In a cross-sectional cohort of 372 patients with Parkinson’s disease (PD), 31% had minor hallucinations (MH) and 15% had visual hallucinations (VH); 25 individuals had both. Participants were grouped by number of MH subtypes (0, 1, 2, or 3), with baseline demographics, motor severity (Unified PD Rating Scale III), and Hoehn and Yahr stage largely comparable across groups. VH prevalence rose with increasing MH burden: roughly twofold higher with two MH subtypes and about sixfold higher with three. This dose-response held across ages, but sex modified risk—women showed a strong gradient (relative risks ~3.9→30.3 from one to three MH), while men showed a significant association only at three MH subtypes. MH frequency also tracked VH risk, increasing from <1/week to daily.
Greater numbers of MH subtypes correlated with higher anxiety, more severe sleep disturbances, greater non-motor symptom burden, and worse quality of life; global cognition did not differ by MH count. Findings suggest patients with multiple MH subtypes may warrant closer monitoring, counseling, and early intervention, but causal inference is limited by the cross-sectional design, small subgroup sizes, semi-structured hallucination assessment, and use of global (not PD-specific) cognitive tools. Longitudinal studies using finer-grained cognitive and neurobiologic measures are needed to validate MH subtype quantification as a predictor of VH and disease trajectory.
Reference: Zhang H, Zhao Y, Chen Y, et al. Association of the number of minor hallucinations and well-structured visual hallucinations in Parkinson’s disease. NPJ Parkinsons Dis. 2025;11(1):244. doi: 10.1038/s41531-025-01106-9.
