Abstract
Purpose As the most frequent and earliest type of psychotic phenomenon in Parkinson's disease (PD), minor hallucination (MH) can occur before the onset of motor symptoms. This sensation may be an early predictor of severe psychotic and cognitive states and is often overlooked in clinics. This study was aimed at providing a comprehensive and in-depth understanding of MHs. Patients and Methods. Demographic information was obtained from 262 patients with PD, and a series of clinical assessment questionnaires were provided. According to the result of the Movement Disorders Society Unified Parkinson's Disease Rating Scale Part I, the patients were classified into the MH and nonhallucination (NH) groups. Results MHs were the most common psychotic symptom with 38.9% prevalence. The most frequent MH was visual illusion, especially object misidentification. Three minor phenomena were somewhat consistent in terms of external factors, temporal factors, and content. Disease duration, daily levodopa equivalent dose, and percentage of levodopa and dopamine-receptor agonist use were remarkably greater in the MH group than in the NH group. After covariate control, the MH group had worse life quality and more severe nonmotor symptoms, including poor sleep quality and rapid eye movement sleep behavior disorder (RBD), than the NH group. The binary logistic regression model showed that RBD, sleep quality, and health-related life quality were associated with MHs. Conclusion A high prevalence of MHs was observed in patients with PD. Further studies are needed to confirm and expand the identified clinical factors related to MH, which have potential prognostic and therapeutic implication.
Highlights
Parkinson’s disease (PD) is the second largest degenerative disease that has affected a large number of people worldwide [1]
Among the 262 patients with PD recruited in our study, 102 (38.9%) experienced minor hallucination (MH), including 74 patients (28.2%) with isolated MHs and 28 patients (10.7%) with combined MHs
Contrary to previous findings [39], the current study found a correlation between sleep disturbance and MHs
Summary
Parkinson’s disease (PD) is the second largest degenerative disease that has affected a large number of people worldwide [1]. As one of the most detrimental nonmotor symptoms, PD associated psychosis (PDP) affects up to 75% of patients throughout the disease course [2]. This prevalence is underestimated because the psychotic symptoms are not fully considered as a spectrum that includes minor hallucinations (MHs), major hallucinations, and delusions. MHs were included in the diagnostic criteria for PDP by the National Institute of Neurological Disorders and Stroke and National Institute of Mental Health group [4]. Three types of phenomena are grouped under the title of MHs: presence hallucinations, passage hallucinations, and visual illusions. Visual illusions include object misidentification illusions (seeing something as another object with a similar shape), pareidolias (seeing human faces or others from complex patterns), and kineptosia (seeing still life as moving) [6]
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