Visual hallucinations (VH) are common in dementia with Lewy bodies (DLB), and are among the core symptoms for its clinical diagnosis. VH have been associated with cognitive alterations, although research findings in this area are still limited. The present study aimed at investigating the cognitive correlates of VH in DLB, and the baseline neuropsychological features predicting the future development of VH. A cross sectional study compared the cognitive profile of 18 DLB patients with VH with that of 32 DLB without VH. A longitudinal study involved 34 DLB patients with no VH at baseline, among whom 17 developed VH and 17 remained without VH at follow-up. Logistic regression analyses were carried out to investigate what baseline cognitive variables independently predicted the development of VH at follow-up. DLB patients with VH had worse performance on the copy of the Rey complex figure, assessing visual construction/perception, than those without VH in the cross-sectional study (p = .001). Significant impairments in attention and visual memory delayed recall were also present. Baseline performance on the immediate prose memory was the only significant predictor of VH development in the longitudinal study (p = .03). DLB patients are more at risk of developing VH if presenting more severe immediate verbal memory impairment, and this might be related to a combination of (a) DMN-related dysfunctions, (b) impairment in medial temporal lobe-related functions, and (c) frontal abilities including long-term encoding of information and working memory. Differences between hallucinating and non-hallucinating patients in visual construction/perception, typical of DLB symptomatology, may be essential for VH to emerge in individuals with an at risk cognitive profile.

幻视 (VH) 在路易体痴呆 (DLB) 中很常见，是其临床诊断的核心症状之一。VH 与认知改变有关，尽管该领域的研究结果仍然有限。本研究旨在调查 DLB 中 VH 的认知相关性，以及预测 VH 未来发展的基线神经心理特征。一项横断面研究比较了 18 名患有 VH 的 DLB 患者与 32 名没有 VH 的 DLB 患者的认知状况。一项纵向研究涉及 34 名基线时没有 VH 的 DLB 患者，其中 17 名发展为 VH，17 名在随访时仍然没有 VH。进行逻辑回归分析以研究哪些基线认知变量独立预测随访时 VH 的发展。p  = .001）。注意力和视觉记忆延迟回忆的显着障碍也存在。在纵向研究中，即时散文记忆的基线表现是 VH 发展的唯一重要预测指标 ( p  = .03)。如果 DLB 患者表现出更严重的即时语言记忆障碍，则更有可能发生 VH，这可能与 (a) DMN 相关功能障碍、(b) 内侧颞叶相关功能障碍和 (c) 的组合有关) 正面能力，包括信息的长期编码和工作记忆。幻觉和非幻觉患者在视觉结构/感知方面的差异（典型的 DLB 症状）对于 VH 在具有风险认知特征的个体中出现可能是必不可少的。