Fantastic wave patterns associated with early simple hallucinations can predict cognitive decline in Parkinson’s patients

New research provides evidence that the presence of early mild hallucinations in Parkinson’s patients, along with specific patterns of brainwave activity, can be indicators of rapid cognitive decline. Results published in Normal mental healthhas important implications for the early identification of cognitive impairment and the potential for interventions to mitigate its effects in patients with Parkinson’s disease.

There is an urgent need to detect and intervene in neurodegenerative diseases such as Parkinson’s disease at an early stage, before they progress to a point where treatment options are limited. The researchers aimed to investigate whether there are changes in brain oscillations associated with simple hallucinations and whether these changes can predict cognitive decline over a five-year period. They also wanted to determine whether electroencephalogram (EEG) data combined with neuropsychological and neuropsychological assessments could serve as an early marker of cognitive decline in Parkinson’s patients who present with minor hallucinations.

“We are neuroscientists working on cognition, and we are particularly interested in how the brain processes stimuli, and how it generates false perceptions (i.e., hallucinations),” explained the author of the study. Fosco Bernasconiis a postdoctoral researcher in the Laboratory of Cognitive Neuroscience at the Federal Polytechnic School of Lausanne. “Hallucinations are of high clinical importance in Parkinson’s disease because they may be a predictor of cognitive decline. We are interested in our research in understanding the brain mechanisms underlying hallucinations and the (potential) associated cognitive decline. We hope that our future research will help develop new diagnostic tools and treatments.”

For the study, the researchers recruited 75 patients, ages 60 to 70, who had been diagnosed with Parkinson’s disease. These patients were divided into two groups: those with mild hallucinations and those without mild hallucinations. The researchers collected data through a combination of clinical assessments, neuropsychological interviews, neuropsychological assessments, and electroencephalography (EEG) measurements.

The patients’ cognitive functions were assessed using the Parkinson’s Disease Cognitive Rating Scale (PD-CRS), which includes several cognitive tasks. The presence of minor hallucinations was assessed using the Hallucinations and Psychosis component of the MDS-UPDRS-I Clinical Scale. Resting-state EEG data were recorded from 19 scalp sites while the participants’ eyes were open.

The researchers found that among patients with Parkinson’s disease, those who experienced early hallucinations showed a rapid decline in frontal executive cognitive functions over the next five years compared to patients without such hallucinations.

“Although Parkinson’s disease is traditionally and mostly defined as a motor disease, characterized by tremors, there are also many non-motor symptoms (such as hallucinations), which are very frequent in Parkinson’s disease,” Bernasconi told PsyPost. “Some non-motor symptoms appear years before motor symptoms and have therefore been identified as prodromal signs of illness. With regard to hallucinations, we believe it is important for the person experiencing hallucinations to share this information with their partner or family. Even so-called ‘simple’ hallucinations (i.e., existential hallucinations, traffic hallucinations, and visual delusions) are of clinical importance, as evidenced by our recent work.

“Hallucinations should be shared with the treating physician, because treatments may have to be adapted. Previous findings have also shown that complex visual hallucinations are a good predictor of dementia in Parkinson’s disease. However, complex visual hallucinations usually occur in the middle and late stage of the disease, which makes them not a candidate. Ideal for early identification of individuals at risk of cognitive decline.Our results show that simple hallucinations, which usually predict complex visual hallucinations, are associated with faster deterioration in (frontal) cognitive functions.This should raise attention to the possible role of simple hallucinations as a potential marker of dementia.However More data and longer studies are needed to confirm the role of simple hallucinations in predicting dementia.

There was a significant correlation between the degree of cognitive decline observed over the 5-year period and specific changes in anterior theta oscillatory activity (4-8 Hz), as measured by EEG during the initial assessment.

Frontal oscillatory theta activity refers to a specific pattern of brain wave activity that occurs in the frontal region of the brain. These waves are typically associated with different cognitive and mental states, including different levels of awareness, attention, memory, and learning.

Importantly, the researchers found that changes in frontal theta oscillations were unique to patients with Parkinson’s disease who experienced early hallucinations. These oscillatory changes were not present in Parkinson’s patients who did not report hallucinations. These findings suggest that changes in the pattern of anterior theta activity may be a biomarker of cognitive decline in these patients.

“Previous evidence has suggested that complex visual hallucinations in Parkinson’s disease are associated with cognitive decline and dementia,” Bernasconi said. “However, visual hallucinations usually occur in a moderate to advanced stage of the disease, and this does not make them suitable as an early sign or indicator of later-onset dementia, which can sometimes last for 5 years or longer. However, mounting evidence suggests that hallucinations Complex visual hallucinations are often preceded by many years of so-called “simple” hallucinations, and these hallucinations may precede motor symptoms and the diagnosis of Parkinson’s disease.

We therefore hypothesized that “simple” hallucinations may also play a role in determining cognitive decline. We were surprised that our data aligned beautifully when combining the presence of these “simple” hallucinations with changes in forebrain activity that were more closely associated with changes in frontal lobe function. We were surprised to find such a clear, selective, and early involvement of changes in the forebrain associated with simple hallucinations.

But the study, like all research, has some limitations.

“Despite the large number of patients included in our study, the results need to be replicated in another study to confirm the findings,” Bernasconi told PsyPost. “In our current research, we demonstrated that patients with mild hallucinations had faster cognitive decline compared to patients without hallucinations. Future findings should follow these patients for a longer period, to assess the development of cognitive functions for a longer period.

“Although there is no approved treatment for Parkinson’s disease and cognitive decline, a better understanding of the underlying mechanisms that allow the development of therapies aimed at slowing Parkinson’s disease (and thus cognitive decline) is part of the major effort being undertaken by the academic and pharmaceutical industries. “For now,” the researcher added. Several non-pharmacological strategies have been shown to somewhat slow the progression of cognitive decline in some individuals.”

“For example, cognitive training, increased social engagement, physical exercise, improving sleep quality and nutrition, and practicing mindfulness are among the possibilities suggested for slowing cognitive decline. While these approaches may have an effect, it is essential for individuals with Parkinson’s disease to work They work closely with their healthcare team to develop a personalized plan that addresses their specific needs and challenges.

the study, “Theta oscillations and subtle hallucinations in Parkinson’s disease reveal a decline in frontal lobe function and later cognitive decline.Written by Fusco Bernasconi, Javier Bagunabaraga, Helena Biger-Kasim, Saul Martínez-Horta, Juan Marín Lahoz, Andrea Horta-Barba, Jaime Kolesewski, and Olaf Blank.