Robot-induced hallucinations in Parkinson’s disease depend on altered sensorimotor processing in fronto-temporal network
Fosco Bernasconi, Eva Blondiaux, Jevita Potheegadoo, Giedre Stripeikyte, Javier Pagonabarraga, Helena Bejr‐Kasem, Michela Bassolino, Michel Akselrod, Saül Martínez‐Horta, Frederic Sampedro, Masayuki Hara, Judit Horváth, Matteo Franza, Stéphanie Konik, Matthieu Béreau, Joseph-André Ghika, Pierre R. Burkhard, Dimitri Van De Ville, Nathan Faivre, Giulio Rognini, Paul Krack, Jaime Kulisevsky, Olaf Blanke
Abstract
Hallucinations in Parkinson's disease (PD) are disturbing and frequent non-motor symptoms and constitute a major risk factor for psychosis and dementia. We report a robotics-based approach applying conflicting sensorimotor stimulation, enabling the induction of presence hallucinations (PHs) and the characterization of a subgroup of patients with PD with enhanced sensitivity for conflicting sensorimotor stimulation and robot-induced PH. We next identify the fronto-temporal network of PH by combining MR-compatible robotics (and sensorimotor stimulation in healthy participants) and lesion network mapping (neurological patients without PD). This PH-network was selectively disrupted in an additional and independent cohort of patients with PD, predicted the presence of symptomatic PH, and associated with cognitive decline. These robotics-neuroimaging findings extend existing sensorimotor hallucination models to PD and reveal the pathological cortical sensorimotor processes of PH in PD, potentially indicating a more severe form of PD that has been associated with psychosis and cognitive decline.