Objective: To investigate whether DLB and PD patients show VEP and OCT alterations in comparison with AD patients, and whether this possible alterations are associated with more prominent cognitive and neuropsychiatric disturbances.

Background: Visuo-spatial and visuo-perceptual deficits are common in Dementia with Lewy Bodies (DLB) and in Parkinson’s Disease with cognitive impairment (PD with Mild Cognitive Impairment, PD-MCI and PD with Dementia, PDD), as well as Visual Hallucinations (VHs). Previous studies documented an association between visual function, assessed by means of Visual Evoked Potential (VEP), and VHs. Alzheimer’s Disease (AD) patients, typically do not show prominent visual impairment or visual hallucinations. Few data are available about retinal alterations at optic coherence tomography (OCT), with regard to visuo-spatial, visuo-perceptual and neuropsychiatric dysfunctions in DLB and PD patients as compared with AD patients.

Method: To the current date, we enrolled 9 patients with DLB, 1 patient with AD and 5 patients with PD. Among these, 3 patients with DLB, 1 patient with AD and 2 patients with PD underwent VEP investigation. All the patients underwent Neuropsychological evaluation with Montreal Cognitive Assessment (MoCA), Rey’s figure immediate copy and delayed recall and also Neuropsychiatric Inventory (NPI). Our target is to create 3 cohorts of 20 patients each one. Also, all the patients will undergo ERG and OCT exams.

Results: A preliminary analysis documented an increase of the conduction latencies in VEP exams in all the DLB and PD patients. On the other hand, the patient with AD showed a normal visual conduction. The VEP alterations do not seem to be related to VH, since they are equally present in both patients with and without VH. Indeed, three out of nine patients with DLB and one out of eight PD patients have reported VH in NPI assessment. Moreover, visual alterations do not seem to be related to cognitive impairment, as observed with MoCA scores.

Conclusion: Previous studies documented an impairment in metabolic functions of dopaminergic amacrine cells in human retina of PD patients, which may account for visual and retinal alterations in PD patients. VEP and OCT have been employed in order to demonstrate this feature, mostly in PD patients with or without VH. Further studies need to be performed in order to assess whether PEV alterations could have a differential diagnostic values in the comparison between PD/DLB and AD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/visual-evoked-potentials-alterations-in-dlb/