Dementia ; pathology ; Hallucinations ; pathology ; Humans ; Lewy Body Disease ; pathology ; Nerve Net ; pathology

Humans ; Cerebral Cortex ; Hallucinations/pathology* ; Neurodegenerative Diseases/pathology* ; Atrophy/pathology* ; Magnetic Resonance Imaging

BACKGROUNDAuditory verbal hallucinations (AVHs) of schizophrenia have been associated with structural and functional alterations of some brain regions. However, the brain regional homogeneity (ReHo) alterations specific to AVHs of schizophrenia remain unclear. In the current study, we aimed to investigate ReHo alterations specific to schizophrenic AVHs.

METHODSThirty-five schizophrenic patients with AVH, 41 schizophrenic patients without AVHs, and fifty healthy subjects underwent resting-state functional magnetic resonance imaging. ReHo differences across the three groups were tested using a voxel-wise analysis.

RESULTSCompared with the healthy control group, the two schizophrenia groups showed significantly increased ReHo in the right caudate and inferior temporal gyrus and decreased ReHo in the bilateral postcentral gyrus and thalamus and the right inferior occipital gyrus (false discovery rate corrected, P < 0.05). More importantly, the AVH group exhibited significantly increased ReHo in the left precuneus compared with the non-AVH group. However, using correlation analysis, we did not find any correlation between the auditory hallucination rating scale score and the ReHo of brain regions.

CONCLUSIONSOur results suggest that increased ReHo in the left precuneus may be a pathological feature exclusive to schizophrenic AVHs.

Adult ; Female ; Hallucinations ; pathology ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Parietal Lobe ; physiopathology ; Schizophrenia ; pathology ; physiopathology

The dementia with Lewy bodies which was common next to the Alzheimer's dementia had been oftenly misdiagnozed as vascular dementia. The pathologic diagnosis of dementia with Lewy bodies was increasing with the development of immunocytochemical techniques, and it also drew much interest recently. The clinical criteria included core symptoms such as fluctuation of cognitive function, well-formed visual hallucination and extrapyramidal symptoms. For the pathologic criteria, presence of brainstem or cortical Lewy bodies were essential, besides of other pathology. However, it was difficult to obtain satisfactory consensus between investigators about the clinical and pathologic criteria of the dementia with Lewy bodies. There were several reports which suggested good response to the cholinesterase inhibitors.
Brain Stem ; Cholinesterase Inhibitors ; Consensus ; Dementia* ; Dementia, Vascular ; Diagnosis ; Hallucinations ; Humans ; Lewy Bodies* ; Pathology ; Research Personnel

BACKGROUNDDysconnectivity hypothesis of schizophrenia has been increasingly emphasized. Recent researches showed that this dysconnectivity might be related to occurrence of auditory hallucination (AH). However, there is still no consistent conclusion. This study aimed to explore intrinsic dysconnectivity pattern of whole-brain functional networks at voxel level in schizophrenic with AH.

METHODSAuditory hallucinated patients group (n = 42 APG), no hallucinated patients group (n = 42 NPG) and normal controls (n = 84 NCs) were analyzed by resting-state functional magnetic resonance imaging. The functional connectivity metrics index (degree centrality [DC]) across the entire brain networks was calculated and evaluated among three groups.

RESULTSDC decreased in the bilateral putamen and increased in the left superior frontal gyrus in all the patients. However, in APG, the changes of DC were more obvious compared with NPG. Symptomology scores were negatively correlated with the DC of bilateral putamen in all patients. AH score of APG positively correlated with the DC in left superior frontal gyrus but negatively correlated with the DC in bilateral putamen.

CONCLUSIONOur findings corroborated that schizophrenia was characterized by functional dysconnectivity, and the abnormal DC in bilateral putamen and left superior frontal gyrus might be crucial in the occurrence of AH.

Adult ; Brain Mapping ; Female ; Gyrus Cinguli ; pathology ; physiopathology ; Hallucinations ; pathology ; physiopathology ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Putamen ; pathology ; physiopathology ; Schizophrenia ; pathology ; physiopathology ; Young Adult

Parkinson's disease dementia (PDD) is notorious for its debilitating clinical course and high mortality rates. Consequently, various attempts to investigate predictors of cognitive decline in Parkinson's disease (PD) have been made. Here we report a case of a 75-year-old female patient with PD who visited the clinic with complaints of recurrent visual hallucinations and cognitive decline, whose symptoms were ameliorated by the titration of rivastigmine. Imaging results showed pronounced diffuse cortical amyloid deposition evidenced by 18F-florbetaben amyloid positron emission tomography (PET) imaging. This observation suggests that pronounced amyloid deposition and visual hallucinations in PD patients could be clinically significant predictors of cognitive decline in PD patients. Future research should concentrate on accumulating more evidence for possible predictors of cognitive decline and their association with PD pathology that can enable an early intervention and standardized treatment in PDD patients.
Aged ; Amyloid* ; Dementia* ; Early Intervention (Education) ; Female ; Hallucinations* ; Humans ; Mortality ; Parkinson Disease* ; Pathology ; Plaque, Amyloid* ; Positron-Emission Tomography ; Rivastigmine

OBJECTIVE: The aims of this study were to determine the factor structure of the BEHAVE-AD, Korean version, and to identify the cross-cultural validity of the observed factors . DESIGN: Cross-sectional study of geriatric patients evaluated at a mental hospital for the elderly. SAMPLE: One hundred and twelve consecutive patients diagnosed with Alzheimer's disease (AD) according to NINCDS-ADRDA diagnostic criteria (52 probable AD and 60 possible AD). RESULTS: Principal component analysis with Varimax rotation resulted in a five-factor solution that accounted for 50.0% of the common variance. The five factors included behavioral dyscontrol (wandering, purposeless activity, inappropriate activity, verbal aggressiveness, physical threats/ violence), anxiety (agitation, anxiety of upcoming events, other anxiety, fear of being left alone and other phobia), delusions (delusion of theft, delusion one's house is not one's home, delusion of infidelity, suspiciousness/paranoia, other delusion), hallucination (visual hallucination, auditory hallucination), depression (delusion of abandonment, tearfulness, depressed mood). CONCLUSION: The results of this study suggest that the BEHAVE-AD measures a wide range of behavioral pathology that can be empirically represented by five independent symptom clusters among AD patients admitted in a mental hospital for the Korean elderly. Cross-cultural persepctive may be necessary to interpret factor structure of this study compared to other studies from Western countries.
Aged ; Alzheimer Disease* ; Anxiety ; Cross-Sectional Studies ; Delusions ; Dementia ; Depression ; Hallucinations ; Hospitals, Psychiatric ; Humans ; Inpatients* ; Pathology* ; Principal Component Analysis ; Psychotic Disorders ; Theft

Pharmacological interventions are critical in dementia treatment to prevent disease progression. In this review, we aim to summarize and discuss about the current developments and recommendations in the pharmacological treatment of dementia. Cholinesterase inhibitors have demonstrated efficacy for Alzheimer's disease, mixed pathology with vascular dementia and Parkinson's disease dementia. The comparison study revealed no difference between each cholinesterase inhibitors. A high incidence of side effects of cholinesterase inhibitors could lower compliance. In this case, changing to the other drug or trying a transdermal type could be the solution. Memantine, a N-methyl-D-aspartate receptor antagonist, has proven to improve function at moderate to severe dementia and for dementia with Lewy body. But there are still insufficient evidences for the combination of a cholinesterase inhibitors and memantine. Discontinuing medicine in moderate to severe dementia may lead to worsening of cognitive function. For this reason, improving patients' compliance is important and for drug selection we should consider the type of dementia, severity of cognitive impairment and side effects of each medicine. Noncognitive symptoms, behavioral and psychological symptoms of dementia (BPSD) are common and can dominate disease presentation. For depression, selective serotonin reuptake inhibitors could be effective. Atypical antipsychotics could be used for other neuropsychological symptoms such as agitation, aggression, delusions and hallucinations.
Aggression ; Alzheimer Disease ; Antipsychotic Agents ; Behavioral Symptoms ; Cholinesterase Inhibitors ; Compliance ; Delusions ; Dementia* ; Dementia, Vascular ; Depression ; Dihydroergotamine ; Disease Progression ; Hallucinations ; Incidence ; Lewy Bodies ; Memantine ; N-Methylaspartate ; Parkinson Disease ; Pathology ; Serotonin Uptake Inhibitors