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ObjectivePatients with Lewy body disease develop a variety of psychotic and misperception symptoms, including visual hallucinations and delusions, as well as ‘minor hallucinations’, that is, a sense of presence, passage hallucinations and visual illusions. Although these symptoms have been suggested to have common underlying mechanisms, the commonalities and differences among them have not been systematically investigated at the neural level.MethodsSixty-seven patients with Parkinson’s disease underwent neuropsychological and behavioural assessments, volumetric MRI and 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET). A factor analysis was performed to discover correlations among psychotic and misperception symptoms, other behavioural symptoms and neuropsychological performances. Partial least-squares correlation analysis was used to investigate the relationship between these symptoms and the joint features of MRI and FDG-PET.ResultsA sense of presence, passage hallucinations and visual illusions constituted a single behavioural factor (minor hallucinations/illusions). Visual hallucinations formed another behavioural factor along with delusions, depression and fluctuating cognition (psychosis/dysphoria). Three distinct brain–behaviour correlation patterns were identified: (1) posterior cortical atrophy/hypometabolism associated with minor hallucinations/illusions and visuospatial impairment; (2) upper brainstem and thalamic atrophy/hypometabolism associated with psychosis/dysphoria and (3) frontal cortical atrophy/hypometabolism associated with non-visual cognition. No significant differences in neuroimaging findings were identified between patients who had minor hallucinations/illusions alone and patients who also had visual hallucinations.ConclusionsOur findings suggest that combined damage to the upper brainstem/thalamus and the posterior neocortex underlies both minor hallucinations/illusions and visual hallucinations and that the former pathology is more associated with visual hallucinations/frank psychosis and the latter is more associated with minor hallucinations/illusions.

This study aims to cross-culturally adapt the Yonsei Lifestyle Profile (YLP) to a Japanese version of YLP (YLP-J) for older Japanese adults. We translated YLP to the YLP-J using a formal forward–backward translation method. Subsequently, we investigated content validity using the Delphi expert method to assess the multifaceted lifestyle of older Japanese adults. A total of 11 health-related experts participated in the panel, and opinions were collected through 61 closed questions on item relevance and linguistic relevance. Based on the responses, sum, average, standard deviation, content validity ratio (CVR), stability, convergence, and consensus of each item were obtained. As the results of the first Delphi, 43 and 25 questions did not meet the CVR in linguistic and item relevance, respectively. We modified the item questions according to the comments of the expert panel. According to the results of the second Delphi in linguistic relevance, the mean values of CVR, stability, convergence, and consensus were 0.92, 0.17, 0.39, and 0.77, respectively. According to the results of the second Delphi in item relevance, the mean value of CVR, stability, convergence, and consensus were 0.93, 0.16, 0.39, and 0.80, respectively. The content validity of the YLP-J was examined so that the YLP tool could be applied to the linguistic and cultural context of Japan. It is expected that the YLP-J will be a useful tool for improving the health and quality of life of older adults in Japan.