Visual Hallucinations in Eye Disease and Lewy Body Disease

Prabitha Urwyler; Tobias Nef; René Müri; Neil Archibald; Selina Margaret Makin; Daniel Collerton; John-Paul Taylor; David Burn; Ian McKeith; Urs Peter Mosimann

doi:10.1016/j.jagp.2015.10.007

Visual Hallucinations in Eye Disease and Lewy Body Disease

Am J Geriatr Psychiatry. 2016 May;24(5):350-8. doi: 10.1016/j.jagp.2015.10.007. Epub 2015 Oct 21.

Authors

Affiliations

¹ Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.
² Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
³ Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland; Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, University Hospital Inselspital, University of Bern, Bern, Switzerland.
⁴ James Cook University Hospital, Middlesbrough, UK; Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
⁵ Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Walton Centre NHS Foundation Trust, Liverpool, UK.
⁶ Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Northumberland, Tyne & Wear NHS Foundation Trust, Bensham Hospital, Gateshead, UK.
⁷ Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
⁸ Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland; University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland; Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. Electronic address: urs.mosimann@artorg.unibe.ch.

PMID: 26796926
DOI: 10.1016/j.jagp.2015.10.007

Abstract

Objectives: Visual hallucinations (VH) most commonly occur in eye disease (ED), Parkinson disease (PD), and Lewy body dementia (LBD). The phenomenology of VH is likely to carry important information about the brain areas within the visual system generating them.

Methods: Data from five controlled cross-sectional VH studies (164 controls, 135 ED, 156 PD, 79 [PDD 48 + DLB 31] LBD) were combined and analyzed. The prevalence, phenomenology, frequency, duration, and contents of VH were compared across diseases and sex.

Results: Simple VH were most common in ED patients (ED 65% versus LBD 22% versus PD 9%, χ(2) = 31.43, df = 2, p < 0.001), whereas complex VH were more common in LBD (LBD 76% versus ED 38%, versus PD 28%, χ(2) = 96.80, df = 2, p < 0.001). The phenomenology of complex VH was different across diseases and sex. ED patients reported more "flowers" (ED 21% versus LBD 6% versus PD 0%, χ(2) = 10.04, df = 2, p = 0.005) and "body parts" (ED 40% versus LBD 17% versus PD 13%, χ(2) = 11.14, df = 2, p = 0.004); in contrast, LBD patients reported "people" (LBD 85% versus ED 67% versus PD 63%, χ(2) = 6.20, df = 2, p = 0.045) and "animals/insects" (LBD 50% versus PD 42% versus ED 21%, χ(2) = 9.76, df = 2, p = 0.008). Men reported more "machines" (13% versus 2%, χ(2) = 6.94, df = 1, p = 0.008), whereas women reported more "family members/children" (48% versus 29%, χ(2) = 5.10, df = 1, p = 0.024).

Conclusions: The phenomenology of VH is likely related to disease-specific dysfunctions within the visual system and to past, personal experiences.

Keywords: Lewy body dementia; Parkinson disease; Visual hallucinations; eye disease; phenomenology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Case-Control Studies
Comorbidity
Cross-Sectional Studies
Eye Diseases / epidemiology*
Female
Hallucinations / epidemiology*
Humans
Lewy Body Disease / epidemiology*
Male
Parkinson Disease / epidemiology*
Sex Factors
United Kingdom / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding