The Pharmacology of Visual Hallucinations in Synucleinopathies
| العنوان: | The Pharmacology of Visual Hallucinations in Synucleinopathies |
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| المؤلفون: | Mirella Russo, Claudia Carrarini, Fedele Dono, Marianna Gabriella Rispoli, Martina Di Pietro, Vincenzo Di Stefano, Laura Ferri, Laura Bonanni, Stefano Luca Sensi, Marco Onofrj |
| المساهمون: | Russo M., Carrarini C., Dono F., Rispoli M.G., Pietro M.D., Di Stefano V., Ferri L., Bonanni L., Sensi S.L., Onofrj M. |
| المصدر: | Frontiers in Pharmacology, Vol 10 (2019) Frontiers in Pharmacology |
| بيانات النشر: | Frontiers Media SA, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | 0301 basic medicine, Parkinson's disease, Review, Pharmacology, Serotonergic, default mode network, 03 medical and health sciences, Glutamatergic, 0302 clinical medicine, Dopamine, medicine, Pharmacology (medical), Default mode network, Synucleinopathies, Dementia with Lewy bodies, business.industry, lcsh:RM1-950, visual hallucination, medicine.disease, lcsh:Therapeutics. Pharmacology, 030104 developmental biology, 030220 oncology & carcinogenesis, Cholinergic, Settore MED/26 - Neurologia, synucleinopathy, dementia with Lewy bodies, business, medicine.drug |
| الوصف: | Visual hallucinations (VH) are commonly found in the course of synucleinopathies like Parkinson's disease and dementia with Lewy bodies. The incidence of VH in these conditions is so high that the absence of VH in the course of the disease should raise questions about the diagnosis. VH may take the form of early and simple phenomena or appear with late and complex presentations that include hallucinatory production and delusions. VH are an unmet treatment need. The review analyzes the past and recent hypotheses that are related to the underlying mechanisms of VH and then discusses their pharmacological modulation. Recent models for VH have been centered on the role played by the decoupling of the default mode network (DMN) when is released from the control of the fronto-parietal and salience networks. According to the proposed model, the process results in the perception of priors that are stored in the unconscious memory and the uncontrolled emergence of intrinsic narrative produced by the DMN. This DMN activity is triggered by the altered functioning of the thalamus and involves the dysregulated activity of the brain neurotransmitters. Historically, dopamine has been indicated as a major driver for the production of VH in synucleinopathies. In that context, nigrostriatal dysfunctions have been associated with the VH onset. The efficacy of antipsychotic compounds in VH treatment has further supported the notion of major involvement of dopamine in the production of the hallucinatory phenomena. However, more recent studies and growing evidence are also pointing toward an important role played by serotonergic and cholinergic dysfunctions. In that respect, in vivo and post-mortem studies have now proved that serotonergic impairment is often an early event in synucleinopathies. The prominent cholinergic impairment in DLB is also well established. Finally, glutamatergic and gamma aminobutyric acid (GABA)ergic modulations and changes in the overall balance between excitatory and inhibitory signaling are also contributing factors. The review provides an extensive overview of the pharmacology of VH and offers an up to date analysis of treatment options. |
| تدمد: | 1663-9812 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9023fd4a8bfd0bdc47cfdcecee71f094Test https://doi.org/10.3389/fphar.2019.01379Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9023fd4a8bfd0bdc47cfdcecee71f094 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16639812 |
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