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Visual hallucinations in dementia with Lewy bodies: transcranial magnetic stimulation study

Lookup NU author(s): Professor John-Paul Taylor, Dr Michael Firbank, Nicola Barnett, Dr Urs Mosimann, Professor Janet Eyre, Professor Ian McKeith, Professor John O'Brien

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Abstract

Background: The aetiology of visual hallucinations (VH) is poorly understood in dementia with Lewy bodies (DLB). Pathological alterations in visual cortical excitability may be one contributory mechanism. Aims: To determine: 1) visual cortical excitability in DLB patients compared to aged matched controls 2) the relationship between visual cortical excitability and VH in DLB. Methods: Visual cortical excitability was determined by using transcranial magnetic stimulation (TMS) applied to the occiput to elicit phosphenes (transient subjective visual responses) in 21 DLB patients and 19 aged matched controls. Results: Phosphene parameters were similar between control and DLB patients tested. However in DLB patients, TMS measures of visual cortical excitability correlated strongly with the severity of VH (p≤0.005). Six DLBs experienced VH-like phosphenes (e.g. seeing people or figures on stimulation) compared with none of the controls (p=0.02). Conclusions: Increased visual cortical excitability in DLB does not appear to explain VH but it may be a marker for their severity.


Publication metadata

Author(s): Taylor JP, Firbank M, Barnett N, Pearce S, Livingstone A, Mosimann U, Eyre JA, McKeith IG, O'Brien JT

Publication type: Article

Publication status: Published

Journal: British Journal of Psychiatry

Year: 2011

Volume: 199

Issue: 6

Pages: 492-500

Print publication date: 20/10/2011

ISSN (print): 0007-1250

ISSN (electronic): 1472-1465

Publisher: Royal College of Psychiatrists

URL: http://dx.doi.org/10.1192/bjp.bp.110.090373

DOI: 10.1192/bjp.bp.110.090373


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