In a cohort of 262 people with Parkinson’s disease (PD), minor hallucinations (MHs)—screened with Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale part I—were common (38.9% overall; 28.2% isolated MHs). The most frequent MHs were visual illusions (48.4%), especially object misidentification (19.7%), followed by pareidolia (13.9%) and kineptosia (14.8%); passage (28.7%) and presence (23.0%) hallucinations were also prevalent. Phenomenology was consistent across types: episodes typically occurred indoors under dim light, began suddenly, lasted seconds, recurred from daily to <weekly, were blurry and normal-sized, and in ~22% began before motor symptom onset. Comorbidity across psychosis features was not rare (12.2% had >1 symptom).
Compared with PD without hallucinations, the MH group had longer disease duration and higher levodopa-equivalent dose with more levodopa/dopamine-agonist use, but medications and duration were not independent predictors. After adjusting for these covariates, MHs were associated with heavier non-motor burden, worse sleep, greater likelihood of REM sleep behavior disorder, and poorer health-related quality of life, with no group differences in global cognition or depression. In multivariable models, rapid eye movement sleep behavior disorder (RBD), poorer sleep, and worse quality of life independently related to MHs. These findings position MHs as an early, frequent marker linked to sleep disturbance/RBD and quality of life decline, underscoring the need for routine screening and longitudinal follow-up to refine prognosis and guide intervention.
Reference: Zhong M, Gu R, Zhu S, et al. Prevalence and Risk Factors for Minor Hallucinations in Patients with Parkinson’s Disease. Behav Neurol. 2021;2021:3469706. doi: 10.1155/2021/3469706.
Link: https://onlinelibrary.wiley.com/doi/10.1155/2021/3469706
