Reduced occipital GABA in Parkinson disease with visual hallucinations.

Neurology

From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX.

Published: August 2018

Objective: To investigate the relationship between visual hallucinations in Parkinson disease (PD) and levels of γ-aminobutyric acid (GABA) in the primary visual cortex.

Methods: We utilized magnetic resonance spectroscopy to investigate occipital GABA levels in 36 participants with PD, 19 with and 17 without complex visual hallucinations, together with 20 healthy controls without hallucinations. In addition, we acquired T1-weighted MRI, whole-brain fMRI during a visual task, and diffusion tensor imaging.

Results: We found lower GABA+/creatine in PD with visual hallucinations (0.091 ± 0.010) vs those without (0.101 ± 0.010) and controls (0.099 ± 0.010) ( = 4.5; = 0.016). Reduced gray matter in the hallucinations group was also observed in the anterior temporal lobe. Although there were widespread reductions in white matter integrity in the visual hallucinations group, this was no longer significant after controlling for cognitive function.

Conclusions: The data suggest that reduced levels of GABA are associated with visual hallucinations in PD and implicate changes to the ventral visual stream in the genesis of visual hallucinations. Modulation of visual cortical excitability through, for example, pharmacologic intervention, may be a promising treatment avenue to explore.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105043PMC
http://dx.doi.org/10.1212/WNL.0000000000006007DOI Listing

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