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Visual Hallucinations in Eye Disease and Lewy Body Disease

Lookup NU author(s): Dr Neil Archibald, Daniel Collerton, Professor John-Paul TaylorORCiD, Professor David Burn, Professor Ian McKeith, Dr Urs Mosimann


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Objective: Visual hallucinations (VH) most commonly occur in eye disease (ED), Parkinson’s disease (PD), and Lewy body dementia (LBD) (i.e. Parkinson’s disease dementia (PDD) or Dementia with Lewy bodies (DLB)). This study was undertaken to study the phenomenology and characteristics of VH across these diseases as 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 (including 164 participants in the comparison group, 135 ED, 156 PD, 79 (PDD 48 + DLB 31) LBD) were combined and analysed. The prevalence, phenomenology, frequency, duration, and contents of VH were compared across diseases and gender. Results: Simple VH were most common in ED patients (ED 65% vs. LBD 22% vs. PD 9%, Chi-square [χ2] test: χ2=31.43, df=2, p<0.001), whilst complex VH were more common in LBD (LBD 76% vs. ED 38%, vs PD 28%, Chi-square test: χ2=96.80, df=2, p<0.001). The phenomenology of complex VH was different across diseases and gender. ED patients reported more "flowers" (ED 21% vs. LBD 6% vs. PD 0%, Chi-square test: χ2=10.04, df=2, p=0.005) and "body parts" (ED 40% vs. LBD 17% vs. PD 13%, Chi-square test: χ2=11.14, df=2, p=0.004); in contrast LBD patients reported "people" (LBD 85% vs. ED 67% vs. PD 63%, Chi-square test: χ2=6.20, df=2, p=0.045) and "animals/insects" (LBD 50% vs. PD 42% vs. ED 21%, Chi-square test: χ2=9.76, df=2, p=0.008). Males reported more "machines" (13 % vs. 2%, Chi-square test: χ2=6.94, df=1, p=0.008), whilst females reported more "family members/children" (48% vs. 29%, Chi-square test: χ2=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.

Publication metadata

Author(s): Urwyler P, Nef T, Müri R, Archibald N, Makin SM, Collerton D, Taylor JP, Burn D, McKeith I, Mosimann UP

Publication type: Article

Publication status: Published

Journal: American Journal of Geriatric Psychiatry

Year: 2016

Volume: 24

Issue: 5

Pages: 350-358

Print publication date: 01/05/2016

Online publication date: 21/10/2015

Acceptance date: 13/10/2015

ISSN (print): 1064-7481

ISSN (electronic): 1545-7214

Publisher: Elsevier


DOI: 10.1016/j.jagp.2015.10.007


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Funder referenceFunder name
Academy of Medical Sciences
GE Healthcare
Gateshead Health NHS Foundation Trust
Michael J. Fox Foundation
National Institute for Health Research Newcastle Biomedical Research Unit
Parkinson's UK
BH090112Wellcome Trust
WT088441MAWellcome Trust