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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are available on request from the corresponding author.
References
Ahn HJ, Chin J, Park A et al (2010) Seoul Neuropsychological Screening Battery-dementia version (SNSB-D): a useful tool for assessing and monitoring cognitive impairments in dementia patients. J Korean Med Sci 25(7):1071–1076
Bar M (2003) A cortical mechanism for triggering top-down facilitation in visual object recognition. J Cogn Neurosci 15(4):600–609
Bertrand JA, Bedetti C, Postuma RB et al (2012) Color discrimination deficits in Parkinson’s disease are related to cognitive impairment and white-matter alterations. Mov Disord 27(14):1781–1788
Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW (2011) The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath 15(3):377–384
Fereshtehnejad SM, Yao C, Pelletier A, Montplaisir JY, Gagnon JF, Postuma RB (2019) Evolution of prodromal Parkinson’s disease and dementia with Lewy bodies: a prospective study. Brain 142(7):2051–2067
Hart de Ruyter FJ, Morrema THJ, den Haan J et al (2023) alpha-Synuclein pathology in post-mortem retina and optic nerve is specific for alpha-synucleinopathies. NPJ Parkinsons Dis 9(1):124
Heinzel S, Berg D, Gasser T et al (2019) Update of the MDS research criteria for prodromal Parkinson’s disease. Mov Disord 34(10):1464–1470
Honeycutt L, Gagnon JF, Pelletier A, De Roy J, Montplaisir JY, Postuma RB (2020) Pareidolias and cognition in isolated REM sleep behavior disorder. Parkinson Relat Disord 75:76–79
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545
Kajiyama Y, Hattori N, Nakano T et al (2021) Decreased frontotemporal connectivity in patients with parkinson’s disease experiencing face pareidolia. NPJ Parkinsons Dis 7(1):90
Kim R, Kim H, Kim YK et al (2022) Brain metabolic correlates of dopaminergic denervation in prodromal and early Parkinson’s disease. Mov Disord 37(10):2099–2109
Kinnear PR (1970) Proposals for scoring and assessing the 100-Hue test. Vision Res 10(5):423–433
Lee JY, Kim JM, Ahn J, Kim HJ, Jeon BS, Kim TW (2014) Retinal nerve fiber layer thickness and visual hallucinations in Parkinson’s disease. Mov Disord 29(1):61–67
Lee JY, Ahn J, Oh S et al (2020) Retina thickness as a marker of neurodegeneration in prodromal Lewy body disease. Mov Disord 35(2):349–354
Lee JY, Martin-Bastida A, Murueta-Goyena A et al (2022) Multimodal brain and retinal imaging of dopaminergic degeneration in Parkinson disease. Nat Rev Neurol 18(4):203–220
Lenka A, Pagonabarraga J, Pal PK, Bejr-Kasem H, Kulisevsky J (2019) Minor hallucinations in Parkinson disease: a subtle symptom with major clinical implications. Neurology 93(6):259–266
Litvan I, Goldman JG, Troster AI et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 27(3):349–356
Liu J, Li J, Feng L, Li L, Tian J, Lee K (2014) Seeing Jesus in toast: neural and behavioral correlates of face pareidolia. Cortex 53:60–77
Miglis MG, Adler CH, Antelmi E et al (2021) Biomarkers of conversion to alpha-synucleinopathy in isolated rapid-eye-movement sleep behaviour disorder. Lancet Neurol 20(8):671–684
Pieri V, Diederich NJ, Raman R, Goetz CG (2000) Decreased color discrimination and contrast sensitivity in Parkinson’s disease. J Neurol Sci 172(1):7–11
Postuma RB, Berg D, Stern M et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30(12):1591–1601
Postuma RB, Iranzo A, Hu M et al (2019) Risk and predictors of dementia and parkinsonism in idiopathic REM sleep behaviour disorder: a multicentre study. Brain 142(3):744–759
Stiasny-Kolster K, Mayer G, Schafer S, Moller JC, Heinzel-Gutenbrunner M, Oertel WH (2007) The REM sleep behavior disorder screening questionnaire—a new diagnostic instrument. Mov Disord 22(16):2386–2393
Sumi Y, Ubara A, Ozeki Y, Kadotani H (2022) Minor hallucinations in isolated rapid eye movement sleep behavior disorder indicative of early phenoconversion: a preliminary study. Acta Neurol Scand 145(3):348–359
Thome I, Hohmann DM, Zimmermann KM, Smith ML, Kessler R, Jansen A (2021) “I spy with my little eye, something that is a face…”: a brain network for illusory face detection. Cereb Cortex 32(1):137–157
Trenkwalder C, Kohnen R, Hogl B et al (2011) Parkinson’s disease sleep scale—validation of the revised version PDSS-2. Mov Disord 26(4):644–652
Uchiyama M, Nishio Y, Yokoi K et al (2012) Pareidolias: complex visual illusions in dementia with Lewy bodies. Brain 135(Pt 8):2458–2469
Visser F, Apostolov VI, Vlaar AMM, Twisk JWR, Weinstein HC, Berendse HW (2020) Visual hallucinations in Parkinson’s disease are associated with thinning of the inner retina. Sci Rep 10(1):21110
Weil RS, Schrag AE, Warren JD, Crutch SJ, Lees AJ, Morris HR (2016) Visual dysfunction in Parkinson’s disease. Brain 139(11):2827–2843
Wu P, Yu H, Peng S et al (2014) Consistent abnormalities in metabolic network activity in idiopathic rapid eye movement sleep behaviour disorder. Brain 137(Pt 12):3122–3128
Yang ZJ, Wei J, Mao CJ et al (2016) Retinal nerve fiber layer thinning: a window into rapid eye movement sleep behavior disorders in Parkinson’s disease. Sleep Breath 20(4):1285–1292
Yokoi K, Nishio Y, Uchiyama M, Shimomura T, Iizuka O, Mori E (2014) Hallucinators find meaning in noises: pareidolic illusions in dementia with Lewy bodies. Neuropsychologia 56:245–254
Yoon EJ, Lee JY, Nam H et al (2019) A new metabolic network correlated with olfactory and executive dysfunctions in idiopathic rapid eye movement sleep behavior disorder. J Clin Neurol 15(2):175–183
You S, Moon HJ, Do SY et al (2017) The REM sleep behavior disorder screening questionnaire: validation study of the Korean version (RBDQ-KR). J Clin Sleep Med 13(12):1429–1433
Acknowledgements
This study was supported by the National Research Foundation (NRF) grant funded by the Ministry of Science and ICT (MSIT) in Korea (No. NRF-2022R1A2C4001834).
Author information
Authors and Affiliations
Contributions
Study concept and design: SK, JHC, and JYL. Data acquisition: SK, JHC, KAW, JYJ, and JYL. Drafting the manuscript: SK and JYL. Critical review of the manuscript: SK, JHC, KAW, JYJ, BJ, and JYL.
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Kim, S., Choi, JH., Woo, K.A. et al. Clinical correlates of pareidolias and color discrimination deficits in idiopathic REM sleep behavior disorder and Parkinson’s disease. J Neural Transm 131, 141–148 (2024). https://doi.org/10.1007/s00702-023-02724-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-023-02724-4