Cited by 69Parkinson's Disease Mechanisms and TreatmentsHallucinations in medical conditionsSchizophrenia research and treatment

Parkinson disease psychosis: from phenomenology to neurobiological mechanisms

Pagonabarraga, Javier, Bejr-Kasem, Helena, Martinez-Horta, Saul, Kulisevsky, Jaime·2024·Nature Reviews Neurology

Abstract

Parkinson disease (PD) psychosis (PDP) is a spectrum of illusions, hallucinations and delusions that are associated with PD throughout its disease course. Psychotic phenomena can manifest from the earliest stages of PD and might follow a continuum from minor hallucinations to structured hallucinations and delusions. Initially, PDP was considered to be a complication associated with dopaminergic drug use. However, subsequent research has provided evidence that PDP arises from the progression of brain alterations caused by PD itself, coupled with the use of dopaminergic drugs. The combined dysfunction of attentional control systems, sensory processing, limbic structures, the default mode network and thalamocortical connections provides a conceptual framework to explain how new incoming stimuli are incorrectly categorized, and how aberrant hierarchical predictive processing can produce false percepts that intrude into the stream of consciousness. The past decade has seen the publication of new data on the phenomenology and neurobiological basis of PDP from the initial stages of the disease, as well as the neurotransmitter systems involved in PDP initiation and progression. In this Review, we discuss the latest clinical, neuroimaging and neurochemical evidence that could aid early identification of psychotic phenomena in PD and inform the discovery of new therapeutic targets and strategies.

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Crossref · 10.1038/s41582-023-00918-8

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Authors
Pagonabarraga, J., Bejr-Kasem, H., Martinez-Horta, S., & Kulisevsky, J.
Affiliations
Universitat Autònoma de Barcelona (ES)
Corresponding author
Pagonabarraga, Javier
Venue
Nature Reviews Neurology
Published
2024-01-15
Volume
20
Issue
3
Pages
135-150
ISSN
  • 1759-4758 (ISSN-L)
  • 1759-4766
OpenAlex
W4390879322
Cited by
69
References
213
Citations by year
2026: 21 · 2025: 41 · 2024: 7
FWCI
4.72
Type
journal article
Language
en
Open access
closed
Locations
  • Nature Reviews Neurology (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
hallucinations, delusions, illusion, dopaminergic therapy, attentional control, sensory processing, limbic system, default mode network, thalamocortical connections, predictive processing, neurotransmitter systems, early detection, therapeutic target
MeSH terms
Brain, Hallucinations, Humans, Parkinson Disease, Psychotic Disorders

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