Visual hallucinations and inferior longitudinal fasciculus in Parkinson's disease

Brain Behav. 2020 Dec;10(12):e01883. doi: 10.1002/brb3.1883. Epub 2020 Oct 20.

Abstract

Introduction: We investigated whether disruption of the inferior longitudinal fasciculus and inferior fronto-occipital fasciculus are associated with visual hallucinations in Parkinson's disease (PD).

Methods: Sixty consecutive right-handed patients with PD with and without visual hallucinations were enrolled in this cross-sectional study. Diffusion tensor imaging was acquired by 3.0 T magnetic resonance imaging. We measured fractional anisotropy and mean diffusivity of the bilateral inferior longitudinal fasciculus and inferior fronto-occipital fasciculus using diffusion tensor tractography analysis software.

Results: Seventeen patients with PD had visual hallucinations; these patients tended to have lower fractional anisotropy and higher mean diffusivity values in all fasciculi than did patients without visual hallucinations. A univariate logistic analysis showed that the presence of visual hallucinations was significantly associated with lower fractional anisotropy and higher mean diffusivity of the left inferior longitudinal fasciculus, and lower Mini-Mental State Examination (MMSE) scores. A multivariable logistic analysis adjusted by MMSE scores and disease duration showed a significant association between the presence of visual hallucinations and fractional anisotropy and mean diffusivity values of the left inferior longitudinal fasciculus.

Conclusions: Our results suggest that disruption of left inferior longitudinal fasciculus integrity is associated with visual hallucinations in patients with PD, independent of cognitive impairment and disease duration.

Keywords: Parkinson's disease; diffusion tensor imaging; inferior longitudinal fasciculus; visual hallucination; white matter.

MeSH terms

  • Brain
  • Cross-Sectional Studies
  • Diffusion Tensor Imaging
  • Hallucinations / diagnostic imaging
  • Humans
  • Parkinson Disease* / complications
  • Parkinson Disease* / diagnostic imaging
  • White Matter* / diagnostic imaging