HALLUCINATION AND RISK FACTORS IN PATIENTS WITH PARKINSON’S DISEASE

Objective: Hallucination is one of the non-motor symptoms in Parkinson disease (PD). Several factors may affect the presence of hallucination. In the present study, we aimed to compare PD patients presenting with and without hallucinations, to determine risk factors, and to find out common hallucination types. Material and Methods: Idiopathic Parkinson patients regarding to UK Parkinson Disease Society Brain Bank with and without hallucinations were compared. The patients with psychotic symptoms due to metabolic, infectious, and structural causes were excluded. Disease severity was evaluated by Unified Parkinson Disease Rating Scale and Hoehn and Yahr staging. Cognitive status was assessed by Minimental State Examination test. Depression was diagnosed on the basis of DSM-V Tr. Description of hallucination, treatment, co-morbidity, sleep disturbances, REM sleep behavioral disorder, age, gender, scores of test and scale, stage of disease were recorded. Results: A total of 91 (59 female, 32 male) patients with idiopathic PD were enrolled. The group with hallucinations (Group 1) had 40 (43.9%) patients and the one without hallucinations (Group 2) had 51 (54.9%) patients. Total score of Unified Parkinson Disease Rating Scale was significantly higher in Group 1 than Group 2 (37.83±16.65; 30.18±14.83; p=0.028). Sleep disturbances were high in Group 1 (n=24, 60%) when compared to Group 2 (n=14, 27.4%) (p=0.007). The mean duration of hallucinations was 24.87±56.47 months in Group 1. Twenty-one patients (23.9%) had visual hallucinations; 15 (16.5%) patients had illusions (minor hallucinations); and four (4.4%) patients had auditory hallucinations. Conclusion: Disease severity in Parkinson's disease may be a factor in the presence of hallucinations. Hallucinations may also occur with sleep disorders. Minor hallucinations are frequently observed in early stages, with visual hallucinations being the most common hallucinations that may occur in every disease stage.

Parkinson Hastalarında Halusinasyon ve Risk Faktörleri

Amaç: Halusinasyon Parkinson hastalığındaki non-motor semptomlardan biridir. Halusinasyon varlığında birçok risk faktörü rol oynayabilir. Bu çalışmada halusinasyonu olan ve olmayan Parkinson hastalarının karşılaştırılması, risk faktörlerinin belirlenmesi, sık görülen halusinasyon tiplerinin bulunması amaçlandı. Gereç ve Yöntemler: İngiltere Beyin Bankası kriterlerine gore idiopatik Parkinson hastalığı tanısı olan hastalarda halusinasyonu olan ve olmayanlar karşılaştırıldı. Metabolik, enfeksiyöz ve yapısal nedenlere bağlı psikotik semptomu olan hastalar çalışmaya dahil edilmedi. Hastalık şiddeti Birleşik Parkinson Hastalığı Değerlendirme Ölçeği ve Hoehn ve Yahr evrelemesine göre belirlendi. Kognitif durum Minimental Durum Değerlendirme testi ile değerlendirildi. Depressif duygu durum tanısı DSM-5 ile konuldu. Mevcut ise halusinasyon tanımlaması, tedavi, komorbidite, uyku bozuklukları, REM uyku davranış bozukluğu, yaş, cinsiyet, ölçek ve test skorları ile hastalık evresi kayıt edildi. Bulgular: Çalışmaya toplam 91 (59 kadın, 32 erkek) idiopatik Parkinson hastası alındı. Halusinasyonu olan grup (Grup 1) da 40 (%43.9), halusinasyonu olmayan grupta (Grup 2) 52 (%54.9) hasta vardı. Birleşik Parkinson Hastalığı Değerlendirme Ölçeği toplam skoru Grup 1 de Grup 2 ye göre anlamlı oranda yüksekti (37.83±16.65; 30.18±14.83; p=0.028). Uyku bozuklukları Grup 2 (n=14, %27.4) ile karşılaştırıldığında Grup 1’de (n=24, %60) anlamlı oranda yüksekti (p=0.007). Halusinasyon süresi Grup 1’de ortalama 24.87±56.47 aydı. 21 (%23.9) hasta görsel halusinasyon, 15 (%16.5) hasta illuzyon (minör halusinasyon) ve dört (%4.4) hasta işitsel halusinasyona sahipti. Sonuç: Parkinson hastalığında hastalık şiddeti halusinasyon varlığında etken olabilir. Halusinasyonlar uyku bozuklukları ile birlikte görülebilir. Minör halusinasyonlar sıklıkla erken evrede izlenirken, en sık görülen görsel halusinasyon her evrede izlenebilir.

Kaynakça

1. Tysnes OB, Storstein A. Epidemiology of Parkinson's disease. J Neural Transm (Vienna). 2017;124(8):901-5.

2. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55 (3):181-4.

3. Papapetropoulos S, Mash DC. Psychotic symptoms in Parkinson’s disease. From description to etiology. J Neurol. 2005;252(7):753-64.

4. Lee AH, Weintraub D. Psychosis in Parkinson’s disease without dementia: common and comorbid with other non-motor symptoms. Mov Disord. 2012;27(7):858-63.

5. Amerikan Psikiyatri Birliği. Mental Bozuklukların Tanısal ve Sayımsal El Kitabı, Beşinci baskı (DSM5) (Çev. ed. E. Köroğlu) Hekimler Aankara. Yayın Birliği, 2013.

6. Akbostancı MC, Balaban H, Atbaşoğlu C. Birleşik Parkinson Hastalığı Değerlendirme Ölçeği motor muayene bölümü ve anormal istemsiz hareketler ölçeğinin değerlendiriciler arası güvenilirlik çalışması. Parkinson Hastalığı ve Hareket Bozuklukları Dergisi. 2000;3:7-13.

7. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17(5):427-42.

8. Folstein MF, Folstein SE, McHugh PR. Minimental state. A practical method for grading the cognitive state of patients fort the cilinican. J Physchiatr Res. 1975;12(3):189-98.

9. Gungen C, Ertan T, Eker E, Yaşar R, Engin F. Reliability and validity of the standardized minimental state examination in the diagnosis of mild dementia in Turkish population. Turk Psikiyatri Derg. 2002;13(4):273-81.

10.Ramaker C, Marinus J, Stiggelbout AM, Van Hilten BJ. Systematic evaluation of rating scales for impairment and disability in Parkinson’s disease. Mov Disord. 2002;17(5):867-76.

11. Levin J, Hasan A, Höglinger GU. Psychosis in Parkinson's disease: identification, prevention and treatment. J Neural Transm (Vienna). 2016;123(1):45-50.

12. Onofrj M, Espay AJ, Bonanni L, Delli Pizzi S, Sensi SL. Hallucinations, somatic-functional disorders of PD-DLB as expressions of thalamic dysfunction. Mov Disord. 2019;34(8):1100-11.

13. Williams DR, Lees AJ. Visual hallucinations in the diagnosis of idiopathic Parkinson’s disease: a retrospective autopsy study. Lancet Neurol. 2005;4(10):605-10.

14. Factor SA, Molho ES, Podskalny GD, Brown D. Parkinson’s disease: drug-induced psychiatric states. Adv Neurol. 1995;65:115-38.

15. Pagonabarraga J, Martinez-Horta S, Fernández de Bobadilla R, Pérez J, Ribosa-Nogué R, Marín J et al. Minor hallucinations occur in drug-naive Parkinson's disease patients, even from the premotor phase. Mov Disord. 2016;31(1):45-52.

16. Kulisevsky J, Roldan E. Hallucinations and sleep disturbances in Parkinson’s disease. Neurology. 2004;63(3):28-30.

17. Panchal SC, Ondo WG. Treating hallucinations and delusions associated with Parkinson's disease psychosis. Curr Psychiatry Rep. 2018;20(1):3.

18. Fenelon, G. Alves G. Epidemiology of psychosis in Parkinson's disease, J. Neurol. Sci.2010;289(1- 2):12-7.

19. Wu DD, Li SH, Jin LY, Jin Y, Cui YY, Zhao H et al. Influencing factors of visual hallucinations in patients with Parkinson's disease and its relationship with sleep disorders. Zhonghua Yi Xue Za Zhi. 2016;96(13):1016-20.

20. Fenelon G, Soulas T, Cleret de Langavant L, Trinkler I, Bachoud-Levi AC. Feeling of presence in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2011;82(11):1219-1224.

21. Fenelon G, Soulas T, Zenashi F, Langavant FC. The changing face of Parkinson's disease associated psychosis: a cross-sectional study based on the new NINDS-NIMH criteria. Mov Disord. 2010;25(6):763-6.

22. Williams DR, Warren JD, Lees AJ. Using the presence of visual hallucinations to differentiate Parkinson's disease from atypical parkinsonism. J Neurol Neurosurg. Psychiatry. 2008;79(6):652-5.

23.Inzelberg R, Kippervasser S, Korczn AD. Auditory hallucinations in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1998;64(4):533-5.

24. Fenelon G, Mahieux F, Huon R, Ziegler M. Hallucinations in Parkinson’s disease. Prevalence, phenomenology and risk factors. Brain. 2000;123(4):733-45.

25. Marsh L, Williams JR, Rocco M, Grill S, Munro C, Dawson TM. Psychiatric comorbidities in patients with Parkinson disease and psychosis. Neurology. 2004;63(2):293-300.

26. Holroyd S, Currie L, Wooten G.F. Prospective study of hallucinations and delusions in Parkinson's disease, J. Neurol. Neurosurg. Psychiatry. 2001;70(6):734-8.

Kaynak Göster

498 197

Arşiv
Sayıdaki Diğer Makaleler

DÜŞÜK VE YÜKSEK OVER REZERVLİ VAKALARDA VEGF POLİMORFİZM SIKLIĞININ KIYASLANMASI

Derya DEVECİ

PREVALENCE AND CHARACTERISTICS OF PNEUMATIZED ARTICULAR EMINENCE ON PANORAMIC RADIOGRAPHS: A RETROSPECTIVE STUDY AND LITERATURE REVIEW

Gözde SERİNDERE, Ceren Aktuna BELGİN

PROF. DR. FUAT SEZGİN VE İSLAM’DA BİLİM, TEKNİK VE TIBBA BAKIŞ

Sedat KAYGUSUZ, Emre ÖZDEŞ

THE MRI FINDINGS IN PATIENTS WITH IDIOPATHIC CARPAL TUNNEL SYNDROME BEFORE AND AFTER TREATMENT

Şahika Burcu KARACA, Rula ŞAHİN, Leman GÜNBEY KARABEKMEZ, Tevfik YETİŞ, Nihal DURAN

CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS

Adnan ÖZDEMİR, Yunus YILMAZSOY, Serdar ARSLAN, Faruk PEHLİVANLI

5-FLOROURACİL VE RESVERATROL KOMBİNASYONUNUN İNSAN AKCİĞER KANSERİ A549 HÜCRE HATTINDA APOPTOZİS ÜZERİNE ETKİSİ

Can Ali AĞCA, Mahinur, Abdurrahman CAN, Yeşim YUMAK

EFFECTIVENESS OF ULTRASONOGRAPHY IN IMAGING ASSESSMENT OF PNEUMOTHORAX, RIB FRACTURES, AND HEMOTHORAX IN PATIENTS PRESENTING TO EMERGENCY DEPARTMENT WITH BLUNT CHEST TRAUMA

Halil ÇETİNKAYA, Yücel YÜZBAŞIOĞLU, Mehmet Akif KARAMERCAN, Yavuz KATIRCI, Meral TANDOĞAN, Figen COŞKUN

NİĞDE İLİ CİVARINDA YAŞAYAN SAĞLIKLI BİREYLERDE AYAK BİLEĞİ MORFOMETRİK ANALİZ ÖLÇÜMLERİ

Ubeydullah SEVGİLİ, Ahmet Sinan SARI, İbrahim Deniz CANBEYLİ

ULTRASONOGRAFİ REHBERLİĞİNDE PERKÜTAN KESİCİ KARACİĞER BİYOPSİSİ (PARANKİM VE LEZYON): KLİNİK DENEYİMİMİZ

Adnan ÖZDEMİR, Mehmet Hamdi ŞAHAN

HALLUCINATION AND RISK FACTORS IN PATIENTS WITH PARKINSON’S DISEASE

Bahar SAY, Yasemin ÜNAL, Tuğba TUNÇ, Ufuk ERGUN, Ufuk ERGÜN