those without visual hallucination(P0.05).Conclusion Visual hallucination is a common non-motor symptom among patients with PD,and cognitive function,disease severity and usage of dopamine agonists may be related to visual hallucination.
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Purpose of review The literature related to visual hallucinations in ophthalmological settings from 2007 to 2008 is presented as a review of recent developments and trends. Recent findings Acuity, contrast sensitivity, age and sex emerge as significant and consistent risk factors for visual hallucinations, together with new evidence to suggest that up to 40% of patients have long-term hallucinations. Scotoma size and specific eye pathology do not influence hallucination risk. Induced hallucinations in normal individuals provide a model for those in eye disease, revealing a shift in thalamocortical circuitry and neurophysiological links to states of drowsy wakefulness. Serotonergic therapy emerges as a potential treatment. Two ophthalmological interventions are added to the list of procedures provoking hallucinations. Historical accounts of Charles Bonnet, his syndrome and two novel visual syndromes highlight ongoing difficulties of case definition and the wider clinical context in which visual hallucinations occur. Summary Current research into visual hallucination is predominantly ophthalmology-led, with increasing recognition of the phenomena, their prevalence and prognosis within the specialty. Deafferentation remains the best available pathophysiological account, although it fails to explain the absence of hallucinations in the majority of patients with eye disease. Whether hallucinations require treatment and, if so, what that treatment should be remains unclear.
Charles Bonnet Syndrome
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Visual hallucination can be defined as visual sensory perception without external stimulation, or something that a patient sees that other observers in the same environment do not see. The images may be unformed (lights, streaks, flashes) or formed (objects, people, scenes). Clinical experience indicates that, despite the infrequency with which they are mentioned, visual hallucinations commonly occur in patients with ophthalmological and neurological diseases. Content, duration and timing of visual hallucinations relate to their cause and provide useful clinical information. This paper reviews the topical, pathophysiological and clinical aspects of visual hallucinations.
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The current review describes the modem Parkinson's disease models in animals, their advantages, limitations and disadvantages. It was noted that the most widespread up-to-date models based on etiology of the Parkinson's disease. Although toxins mostly produce the Parkinson's disease, a study of involved genes allows investigating not only inherited but also sporadic (not inherited) forms of disease since the same genes are involved in both cases. Mutations of genes lead to formation of mutant toxic proteins, which produce a death of the specialized neurons of the nigrostriatal dopaminergic system and the development of Parkinson's disease. A significant place in the review takes adescription of characteristics of the toxic models produced by 6-OHDA, MPTP and rotenone, their similarities and differences in pathogenetic mechanisms of the Parkinson's disease development. On the basis of the considered experimental models of Parkinson's disease a conclusion has been done that none of these models may in full and adequate scale imitate the entire clinical, pathophysiological, morphological, biochemical and other aspects of the Parkinson's disease development.
MPTP
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Parkinson's disease is caused by the reduction of dopamine in the brain and related to many genes. In addition, the getting together of the α-Synuclein is the important factor of Parkinson's disease. This research mainly discusses the effect of heavy metals and genetics on the prevalence of Parkinson's disease. The author found 10 articles that investigate the relationship between the heavy metals, genetics and the prevalence of Parkinson's disease. In all these materials, 9 of 10 articles focus on the relationship between the heavy metals and the prevalence of Parkinson's disease, namely, how different heavy metals can cause Parkinson's disease. The last reference article is about the genetics and the prevalence of Parkinson's disease. This article is mainly about which gene is changed and will let people get Parkinson's disease. Iron, copper and lead can contribute to the prevalence of Parkinson's disease, while the manganese does not show much related to the prevalence of Parkinson's disease. Besides, many genes together will contribute to the prevalence of Parkinson's disease. Different genes getting together will cause different Parkinson's disease.
LRRK2
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Visual hallucinations in the elderly population are a common and frequently unapprised phenomenon. In these patients, often there are abnormalities of visual function. There are a few case reports that have demonstrated a decrease in visual hallucinations with the use of optical aids. Although this area is understudied, this article looks at the possible role that the low vision specialist may play in the reduction of visual hallucinations in the geriatric population.
Vision rehabilitation
Visual Impairment
Charles Bonnet Syndrome
Visual rehabilitation
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Prism
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We report two cases of Parkinson's disease in which visual hallucinations disappeared after cataract surgery. Patient 1 was a 72-year-old woman with Parkinson's disease, visual hallucinations and musical hallucinations. Patient 2 was a 77-year-old woman with Parkinson's disease and visual hallucinations. Both patients had severe bilateral cataracts. Though it was difficult to control their visual hallucinations with medication only, cataract surgery made them disappeared quickly. The visual hallucinations of Parkinson's disease are similar to those of Charles Bonnet syndrome. For example, both hallucinations often happen in dim light, at night and when patients are awake with eyes open. Though there have been many reports describing visual hallucinations in Parkinson's disease, there have been few reports discussing the relation between these hallucinations and impaired visual acuity. Similar to the hallucinations of Charles Bonnet syndrome, impaired visual acuity should be related to the visual hallucinations of Parkinson's disease. When Parkinson's disease, visual hallucinations and severe cataract coexist, visual hallucinations may disappear after cataract surgery.
Charles Bonnet Syndrome
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Visual hallucinations are reported in 16-37% of drug-treated patients with Parkinson's disease (PD) and are the most common hallucinations in PD. We report two patients with PD with symptoms that uniquely integrate visual hallucinations and delusions. We report two cases of patients with PD with visual hallucinations who saw the persistence of these hallucinations in photographs. These pictures were taken to prove the absence of these hallucinations. We believe this is the first description of this peculiar phenomenon, in which hallucinations or illusions could be replicated in photographs. Both patients had delusions associated with the images and we speculate that the images they saw in the photographs represent a further delusion, hence a 'delusional hallucination' or 'delusional illusion.' We believe that delusions fostering hallucinations are rare.
Charles Bonnet Syndrome
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