Visual hallucinations (VH) can increase the burden of disease for both patients with Parkinson’s disease (PD) and their caregivers. Multiple neurotransmitters have been implicated in the neuropathology of VH, which provide targets for treatment and prevention. In this study, we assessed the association between cholinergic denervation and VH in PD in vivo, using PET imaging of the cholinergic system. A total of 38 PD patients participated in this study. A group of 10 healthy subjects, matched for age, sex and education, was included for comparison. None of the participants used cholinergic drugs. Thirteen patients who had experienced VH in the past month (VH+) were compared to 20 patients who had never experienced VH in their lives (VH-). Cholinergic system integrity was assessed with PET imaging using [18F]fluoroethoxybenzovesamicol ([18F]FEOBV) as the tracer. We assessed the differences in tracer uptake between groups by cluster-based analysis and by analysis of predefined regions of interest (ROIs) consisting of the ventral visual stream, the dorsal attentional network, the ventral attentional network and the lateral geniculate nucleus and mediodorsal nucleus of the thalamus. The PD group (n=38) showed an extensive pattern of decreased tracer uptake throughout the brain, compared to the controls (n=10). Within the PD group, the VH+ group (n=13) showed a cluster of decreased tracer uptake compared to the VH- group (n=20), which covered most of the left ventral visual stream and extended towards superior temporal areas. These results were mirrored in the ROI-based analysis, where the VH+ group showed the strongest deficits in the left inferior temporal gyrus and the left superior temporal gyrus, compared to the VH- group. VH in PD are associated with a marked cholinergic deficiency in the left ventral visual stream and the left superior temporal lobe, in addition to an extensive global cholinergic denervation in the general PD population.

中文翻译：

---

帕金森病患者胆碱能缺乏导致幻视


幻视 (VH) 会增加帕金森病 (PD) 患者及其护理人员的疾病负担。 VH 的神经病理学涉及多种神经递质，这为治疗和预防提供了靶点。在这项研究中，我们使用胆碱能系统的 PET 成像评估了体内 PD 中胆碱能去神经支配与 VH 之间的关联。共有 38 名 PD 患者参与了这项研究。一组 10 名年龄、性别和教育程度相匹配的健康受试者被纳入比较。没有参与者使用胆碱能药物。将过去一个月经历过 VH 的 13 名患者 (VH+) 与一生中从未经历过 VH 的 20 名患者 (VH-) 进行比较。使用[18F]氟乙氧基苯并维沙考（[18F]FEOBV）作为示踪剂，通过 PET 成像评估胆碱能系统完整性。我们通过基于聚类的分析和对由腹侧视觉流、背侧注意网络、腹侧注意网络以及外侧膝状核和内侧核组成的预定义感兴趣区域（ROI）的分析来评估组间示踪剂摄取的差异。丘脑。与对照组 (n=10) 相比，PD 组 (n=38) 表现出整个大脑示踪剂摄取的广泛减少。在 PD 组中，与 VH- 组 (n=20) 相比，VH+ 组 (n=13) 显示示踪剂摄取减少，覆盖了大部分左腹侧视觉流并向颞上区延伸。这些结果反映在基于 ROI 的分析中，其中与 VH- 组相比，VH+ 组在左侧颞下回和左侧颞上回表现出最强的缺陷。 PD 中的 VH 与左腹侧视觉流和左上颞叶的显着胆碱能缺乏有关，此外，PD 人群中还存在广泛的整体胆碱能去神经支配。