Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.

<h4>Background</h4>Though infections are associated with psychotic symptoms, whether or not subclinical inflammation is associated with hallucinations is not known in Parkinson's disease (PD).<h4>Purpose</h4>To investigate the association of illusions/hallucinations and...

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Autores principales: Hideyuki Sawada, Tomoko Oeda, Atsushi Umemura, Satoshi Tomita, Ryutaro Hayashi, Masayuki Kohsaka, Kenji Yamamoto, Shinji Sudoh, Hiroshi Sugiyama
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spelling oai:doaj.org-article:db4561ce61b347fa8d8297d1b64ecde42021-11-18T08:34:42ZSubclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.1932-620310.1371/journal.pone.0085886https://doaj.org/article/db4561ce61b347fa8d8297d1b64ecde42014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24497930/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Though infections are associated with psychotic symptoms, whether or not subclinical inflammation is associated with hallucinations is not known in Parkinson's disease (PD).<h4>Purpose</h4>To investigate the association of illusions/hallucinations and plasma CRP levels in PD patients without symptomatic infections.<h4>Methods</h4>PD patients not diagnosed as having infections were assessed for illusions and hallucinations using the Parkinson Psychosis Questionnaire (PPQ). It comprises four-domain questions: PPQ-A for sleep problems, PPQ-B for hallucinations/illusions, PPQ-C for delusions, and PPQ-D for disorientation. Assigning patients with ≥1 points in the PPQ-B score to be cases and others as controls, the association of hallucinations/illusions and clinical features (age, sex, duration of PD, Unified Parkinson's Disease Rating Scale part 3 (UPDRS-3), Mini-Mental State Examination (MMSE) score, sleep disturbance (PPQ-A score) as well as daily doses of L-Dopa, dopamine agonists, amantadine, and selegiline) were analyzed using a case-control design.<h4>Results</h4>A total of 111 patients were examined and plasma CRP levels were <0.1-6.0 mg/L. Hallucinations or illusions were detected in 28 (25.2%). There were significant differences in age, UPDRS-3 score, MMSE score, PPQ-A, daily doses of L-Dopa and dopamine agonists and plasma CRP levels between cases and controls. A multivariate logistic regression model revealed that UPDRS-3 scores and plasma CRP levels were significantly associated with hallucinations/illusions with an adjusted odds ratio of 1.96 (95% confidence interval (CI) 1.20-3.20) per 10 points and 1.57 (95% confidence interval 1.13-2.16) per two-fold, respectively. Dividing patients into thirds by CRP levels (≤0.2, 0.3-0.6, ≥0.7 mg/L), the prevalence of hallucinations/illusions was 13.2%, 21.6%, and 41.7%, in the bottom-, middle-, and top-thirds, respectively (for trend p = 0.012).<h4>Conclusions</h4>Subclinical elevation of plasma CRP levels was associated with hallucinations or illusions after adjustment for motor disability, suggesting that subclinical elevations of CRP levels might be an independent risk for hallucinations/illusions.Hideyuki SawadaTomoko OedaAtsushi UmemuraSatoshi TomitaRyutaro HayashiMasayuki KohsakaKenji YamamotoShinji SudohHiroshi SugiyamaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e85886 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Hideyuki Sawada
Tomoko Oeda
Atsushi Umemura
Satoshi Tomita
Ryutaro Hayashi
Masayuki Kohsaka
Kenji Yamamoto
Shinji Sudoh
Hiroshi Sugiyama
Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.
description <h4>Background</h4>Though infections are associated with psychotic symptoms, whether or not subclinical inflammation is associated with hallucinations is not known in Parkinson's disease (PD).<h4>Purpose</h4>To investigate the association of illusions/hallucinations and plasma CRP levels in PD patients without symptomatic infections.<h4>Methods</h4>PD patients not diagnosed as having infections were assessed for illusions and hallucinations using the Parkinson Psychosis Questionnaire (PPQ). It comprises four-domain questions: PPQ-A for sleep problems, PPQ-B for hallucinations/illusions, PPQ-C for delusions, and PPQ-D for disorientation. Assigning patients with ≥1 points in the PPQ-B score to be cases and others as controls, the association of hallucinations/illusions and clinical features (age, sex, duration of PD, Unified Parkinson's Disease Rating Scale part 3 (UPDRS-3), Mini-Mental State Examination (MMSE) score, sleep disturbance (PPQ-A score) as well as daily doses of L-Dopa, dopamine agonists, amantadine, and selegiline) were analyzed using a case-control design.<h4>Results</h4>A total of 111 patients were examined and plasma CRP levels were <0.1-6.0 mg/L. Hallucinations or illusions were detected in 28 (25.2%). There were significant differences in age, UPDRS-3 score, MMSE score, PPQ-A, daily doses of L-Dopa and dopamine agonists and plasma CRP levels between cases and controls. A multivariate logistic regression model revealed that UPDRS-3 scores and plasma CRP levels were significantly associated with hallucinations/illusions with an adjusted odds ratio of 1.96 (95% confidence interval (CI) 1.20-3.20) per 10 points and 1.57 (95% confidence interval 1.13-2.16) per two-fold, respectively. Dividing patients into thirds by CRP levels (≤0.2, 0.3-0.6, ≥0.7 mg/L), the prevalence of hallucinations/illusions was 13.2%, 21.6%, and 41.7%, in the bottom-, middle-, and top-thirds, respectively (for trend p = 0.012).<h4>Conclusions</h4>Subclinical elevation of plasma CRP levels was associated with hallucinations or illusions after adjustment for motor disability, suggesting that subclinical elevations of CRP levels might be an independent risk for hallucinations/illusions.
format article
author Hideyuki Sawada
Tomoko Oeda
Atsushi Umemura
Satoshi Tomita
Ryutaro Hayashi
Masayuki Kohsaka
Kenji Yamamoto
Shinji Sudoh
Hiroshi Sugiyama
author_facet Hideyuki Sawada
Tomoko Oeda
Atsushi Umemura
Satoshi Tomita
Ryutaro Hayashi
Masayuki Kohsaka
Kenji Yamamoto
Shinji Sudoh
Hiroshi Sugiyama
author_sort Hideyuki Sawada
title Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.
title_short Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.
title_full Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.
title_fullStr Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.
title_full_unstemmed Subclinical elevation of plasma C-reactive protein and illusions/hallucinations in subjects with Parkinson's disease: case-control study.
title_sort subclinical elevation of plasma c-reactive protein and illusions/hallucinations in subjects with parkinson's disease: case-control study.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/db4561ce61b347fa8d8297d1b64ecde4
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