Effectiveness of anti-psychiatric treatment on visual and haptic perceptual disorder for a patient with Alzheimer’s disease: A case report

BACKGROUND Perception is frequently impaired in patients with Alzheimer’s disease(AD).Several patients exhibit visual or haptic hallucinations.CASE SUMMARY A 71-year-old Chinese man presented with visual and haptic hallucinations he had been experiencing for 2 weeks.The clinical manifestations were the feeling of insects crawling and biting the limbs and geison.He looked for the insects while itching and scratching,which led to skin breakage on the limbs.He was treated with topical and anti-allergic drugs in several dermatology departments without any significant improvement.After admission,the patient was administered risperidone(0.5 mg)and duloxetine(2 mg/day).One week later,the dose of risperidone was increased to 2 mg/day,and that of duloxetine was increased to 60 mg/day.After 2 weeks of treatment,the patient’s sensation of insects crawling and biting disappeared,and his mood stabilized.CONCLUSION This patient manifested psychiatric behavioral symptoms caused by AD brain atrophy.It was important to re-evaluate the patient’s cognitive-psychological status when the patient repeatedly went to the hospital for treatment.Follow-up attention to cognitive function and the consideration of perceptual deficits as early manifestations of AD should be considered.

Knowledge domain and emerging trends in visual hallucination research:A scientometric analysis

BACKGROUND Visual hallucination(VH)refers to a spontaneous visual perception without corresponding external stimuli and often occurs in ophthalmological and neuropsychiatric disorders.It is associated with poor quality of life,and increased patient hospitalization and nursing home admission.To date,a scientometric analysis of research on VH is lacking.AIM To objectively summarize the features of VH research and gain insights into the emerging trends in research on VH.METHODS CiteSpace V was used in this article.Publication outputs,document types,geographic distributions,co-authorship status,research hotspots,and co-citation status were analyzed.A total of 2176 original articles and 465 reviews were included in the database downloaded from the Web of Science Core Collection.We selected the top 50 most cited or occurring articles or items to create a visualized network with a 1-year interval.In the document co-citation analysis stage,we performed clustering analysis on co-cited references,and log likelihood tests were used to name the clusters.RESULTS The results showed that most publications can be classified into neurology,sports,and ophthalmology studies.In addition,North America,Europe,Asia and Australia published the most documents.Some well-known authors have always had a leading role in this field;meanwhile,new authors keep emerging.A relatively stable cooperation has been formed among many authors.Furthermore,neuropsychiatric symptom and functional connectivity are the top hotspots.Research on VH in dementia with Lewy bodies and Parkinson’s disease(PD)have received much attention.Studies on VH in PD are likely to be the new emerging trends in the future,especially the mechanisms of VH.CONCLUSION Research on VH has formed a complete system.More large-scale clinical and indepth basic research are required to better understand the mechanisms underlying VH,which will contribute to our understanding of the pathophysiology and therapeutic options for VH.

Prevalence of Charles Bonnet syndrome in low vision:a systematic review and meta-analysis

Background:Charles Bonnet syndrome(CBS)is characterized by vivid lifelike visual hallucinations and is typically seen in individuals with visual impairment.In this systematic review,we summarize current knowledge on the prevalence of CBS in patients with low vision.Methods:We searched 11 literature databases on 21 April 2021 for studies on the prevalence of CBS in low vision populations.Our protocol was registered in the PROSPERO database(reg.No.CRD42021255021).Eligible studies were defined as those on a population of low vision patients wherein the prevalence of CBS was evaluated(without any further restriction on the method for diagnosis of CBS).No restriction was enforced on study design,but we expected observational cross-sectional studies due to the nature of our research question.Two authors independently extracted data and evaluated risk of bias of individual studies using the Agency for Healthcare Research and Quality checklist for cross-sectional studies.Studies underwent qualitative review in the text and quantitatively in a prevalence meta-analysis using the random-effects model.Sensitivity analysis was made to evaluate the robustness of the summary estimate.Results:We identified 11 studies,which summarized data on 4,521 individuals with visual impairment.Diagnosis of CBS was based on screening questions or interviews,which in positive cases often was explored in more detail with follow-up questions or interviews.Most studies either had normal mental state as a participant eligibility criterion or as a part of the diagnosis of CBS.The pooled prevalence of CBS in low vision patients aged≥40 years was 19.7%(95%CI:13.8%to 26.4%).The sensitivity analysis showed certain robustness in the summary prevalence estimate wherein prevalence estimates ranged from 16.9%to 22.5%.Conclusions:CBS is a prevalent condition in patients with low vision at a rate of approximately one in five patients.Considering that an estimated 239 million individuals have moderate visual impairment or worse,we estimate a global number of patients with CBS at approximately 47.2 million.