Hallucinations in Parkinson's disease: new insights into mechanisms and treatments

Rimona S Weil, Suzanne Reeves, Rimona S Weil, Suzanne Reeves

Abstract

Hallucinations are common in Parkinson's disease and can be distressing to patients and their families. They are associated with higher rates of nursing home placement and with increased mortality. Their underlying mechanisms have been elusive, but recent advances in network imaging provides some intriguing insights into possible underlying drivers. Treatment is complicated by risk of worsening Parkinson's motor symptoms and by higher rates of mortality with antipsychotics, but new therapeutic avenues are emerging that offer potential hope.

Conflict of interest statement

Conflict of interest statement: Dr Weil received personal fees from GE Healthcare.

Figures

Figure 1
Figure 1
Patients with visual hallucinations over rely on prior information. A. Two-tone test image shown to patients with visual hallucinations. B. Greater improvement in image recognition is seen in Parkinson’s hallucinators than those with no hallucinations after viewing the template image. C. Template colour image, from which the two-tone image was generated. Adapted from Zarkali A, Adams RA, Psarras S, Leyland LA, Rees G, Weil RS. Increased weighting on prior knowledge in Lewy body-associated visual hallucinations. Brain Commun. 2019;1(1):fcz007. doi:10.1093/braincomms/fcz007

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