Researchers of this single-center cohort enrolled 213 patients with Parkinson’s disease (PD) between April 2020 and September 2021 and followed them for one year. Patients with major psychiatric histories, antipsychotic use, or abnormal/uncorrected vision were excluded. Minor hallucinations (MHs) were screened with Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale part one (score = 1 sustained ≥2 months), and motor phenotype was classified as tremor-dominant (TD), postural-instability/gait-difficulty (PIGD), or intermediate. Standardized scales assessed motor/non-motor symptoms, sleep, mood, cognition, quality of life, and medication burden. Of 213 patients (42.3% TD, 46.0% PIGD), 70 (32.9%) had MHs.
Compared with TD, PIGD showed higher Hoehn and Yahr stage and equivalent daily dose of levodopa, more MHs, and greater non-motor and quality-of-life burden. Among those with MHs, PIGD also had worse disability, more anxiety, poorer sleep/quality of life, and lower Montreal Cognitive Assessment scores. MHs appeared earlier in PIGD (latency ~2.6 vs ~6.2 years from motor onset), with visual illusions more common in PIGD and passage hallucinations more common in TD. Other MH features were similar (brief, sudden, often daytime). MH latency correlated negatively with probable rapid eye movement sleep behavior disorder and with the PIGD subtype, linking sleep dysregulation to earlier psychosis risk. Overall, PIGD marks a more aggressive PD phenotype with earlier, more frequent MHs, supporting early identification and targeted management.
Reference: Wang Y, Li D, Chen Y, et al. Clinical features of minor hallucinations in different phenotypes of Parkinson’s disease: A cross-sectional study. Front Neurol. 2023;14:1158188. doi: 10.3389/fneur.2023.1158188.
Link: https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1158188/full
