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How does brain network activity relate to visual hallucinations?

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People with Parkinson's disease who experience visual hallucinations show abnormally high connectivity within the brain's default mode network compared to those without hallucinations, despite an overall decline in network connectivity caused by the disease itself.

Source

The default mode network is disrupted in Parkinson's disease with visual hallucinations

Yao N, Shek-Kwan Chang R, Cheung C, et al. · Human brain mapping · 2014

doi.org/10.1002/hbm.22577Read the full paper ↗130 citationscc by

Study at a glance

Design
Cross-sectional — Resting-state fMRI of Parkinson’s patients with vs without visual hallucinations and controls
N
N=38 · 24 Parkinson’s patients (12 with VH, 12 without) and 14 healthy controls
Population
Parkinson’s disease patients with and without visual hallucinations and healthy controls
Outcome
Overall DMN hypoconnectivity in PD with relatively higher DMN connectivity in hallucinators

Structured fields used in claim comparison tables when every cited study has a complete layer.

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How does brain network activity relate to visual hallucinations?

These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.

38 participants in the study

Data from 38 individuals were entered into the analysis.

24 patients with Parkinson's disease

Of these, 24 were patients with PD idiopathic type (comprising 12 with VH and 12 without) and 14 were unaffected healthy controls.
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What they did

The researchers scanned 38 participants, including 24 individuals with Parkinson's disease—divided into 12 with visual hallucinations and 12 without—and 14 healthy controls. Each participant underwent resting-state functional MRI to measure brain network connectivity during rest. The authors also collected high-resolution structural scans to measure cortical thickness across the brain.

What they found

Parkinson's patients overall showed lower default mode network connectivity compared to healthy controls. However, patients who experienced visual hallucinations had significantly higher functional connectivity in specific default mode network regions—specifically the precuneus, posterior cingulate gyrus, and middle frontal gyrus—than patients without hallucinations. No differences in cortical thickness were found among the groups, indicating these network changes occur without detectable structural tissue loss.

The limits

What it doesn't show

The study does not establish a causal relationship between default mode network hyperconnectivity and the actual occurrence of hallucinations. Because the sample size was small, subtle structural differences or weak correlations between symptom severity and connectivity may have been missed. Additionally, because participants were cognitively intact and had relatively mild to moderate hallucinations, the findings may not apply to patients with severe cognitive decline or more extreme hallucinatory symptoms. Finally, patients were scanned while taking their regular dopaminergic medications, which could potentially influence network activity.

Key terms

Default Mode Network (DMN)
A network of interacting brain regions that is highly active when a person is at rest and not focused on the outside world.
Independent Component Analysis (ICA)
A statistical method used to separate a mixed signal into distinct, independent source signals, helping identify coherent brain networks in fMRI data.
Functional Connectivity
A measure of how temporally correlated the activity of different, spatially distinct brain regions is over time.
Cortical Thickness
The structural depth of the brain's outer gray matter layer, often measured to detect tissue loss or atrophy.
Resting-state fMRI
A functional neuroimaging method used to evaluate brain activity when a participant is awake but not performing any specific cognitive task.
Dopaminergic Medication
Drugs that mimic or increase the levels of dopamine in the brain, primarily used to treat motor symptoms in Parkinson's disease.

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What is the main contrasting finding regarding Default Mode Network (DMN) functional connectivity in Parkinson's disease (PD) patients compared to healthy controls, versus PD patients with visual hallucinations (PDVH) compared to those without (PDnonVH)?

Common questions

Why would people with hallucinations have higher brain connectivity if Parkinson's usually reduces it?

The increased connectivity in the default mode network may represent an overactive retrieval of internal memories and self-referential thoughts, causing the brain to prioritize internal mental imagery over external sensory input.

Were participants experiencing hallucinations while inside the MRI scanner?

No, none of the participants reported experiencing active visual hallucinations during their scanning sessions.

Does this study show that brain tissue dies off when patients start hallucinating?

No, the structural analysis showed no significant differences in cortical thickness among the groups, suggesting these functional network changes occur before or independent of noticeable brain tissue loss.

Did the medications patients were taking affect the results of the scan?

While dopaminergic medications can influence brain networks, the researchers controlled for medication dosage mathematically in their analysis, making it unlikely that the drugs were the main cause of the differences.

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