CHARLES-BONNET SYNDROME - AN EARLY MARKER FOR DEMENTIA

OBJECTIVE: To clarify the neuropsychological function in patients with Charles Bonnet Syndrome. DESIGN: Control group comparison study. SETT ING: University of Chicago Hospitals. PARTICIPANTS: The neuropsycholog ical function of 15 older adults with presenting complaints of visual hallucinations who met criteria for Charles Bonnet Syndrome (CBS) were compared with 11 demographically matched controls to determine if the re was any evidence of functional brain impairment. CBS patients were screened for focal brain lesions and epileptic disturbance via MRI and EEG and also received pattern visual evoked potentials and ophthalmol ogical examinations. MEASUREMENTS: Scores from the Wechsler Adult Inte lligence Scale-Revised, Mattis Dementia Rating Scale, Wechsler Memory Scale, and the Auditory Verbal Learning Test were compared. RESULTS: S ignificant differences were found between the two groups on the neurop sychological measures. Moreover, 14 of 14 subjects had ocular abnormal ities and six of eight had abnormal age-corrected pattern visual evoke d potentials indicative of dysfunction in the visual system. CONCLUSIO NS: The results of the study indicate that patients diagnosed with Cha rles Bonnet Syndrome evidence neuropsychological changes commonly asso ciated with the early stages of dementia. Therefore, in patients with impaired vision, the appearance of cognitive deficits, albeit subtle, occur with the onset of visual hallucinations. We propose that isolate d visual hallucinations in the older adult may be an indication of the early stages of dementia.