Relevant conflicts of interest/financial disclosures: Nothing to report.
Article first published online: 23 SEP 2011
Copyright © 2011 Movement Disorder Society
Volume 26, Issue 12, pages 2154–2159, October 2011
How to Cite
Shine, J. M., Halliday, G. M., Naismith, S. L. and Lewis, S. J.G. (2011), Visual misperceptions and hallucinations in Parkinson's disease: Dysfunction of attentional control networks?. Mov. Disord., 26: 2154–2159. doi: 10.1002/mds.23896
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 21 OCT 2011
- Article first published online: 23 SEP 2011
- Manuscript Accepted: 5 JUL 2011
- Manuscript Revised: 28 JUN 2011
- Manuscript Received: 21 APR 2011
- Parkinson's disease;
- Lewy body pathology;
- neural networks; hallucinations
Visual misperceptions and hallucinations are a major cause of distress in patients with Parkinson's disease (PD), particularly in the advanced stages of the condition. Recent work has provided a framework for understanding the pathogenesis of these symptoms, implicating impairments from the retina to the integration of external information with preformed internal images. In this article, we propose a novel hypothesis that attempts to explain the presence of visual misperceptions and hallucinations in PD through the aberrant coordination of complimentary yet competing neural networks. We propose that hallucinations in PD reflect the relative inability to recruit activation in the dorsal attention network in the presence of an ambiguous percept, leading to overreliance on default mode network processing and salience arising from the ventral attention network. This inability is proposed to stem from improper function across cortical and subcortical structures secondary to the presence of Lewy body pathology. This hypothesis may be empirically tested by the use of targeted cognitive paradigms. In turn, this may assist our understanding of the pathophysiological mechanisms and cognitive processes contributing to visual misperceptions and hallucinations and ultimately may inform more effective treatment strategies for this troubling symptom. © 2011 Movement Disorder Society