Clinical Analysis Of Risk Factors Of Visual Hallucinations In Parkinson's Disease

[Objective]To investigate the relationship between visual hallucinations(VH) and its clinical factors in Parkinson's disease (PD), and explore the probable pathophysiology of hallucinations in PD. Attempt to search one of the predictors for VH in objection.[Methods]Twelve cases of PD with VH from the inpatient and outpatient department of neurology of Fujian Provincial Institution Hospital was regarded as study group, and twenty-one cases of PD without VH was regarded as control group. By the case, control study basic clinical data such as age, gender, disease duration, education, the dosage of dopaminergic drugs were collected. The differences in unified Parkinson's disease rating scale-Ⅲ(UPDRS-Ⅲ) scores, Hoehn-Yahr stage, mini-mental state examination (MMSE) scores, depression status inventory (DSI) scores, frontal assessment battery (FAB) scores were compared. The prevalence of REM sleep behavior disorder (RBD) was investigated. Ophthalmologists performed ophthalmologic examinations including vision test, screening for cataracts, and funduscopy. Visual evoked potential (VEP) using a checkerboard stimulus were recorded. SSPS 13.0 was used to analyze all the data.[Results]1.There were significant difference in FAB scores, the prevalence of RBD between patients with VH and those without VH(P﹤0.05). Age, gender, disease duration, education, levodopa equivalent doses, UPDRS-Ⅲscores,Hoehn-Yahr stage, MMSE scores, DSI scores, need glasses or not, unassisted vision, best eyesigh, corrected vision, or average P100 latency had no significant differences between two groups(P>0.05).2.Binary logistic regression showed that, by adjusting other confounding factors, the factors entered the final equation were: RBD(OR=11.763),FAB(OR=0.323).[Conclusions]1.The prevalence of RBD might be one of risk factor for VH in PD.2.A dysfunction of the prefrontal cortex associated with the control of executive functions could be a risk factor for VH in PD. To evaluate the development of VH in PD by neuropsychology, we subjected detecting frontal dysfunction was more sensitive than general cognitive impairment.3.Dopaminergic medication, abnormal vision, increased age, gender, disease duration, disease severity and depression were unrelated to the presence of visual hallucinations in Parkinson's disease.