Abstract

Visuoperceptual dysfunction is common in Parkinson’s disease (PD) and is also reported in its prodromal phase, isolated REM sleep behavior disorder (iRBD). We aimed to investigate color discrimination ability and complex visual illusions known as pareidolias in patients with iRBD and PD compared to healthy controls, and their associating clinical factors. 46 iRBD, 43 PD, and 64 healthy controls performed the Farnsworth–Munsell 100 hue test and noise pareidolia tests. Any relationship between those two visual functions and associations with prodromal motor and non-motor manifestations were evaluated, including MDS-UPDRS part I to III, Cross-Cultural Smell Identification Test, sleep questionnaires, and comprehensive neuropsychological assessment. iRBD and PD patients both performed worse on the Farnsworth–Munsell 100 hue test and had greater number of pareidolias compared to healthy controls. No correlations were found between the extent of impaired color discrimination and pareidolia scores in either group. In iRBD patients, pareidolias were associated with frontal executive dysfunction, while impaired color discrimination was associated with visuospatial dysfunction, hyposmia, and higher MDS-UPDRS-III scores. Pareidolias in PD patients correlated with worse global cognition, whereas color discrimination deficits were associated with frontal executive dysfunction. Color discrimination deficits and pareidolias are frequent but does not correlate with each other from prodromal to clinically established stage of PD. The different pattern of clinical associates with the two visual symptoms suggests that evaluation of both color and pareidolias may aid in revealing the course of neurodegeneration in iRBD and PD patients.

中文翻译：

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特发性快速眼动睡眠行为障碍和帕金森病中幻想性视错觉和颜色辨别缺陷的临床相关性

摘要

视觉知觉功能障碍在帕金森病 (PD) 中很常见，在其前驱期、孤立性快速眼动睡眠行为障碍 (iRBD) 中也有报道。我们的目的是调查 iRBD 和 PD 患者与健康对照组相比的颜色辨别能力和复杂的视错觉（称为空想性错觉）及其相关临床因素。 46 名 iRBD、43 名 PD 和 64 名健康对照者进行了 Farnsworth–Munsell 100 色调测试和噪音空想性视错觉测试。对这两种视觉功能之间的关系以及与前驱运动和非运动表现的关联进行了评估，包括 MDS-UPDRS 第 I 至 III 部分、跨文化气味识别测试、睡眠问卷和综合神经心理学评估。与健康对照相比，iRBD 和 PD 患者在 Farnsworth-Munsell 100 色调测试中的表现均较差，并且具有更多的空想性视错觉。两组中颜色辨别能力受损的程度与幻想性视错觉评分之间均未发现相关性。在 iRBD 患者中，空想性错觉与额叶执行功能障碍相关，而颜色辨别能力受损则与视觉空间功能障碍、嗅觉减退和较高的 MDS-UPDRS-III 评分相关。 PD患者的空想性错觉与较差的整体认知相关，而颜色辨别缺陷与额叶执行功能障碍相关。颜色辨别缺陷和幻想性幻想很常见，但从 PD 的前驱期到临床确定阶段彼此不相关。与这两种视觉症状相关的不同临床模式表明，对颜色和空想性幻想的评估可能有助于揭示 iRBD 和 PD 患者的神经退行性病变过程。