Abstract Details

Title Neuropathological Correlates of Visual Hallucinations in Parkinsonism

Topic Movement Disorders

Presentation(s) S03 - (-)

Poster/Presentation
Number 006

Objective

Background Previous researchers have correlated visual hallucinations (VH) with Lewy-related pathology in widespread brain regions, from limbic system to neocortex (Papapetropoulus 2006, Halliday 2008, Kalaitzakis 2009, Gallagher 2011). It is not known whether plaques and/or tangles cause or contribute to these phenomena.

Design/Methods Subjects were part of the Arizona Study of Aging and Neurodegenerative Disorders, had parkinsonism, and were autopsied between 2007 and 2011. VH were defined as formed images reported at one or more evaluations (Fenelon 1999). Clinical variables included the MMSE, dopaminergic medication dosage, and Hoehn & Yahr stage. Neuropathological variables included total and regional Lewy related pathology density scores, plaque and tangle density scores, white matter rarefaction scores, and location and volume of infarcts. Data were analyzed using STATA-12.

Results We identified 84 subjects with parkinsonism, 27 with VH and 57 without. The VH group was more likely treated with levodopa (72% versus 44%; p=0.019), at higher levodopa-equivalent dosages (538 mg versus 267 mg; p=0.041); however, 42% of non-hallucinators were also treated with levodopa. There was no difference between groups in MMSE score. On neuropathological examination, the VH group was at a higher Unified Lewy body stage (2.76) compared to the non-VH group (1.21); p=0.003. The density of Lewy-related pathology was higher in the VH group in sum (22.8 versus 8.28; p<0.001) and across all brain areas examined. No difference was found between the groups in plaque or tangle burden.

Conclusions These findings suggest that Lewy-related pathology is specifically implicated in the genesis of VH in PD and related disorders. Plaque and tangles, although present in many cases, did not contribute to the occurrence of VH.

Authors/Disclosures
Trisha Morshed PRESENTER	No disclosure on file
	No disclosure on file
Thomas Beach (Banner Sun Health Research Institute)	Thomas Beach has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vivid Genomics. Thomas Beach has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche Diagnostics. The institution of Thomas Beach has received research support from National Institutes of Health. The institution of Thomas Beach has received research support from Michael J Fox Foundation . The institution of Thomas Beach has received research support from State of Arizona.
Charles H. Adler, MD, PhD, FAAN (Mayo Clinic Arizona)	Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avion. Dr. Adler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CND Life Sci. Dr. Adler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Precon. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. The institution of Dr. Adler has received research support from NIH. The institution of Dr. Adler has received research support from Michael J. Fox Foundation. The institution of Dr. Adler has received research support from Arizona Biomedical Research Commission. Dr. Adler has received publishing royalties from a publication relating to health care.
Holly A. Shill, MD, FAAN (Barrow Neurology Clinics)	Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage Biogen. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for KeifeRx. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis Precision Medicine. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fasikl Inc. Dr. Shill has received personal compensation in the range of $0-$499 for serving as a Consultant for Boston Scientific. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Tanabe Pharma America.
John N. Caviness, MD, FAAN (Mayo Clinic)	Dr. Caviness has nothing to disclose.
Christine Belden	Christine Belden has nothing to disclose.
Rui Sousa	No disclosure on file
	No disclosure on file
Marwan N. Sabbagh, MD, FAAN (Barrow Neurological Institute)	Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eisai. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genetech=Roche. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Synaptogenix. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant Health. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Anavex. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cognito Therapeutics. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for CervoMed. Dr. Sabbagh has stock in Neurotau. Dr. Sabbagh has stock in Seq Biomarque. Dr. Sabbagh has stock in uMethod Health. Dr. Sabbagh has stock in Athira. Dr. Sabbagh has stock in Lighthouse Pharmaceuticals. Dr. Sabbagh has stock in Alzheon. The institution of Dr. Sabbagh has received research support from NIH. The institution of Dr. Sabbagh has received research support from ADDF.
	No disclosure on file
	No disclosure on file

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