Understanding Hallucinations and Brain Disconnections in Parkinson's Disease

The Problem

Those who suffer from Parkinson’s may experience a variety of symptoms through their life, but doctors state that Parkinson's patients who experience hallucination are more susceptible to encountering disconnections in their brains relative to Parkinson's patients that are not experiencing hallucinations.  This is important due to the fact that the disconnections occurring in patient’s brains may very well inhibit the ability to comprehend visuals, as well as focus on tasks.

The cause of these hallucinations are believed to be prolonged use of Parkinson’s-related medications, a theory that has not yet linked how exactly the drugs have altered the brain’s function.  The primary source that has been identified at this point though include the disconnects between neural pathways.

The focus on hallucinations, as well as disconnections in the brain, being associated with Parkinson’s disease has come about due to its unanswered source.  Although various theories have been proposed, one stated above, researchers have yet to understand whether or not these disconnects and hallucinations are the product of the disease itself, or the usage of the drugs to cure Parkinson’s.  This was an area of concern when researchers discovered cases in which hallucination occurred in patients that were not taking drugs to suppress the Parkinson’s symptoms.  The hallucinations are commonly visual, but may also include auditory.  It was believed that the American actor Robin Williams experienced these troubling symptoms before his death in 2014.  The degree to which these symptoms affected patients were highlighted when Dr. Dagmar H. Hepp stated, “Visual hallucinations in Parkinson’s disease are frequent and debilitating.”

Dr. Hepp and his team had their work surrounding the case published by the Radiological Society of North America.  Their work made use of magnetic resonance imaging, commonly referred to as an MRI.  The team utilized the technology to analyze the resting states of the patient’s brains with Parkinson’s disease with hallucinations to those with the disease that were not experiencing hallucinations.  This ultimately enable the team to see the contrasts between the two brains without having patients complete tasks, as this differs from a more common approach to analysis of brain function.

What is Parkinson’s disease?

To better understand the impact of the mentioned researcher’s work surrounding Parkinson’s disease, it is important to have a foundation of basic knowledge about the disease.  The primary cause of the disease has to do with the breakdown of neurotransmitters which explains its classification as a neurodegenerative brain disorder.  The neurotransmitter that is specifically affected is that of dopamine.  As the amount of dopamine reduces, the Parkinson’s patient loses their ability to control their movements, as well as their emotions.  The disease progressively gets worse, but that the rate at which it does varies.  Most cases though are slow, with some patients not experiencing the severe symptoms of the disorder for years. 

Revisiting the cause of the disease, Parkinson’s is attributed to inhibiting the neurons specifically in the area of the brain known as the substantia nigra.  The chemical that the disorder inhibits, dopamine, is a chemical that has the function of transferring messages from the aforementioned substantia nigra, as well as other parts of the body, to dictate how the body knows when to move.  Without dopamine, patients are unable to have smooth movements with their muscles, which is also why tremors are common among patients.  The process by which these neurons diminish is known as neurodegeneration.

The disease itself is not fatal, but is highly likely to cause severe distress among patients.  This is thought to be the primary reason why Robin Williams was pushed towards suicide.  Although the stages of Parkinson’s may greatly differ from patient to patient, they all generally share the same stages.  In the earliest of stage, the simplest functions such as walking and sitting down begin to change.  Another occurrence includes tremors and other symptoms relating to physical movement, all of which tend to happen on one side of the body.   Although these symptoms may appear, they do not commonly stop one’s ability to carry out day to day tasks.  This of course depends on the patient though, as cases are known to differ in how quickly the symptoms worsen and the disease progresses.

As the disease worsens, the ability to walk noticeably decreases.  At this point, both sides of the body are likely to have been affected, with poor posture being present as well.  Patients often report that day to day tasks become less trivial, as well as harder to carry out.  An important characteristic seen in the first half of the timeline for Parkinson’s disease symptoms is the loss of balance.  When the time comes and patients are unable to balance easily by themselves, it is important to not leave them unattended, as injuries may occur.

The pinnacle of the symptoms seen in Parkinson’s patients includes distinct stiffness in the legs, making it nearly impossible to stand.  This will depend on the severity of the disorder, but is likely for patients.  By this point, patients will be bed-ridden, and will also require a wheelchair for transport.  Most times, around the clock nurses are utilized to ensure the complete safety of the patient as the disorder worsens.

It is important to note that the above study conducted by Dr. Hepp and his team shines light on an otherwise lesser known side of Parkinson’s.  The general understanding of the disease is the effect on the movement, including the inability to walk, or the uncontrollable tremors.  This study though, puts a focus towards the hallucinations that may be experienced, as well as the driving forces that ultimately cause patients to reach this point, if they ever do in fact reach this point.

The Future of Parkinson’s Disease and Hallucinations

The findings showed various distinguishing factors between the different brains being analyzed.  The scans showed some characteristics to be similar, of which are common for Parkinson’s disease patients, but distinct contrasts having to do with the brain’s connectivity were present as well.  With the patients whom reported hallucinations, their brains had failed in making connections vital to comprehending visual information and paying attention to their surrounding environment. 

This finding may very well lead the way into more insights, as researchers will attempt to vary how exactly analysis is carried out.  Doing so presents the opportunity to bring about new insights.  This process will be dependent on the ever changing technology, which shows hope for rapid improvement in the coming years. In addition to the technology to be utilized, further focus on the medications by which patients are given will be a topic of interest.  Doing so also brings the ability to understand the complexity of the disease and the root cause of the hallucinations and disconnections within the brain.

In the meantime, those affected by the disease, as well as loved ones, must stay diligent in recognizing the development of the disease.  Doing so better prepares both the patient and those assisting the patient for the transitions into worsening symptoms. This must also be supplemented by an understanding of what Parkinson’s disease entails, in order to improve the quality of life for those suffering from the unfortunate symptoms of the disorder.  The opportunities for improving the understanding of this disease are vast, and have been well pursued by teams such as Dr. Hepp’s and other researchers across the globe.