Minor hallucinations occur in drug‐naive Parkinson's disease patients, even from the premotor phase
Abstract
Objectives: The description of minor hallucinatory phenomena (presence, passage hallucinations) has widened the spectrum of psychosis in Parkinson's disease (PD). Minor hallucinatory phenomena seem to antedate the development of more severe hallucinations. Early detection of minor hallucinations may be useful for screening patients with more severe endophenotypes. Motivated by the observation of “de novo,” drug‐naive PD patients reporting minor hallucinations, we aimed to prospectively identify “de novo” untreated PD patients experiencing hallucinatory phenomena, and to compare their clinico‐demographic characteristics with those of untreated PD patients without hallucinations and healthy controls. Methods: Screening and description of psychosis was assessed by the Movement Disorders Society Unified Parkinson's Disease Rating Scale—Part I and a structured interview covering all types of psychotic phenomena reported in PD. Clinical, neuropsychological, and demographic data of PD patients with and without psychotic phenomena were compared with those of age‐ and education‐matched healthy controls. Results: Fifty drug‐naive, “de novo” PD patients and 100 controls were prospectively included. Minor hallucinations were experienced in 42% (21 of 50) PD patients and 5% controls (P < 0.0001). Coexistence of passage and presence hallucinations was the most common finding. Unexpectedly, 33.3% of patients with minor hallucinations manifested these as a pre‐motor symptom, starting 7 months to 8 years before first parkinsonian motor symptoms. The presence of minor hallucinations was significantly associated with presence of rapid eye movement sleep behavior disorder. Conclusions: In this first study to prospectively analyze the frequency of minor hallucinatory phenomena in incident, untreated PD patients, hallucinations appeared as a frequent early non‐motor symptom that may even predate the onset of parkinsonism. © 2015 International Parkinson and Movement Disorder Society
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Healthy controls may also experience multimodal hallucinations, even if in a smaller fraction of cases compared with PD.
“Indeed, healthy controls may also experience MH, even if in a smaller fraction of the cases compared with PD58”
From Deviations in effective connectivity explain different hallucination subtypes in Parkinson's disease psychosis (2026) · cites this paper as [58]
Visual hallucinations in Parkinson's disease have also been reported to occur prior to drug treatment.
“Although virtually all anti-parkinsonian medications have been reported to induce hallucinations and psychosis, visual hallucinations have also been reported to occur prior to drug treatment (Pagonabarraga et al. 2016).”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Pagonabarraga et al. 2016
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- Authors
- Pagonabarraga, J., Martinez‐Horta, S., Fernández de Bobadilla, R., Pérez, J., Ribosa‐Nogué, R., Marín, J., Pascual‐Sedano, B., García, C., Gironell, A., & Kulisevsky, J.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Universitat Autònoma de Barcelona Spain
- Movement Disorders Unit, Neurology Department Sant Pau Hospital Barcelona Spain
- Corresponding author
- Kulisevsky, Jaime
- Venue
- Movement Disorders
- Publisher
- Wiley
- Published
- 2015-09-26
- Volume
- 31
- Issue
- 1
- Pages
- 45-52
- ISSN
- 0885-3185 (ISSN-L)
- 1531-8257
- OpenAlex
- W2144389919
- Cited by
- 236
- References
- 64
- Citations by year
- 2026: 15 · 2025: 25 · 2024: 22 · 2023: 20 · 2022: 26 · 2021: 22 · 2020: 21 · 2019: 20 · 2018: 15 · 2017: 26 · 2016: 22 · 2015: 1
- FWCI
- 14.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Movement Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- Parkinson's disease, psychosis, drug-naive patients, de novo Parkinson's disease, rapid eye movement sleep behavior disorder, prodromal Parkinson's disease
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Hallucinations, Humans, Longitudinal Studies, Male, Middle Aged, Parkinson Disease, Prospective Studies, Psychiatric Status Rating Scales, Statistics, Nonparametric
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