Neuroanatomical and neurochemical substrates for visual hallucinations

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Visual hallucinations are spontaneous phenomena and hard to detect in experimental settings. Tools to evoke visual hallucinations would enable functional neuroimaging investigations and therapeutic intervention studies. We previously devised a new experimental task to detect and measure hallucination-like illusions in patients with dementia with Lewy bodies (DLB) and Parkinson's disease. In the present study, we developed another task to evoke visual illusions, which is easier to administer and has simpler scoring system. Using this new test, we successfully evoked hallucination-like illusory responses in patients with DLB. The number of illusory responses was dramatically reduced by administration of donepezil, a cholinesterase inhibitor. The result suggests the relationship between visual hallucinations and cholinergic insufficiency in DLB.