Structural and Functional Imaging Correlates of Visual Hallucinations in Parkinson's Disease

Curr Neurol Neurosci Rep. 2023 Jun;23(6):287-299. doi: 10.1007/s11910-023-01267-1. Epub 2023 May 1.

Abstract

Purpose of review: To review recent structural and functional MRI studies of visual hallucinations in Parkinson's disease.

Recent findings: Previously, neuroimaging had shown inconsistent findings in patients with Parkinson's hallucinations, especially in studies examining grey matter volume. However, recent advances in structural and functional MRI techniques allow better estimates of structural connections, as well as the direction of connectivity in functional MRI. These provide more sensitive measures of changes in structural connectivity and allow models of the changes in directional functional connectivity to be tested. We identified 27 relevant studies and found that grey matter imaging continues to show heterogeneous findings in Parkinson's patients with visual hallucinations. Newer approaches in diffusion imaging and functional MRI are consistent with emerging models of Parkinson's hallucinations, suggesting shifts in attentional networks. In particular, reduced bottom-up, incoming sensory information, and over-weighting of top-down signals appear to be important drivers of visual hallucinations in Parkinson's disease.

Keywords: Diffusion; MRI; Parkinson’s disease; VBM; Visual hallucinations; fMRI.

Publication types

  • Review

MeSH terms

  • Cerebral Cortex
  • Gray Matter
  • Hallucinations / diagnostic imaging
  • Hallucinations / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Parkinson Disease* / complications
  • Parkinson Disease* / diagnostic imaging