Abstract
Pareidolia is a visual illusion of meaningful objects that arise from ambiguous forms embedded in visual scenes. Previous studies showed that pareidolias are frequently observed in patients with Parkinson's disease (PD) as well as dementia with Lewy bodies. However, whether pareidolias are useful for differentiating PD from other neurodegenerative parkinsonism disorders including multiple system atrophy (MSA) is unclear. The noise pareidolia test (NPT) was performed in 40 and 48 patients with PD and MSA, respectively. A receiver operating characteristic (ROC) curve analysis was used to evaluate sensitivity and specificity. Results of neuropsychological tests were also compared between patients with PD with and without pareidolias. Visual hallucinations were present in none of the subjects. Pareidolic response in the NPT was observed in 47.5% and 18.8% of patients with PD and MSA, respectively. The number of pareidolic responses in patients with PD was significantly larger compared with patients with MSA (P=0.001). ROC curve analyses showed the sensitivity and specificity at 33% and 98%, respectively. Among patients with PD, those with pareidolias demonstrated higher State-Trait Anxiety Inventory-state (P=0.044) and State-Trait Anxiety Inventory-trait (P=0.044) than those without pareidolias. Pareidolias can be found in patients with PD without visual hallucinations, and the pareidolia test may be a highly specific test for differentiating PD from MSA. Thus, anxiety may be associated with pareidolias in patients with PD.
Highlights
Visual symptoms are common in Parkinson’s disease (PD), which include double vision, blurry vision, watery eyes, illusions, feelings of presence and passage, and visual hallucinations [1, 2]
Pareidolias are visual illusions of meaningful objects that arise from ambiguous forms embedded in visual scenes and have phenomenological similarities with visual hallucinations [5]. e pareidolia test has been reported as a tool for evoking and measuring pareidolias with good test-retest/
Age at the pareidolia test was significantly higher in patients with PD than in patients with multiple system atrophy (MSA) (P 0.020)
Summary
Visual symptoms are common in Parkinson’s disease (PD), which include double vision, blurry vision, watery eyes, illusions, feelings of presence and passage, and visual hallucinations [1, 2]. Visual illusions have been categorized as minor hallucinations [1] and have been reported to be present in 4.2%–19% of patients with PD [1, 3, 4]. E pareidolia test has been reported as a tool for evoking and measuring pareidolias with good test-retest/. E number of illusory responses in the pareidolia test was significantly correlated with the severity of visual hallucinations, suggesting the usefulness of the pareidolia test as a surrogate marker of visual hallucination in dementia with Lewy bodies (DLB) [5,6,7]. The pareidolia test exhibited high diagnostic accuracy for discriminating DLB from Alzheimer’s disease [5, 7]. Whether pareidolias evoked by the pareidolia test are useful in differentiating PD from other
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