Document Detail

Functional involvement of central cholinergic circuits and visual hallucinations in Parkinson's disease.
MedLine Citation:
PMID:  19584099     Owner:  NLM     Status:  MEDLINE    
Visual hallucinations (VHs) represent a frequent and disturbing complication of Parkinson's disease. Evidence suggests that VH can be related to central cholinergic dysfunction. Short-latency afferent inhibition (SAI) technique gives the opportunity to test an inhibitory cholinergic circuit in the human cerebral motor cortex. This inhibition of motor-evoked potentials can be observed when transcranial magnetic stimulation is delivered with a delay ranging from 2 to 8 ms, after a peripheral nerve afferent input has reached the somatosensory cortex. We applied SAI technique in 10 non-demented patients with Parkinson's disease with VHs, in 12 non-demented patients with Parkinson's disease without VHs (NVH-pts) and in 11 age-matched normal controls. All patients with Parkinson's disease underwent a battery of neuropsychological tests to assess frontal and visuospatial functions, memory and attention. SAI was significantly reduced in patients with VHs compared with controls and patients without VHs. Neuropsychological examination showed a mild cognitive impairment in 16 out of 22 patients with Parkinson's disease. In addition, we found that in our patients with VHs, performance of some tasks evaluating visuospatial functions and attentional/frontal lobe functions was significantly more impaired than in patients without VHs. SAI abnormalities, presence of VH and neuropsychological results strongly support the hypothesis of cholinergic dysfunction in some patients with Parkinson's disease, who will probably develop a dementia. A follow-up study of our patients is required to verify whether SAI abnormalities can predict a future severe cognitive decline. Moreover, SAI can also be very useful to follow-up the efficacy of anti-cholinesterase therapies.
Fiore Manganelli; Carmine Vitale; Gabriella Santangelo; Chiara Pisciotta; Rosa Iodice; Autilia Cozzolino; Raffaele Dubbioso; Marina Picillo; Paolo Barone; Lucio Santoro
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Publication Detail:
Type:  Journal Article     Date:  2009-07-07
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  132     ISSN:  1460-2156     ISO Abbreviation:  Brain     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-27     Completed Date:  2009-12-14     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  2350-5     Citation Subset:  AIM; IM    
Department of Neurological Sciences, University Federico II of Naples, Naples, Italy.
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MeSH Terms
Aged, 80 and over
Cholinergic Fibers / physiology*
Cognition Disorders / etiology,  physiopathology
Evoked Potentials, Motor / physiology
Hallucinations / etiology*,  physiopathology
Middle Aged
Motor Cortex / physiopathology
Neural Inhibition / physiology
Neuropsychological Tests
Parkinson Disease / physiopathology,  psychology*
Reaction Time / physiology
Transcranial Magnetic Stimulation / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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