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Perfil neuropsicológico diferencial de las alucinaciones visuales con y sin insight en la enfermedad de Parkinson
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Perfil neuropsicológico diferencial de las alucinaciones visuales con y sin insight en la enfermedad de Parkinson  
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Background and objective: the development of visual hallu- cinations (VH) is a frequent complication of Parkinson's dis- ease (PD). Impact of VH on emotion and daily living activities is mainly related to loss of insight. The neuropsychological bases of loss of insight have not been explored. We present data on the neuropsychological profile of PD patients with VH with and without insight retained. Material and methods: pros- pective study of 77 PD patients (37 without VH, 22 with minor VH, 10 with VH with insight, 8 with VH without insight) cog- nitively assessed by the Parkinson's Disease Cognitive Rating Scale (PD-CRS) and the Clinical Dementia Rating (CDR). Results: patients without VH and patients with minor VH were only differentiated by the CDR score. The subcortical PD- CRS score significantly differed patients with minor VH from patients with VH with insight retained. Comparison between patients with VH, with and without insight retained, showed a significant difference only in the PD-CRS cortical score. Conclusions: loss of insight seems to be linked to the ap- pearance of cortical-type cognitive defects, while development of VH with preserved insight is related to the progression of frontal-subcortical cognitive dysfunction. Development of minor VH may represent an early marker of cognitive impairment
Published in 2009.
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