Abstract
Purpose Minor hallucinations (MHs) are the most common psychotic phenomena in Parkinson's disease (PD), and it has important clinical and prognostic implications in PD. Plasma homocysteine (Hcy) has been reported to predict the outcome of PD; whether or not Hcy is associated with MH is not known. We aim to investigate the Hcy level and related factors in patients with PD and MH. Methods We conducted a cross-sectional study and included 99 patients with PD, 34 with MH, and 65 without any hallucinations. The clinical and demographic data of the patients with and without hallucinations were compared. Hcy-related clinical factors were also analyzed. Results The plasma Hcy level was higher in MH patients than in patients without hallucinations, and the result was more pronounced in male patients than in female patients. Differences were also observed when the groups were divided on the basis of levodopa equivalent daily dose and disease duration. The high Hcy concentration was correlated with some symptoms in patients with MH, including motor dysfunction and nonmotor symptoms, such as symptoms of the gastrointestinal tract, angiocarpy, sleep/fatigue, and poor visuospatial/executive function. Conclusions Results indicated a higher plasma Hcy concentration in MH patients than in their counterparts and revealed that Hcy is associated with certain motor and nonmotor symptoms in patients with MH. Hcy may be a marker of MH and have important therapeutic implications in PD.
Highlights
Parkinson’s disease (PD) is the second-largest neurodegenerative disease with clinical manifestations of motor and nonmotor symptoms
As Hcy is associated with neuropsychiatric diseases, we proposed that Hcy might be related to PD-minor hallucinations (MHs)
No significant differences were noted in terms of the family history of PD, predominance of motor symptoms, disease duration, PD medication, levodopa equivalent daily dose (LEDD), Unified Parkinson’s Disease Rating Scale (UPDRS) III scores, and modified H– Y stage
Summary
Parkinson’s disease (PD) is the second-largest neurodegenerative disease with clinical manifestations of motor and nonmotor symptoms. As a common nonmotor symptom, minor hallucinations (MHs) have been recognized as a premotor symptom [1, 2] and the most frequently present hallucination in PD [3]. MHs consist of presence hallucinations, passage hallucinations, and visual illusions [4]. The patient feels the presence of someone nearby and tends to look around for verification. The patient catches a glimpse of a fuzzy shadow passing by, which is often reported as a person or an animal. Visual illusions include kineptosia (seeing still life as moving), pareidolias (seeing human faces or others from complex patterns), and object misidentification illusions (seeing something as another object with a similar shape) [5]. MHs are associated with a high risk of severe psychiatric symptoms, deterioration of cognitive state, or accelerated disease progression [4]
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