Parkinson Disease Psychosis
Conditions
Keywords
Parkinson, fMRI, connectivity, hallucinations, psychosis, presence hallucination
Brief summary
Investigation on how robotically mediated sensorimotor stimulation induces and triggers presence hallucinations in patients with Parkinson disease
Detailed description
Parkinson's Disease (PD) is primarily known and characterized by motor symptoms such as tremor, rigidity and bradykinesia. However, a significant number of non-motor symptoms also accompany the unfolding of this disease. In fact, hallucinations are experienced by approximately 60% of the patients. The most common and amongst one of the earliest hallucinations in Parkinson's Disease, is the Presence Hallucination (PH), i.e., the strange sensation of perceiving someone behind when no one is actually there. In the present study the researchers aim at investigating the behavioural and neural mechanisms underlying symptomatic PH in PD. To do so the researchers intend to induce the PH in a repeated and controlled manner in the MRI scanner, with an extensively verified paradigm which gives rise to this sensation by means of robotically-mediated sensorimotor stimulation. This setup has in fact been shown to trigger the occurrence of symptomatic PH in these patients. The possibility to induce PH while the patient is in the MRI will allow the researchers to investigate online the brain networks associated with it. With analysis on the fine brain connectivity changes during PH-induction, the investigators intend to pinpoint the exact mechanism behind the appearance of this hallucination in these patients, in a similar fashion to previous work with the PH-induction in healthy individuals.
Interventions
OTHERBrain changes triggered by PH induction in Parkinson's disease patients with presence hallucinations
Parkinsonian patients will undergo a two distinct experimental sessions, conducted in two separate days. In day 1, they will complete a series of validated and lab-tailored clinical evaluations, alongside with semi-structured interviews. These tests are designed to assess, the extent of the movement disorder, the predominance of positive symptoms and presence hallucination, potential cognitive impairment, amongst other relevant measures, for sleep assessment, loneliness, apathy and depression. In day 2 patients will perform the described robotic manipulation task in the MRI.
Sponsors
University Hospital, Geneva
Centre Hospitalier Universitaire Vaudois
Insel Gruppe AG, University Hospital Bern
Hôpital du Valais
Olaf Blanke
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosed with Parkinson's disease * Able to understand instructions and provide informed consent. * Native speaking language of experimental site (or acquisition of language of experimental site before 6 years old). * Montreal Cognitive Assessment (Nasreddine & Patel, 2016) with score ≥ 22. * Able to manipulate the robotic device.
Exclusion criteria
* Neurological comorbidities other than Parkinson's disease (e.g. Alzheimer's disease, vascular dementia, multiple sclerosis, stroke, traumatic brain injury, epilepsy, chronic migraine, etc.) * History or current condition of substance abuse and/or dependence (e.g., alcohol, drugs). * Suffering from or diagnosed with psychiatric illnesses according to DSM-V criteria (e.g., schizophrenia, bipolar disorders, autism, personality disorders, phobia etc.). * Family history (1st and 2nd degree) of psychiatric disorders (e.g., schizophrenia or bipolar disorders). * Severe somatic illnesses (e.g., cancer). * Severe tremors or physical disability preventing optimal use of robotic device. * Participating in a pharmacological study. * Local or general anaesthesia 30 days prior experiment * Inability to provide informed consent (legal guardianship) * The following are due to the MRI scanner: body weight exceeding 160kg, implanted metallic devices, foreign metallic objects, unstable angina, cardio-vascular diseases, tattoos with metallic components, external metallic objects, claustrophobia, pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| fMRI bold signal response during robotic manipulation | Approximately 45 minutes during each participant's experimental session in arm 1 | Analysis of changes of BOLD activity during the asynchronous condition as compared to the synchronous condition |
| Sensitivity to the induction bodily illusions of Presence Hallucination, Passivity experiences, loss of agency, and control questions, through lab-tailored questionnaires (7-point Likert-scale) | Approximately 5 minutes at the end of each participant's experimental session in arm 1 | Note that for the assessment of the sensitivity of each patient to the induction of the presence hallucination, passivity sensations, loss of agency, and control questions, the patients will perform two manipulations with the robotic system described in the introduction, in both the synchronous and asynchronous conditions |
Countries
Switzerland
Contacts
Primary ContactOlaf Blanke
Backup ContactJevita Potheegadoo
Outcome results
None listed