Novartis Foundation for medical-biological research supports LNCO

The research project entitled "Brain mechanisms of robot-induced hallucinations in patients with Parkinson's disease" presented by LNCO was accepted by the Board of the NovartisFoundation for medical-biological research. The project will start in the fall 2020.

Project summary

Parkinson’s disease (PD) is the second most common neurodegenerative disease. The disease is characterized by the major motor symptoms of tremor, rigidity and bradykinesia but also by non-motor symptoms such as hallucinations (including minor and well-structured hallucinations). Hallucinations are abnormal sensory perceptions that occur in the absence of external stimuli. Mostly known for occurring in psychiatric illnesses such as schizophrenia, hallucinations are also severe and frequent symptoms affecting 50% of patients with Parkinson’s disease. Hallucinations are of negative prognosis in PD and represent important functional and social disabilities for the patient and major health costs for families and society. The present project proposes to investigate a very frequent hallucination in PD (30-40%) called sense of presence or presence hallucination (PH). PH is defined as the sensation that another person is nearby when no one is actually here and, importantly appears at very early stage of the illness, in some cases even preceding motor symptoms. Recently, our lab has developed and tested a non-invasive robotic device that is able to induce PHs (robot-induced PHs) safely, repeatedly, and under non-invasive controlled experimental conditions in healthy subjects and clinical populations, including patients with PD (Bernasconi, Blondiaux et al., in preparation; Blanke et al., 2014).

To date little is known about the neural mechanisms of robot-induced PHs and their relation to symptomatic PHs in PD patients. In this project, we propose to investigate the underlying brain networks involved in symptomatic and robot-induced PHs in patients with PD. To achieve this aim, and based on our previous work, we will use a newly designed MRIcompatible robotic device and analyse the brain networks associated with the robot-induced PHs in PD patients during MRI acquisition. (Study 1). In study 2, we propose to acquire resting state fMRI data in two groups of patients with PD (those with vs. without symptomatic PHs) and analyse the classic and dynamic full-brain functional connectivity differences between both groups. Detailed clinical analysis by our neuropsychological team will include patients’ subjective ratings of the robot-induced PHs, interviews about symptomatic PHs, demographic and clinical characteristics (e.g., medication, illness duration), and neuropsychological deficits (e.g., cognitive dysfunctions).

The project supported by Novartis Foundation will be a first important step to better understand the neural network involved in robot-induced PHs and their relation to symptomatic PH in patients with PD. Of note, we have already established a Swiss network of PD clinics for patient recruitment for a related research project and have obtained approval from the local ethics commissions to start the project. The results of the present project may pave the way to establish robot-induced PHs and the associated brain networks as an early biomarker of a more severe and rapidly advancing form of PD, characterized by heightened sensitivity based on robot-controlled behavioral and brain measures.