α-synuclein is a constituent of Lewy bodies and mutations of its gene cause familial PD. A previous study showed that a variant of α-synuclein gene (SNCA), namely the 263bp allele of Rep1 was associated to faster motor progression in PD. On the contrary, a recent report failed to detect a detrimental effect of Rep1 263 on both motor and cognitive outcomes in PD. Aim of this study was to evaluate the influence of the Rep1 variants on disease progression in Parkinson’s Disease (PD) patients. We recruited and genotyped for SNCA-Rep1 426 PD patients with age at onset ≥40 years and disease duration ≥4 years. We then analyzed frequency and time of occurrence of wearing-off, dyskinesia, freezing of gait, visual hallucinations and dementia. SNCA Rep1 263 carriers showed increased risk of both dementia (HR=3.03) and visual hallucinations (HR=2.69) compared to 263 non-carriers. In conclusion, SNCA Rep 1 263 allele is associated to a worst cognitive outcome in PD.

Recent studies have discovered that functional connections are impaired in patients with Parkinson's disease (PD) accompanied by hallucinations(PD-H), even at the preclinical stage. The cerebellum has been implicated as playing a role in cognitive processes. However, the functional connectivity (FC) between cognitive sub-regions of the cerebellum of PD patients with hallucinations needs to be further clarified. Resting-state functional magnetic resonance imaging (rs-fMRI) data from three groups (17 PD-H, 13 no hallucinations accompanying the (PD-NH), and 26 healthy controls (HC) ) was collected in this study to explore the role of cerebellar FC changes in the cognitive performance. Additionally, we define cerebellar FC as a training feature for classifying all subjects using Support Vector Machine(SVM). We found that PD-H patients' cerebellum(Vermis_4_5 ) FC had increased within the left side of the precuneus(PCUN) compared to HC, cerebellum(Vermis_1_2) had increased within bilateral opercular part of the inferior frontal gyrus(IFGoprec) and triangular part of the inferior frontal gyrus(IFCtriang), left side of postcentral gyrus(PoCG), Inferior parietal lobe(IPL), and PCUNs compared to PD-NH. In the training results of machine learning, cerebellar FC has also been proven to be an effective biomarker feature, with a recognition rate of over 90% for PD-H. These findings indicate that cortico-cerebellar FC in PD-H and PD-NH patients were significantly disrupted with different distributions. The proposed pipeline offers a promising low-cost alternative for the diagnosis of preclinical PD-H and can be useful for other degenerative brain disorders.

Introduction: The aim is to investigate the possibility of altering the delusional perceptions of psychotic patients by exposing them to a cognitively flexible virtual environment. A flexible vir-tual reality (VR) environment could challenge and enhance the ability to adapt to changing situa-tions and generate novel solutions to core psychotic symptoms. Materials and methods: A systematic review was conducted using different combinations of keywords in different databases. This study was conducted using the PRISMA statement. Results: There is a growing literature on the use of VR to manipulate and normalise perceptual distortions in psychosis. Over the last decade, the number of published studies on VR in mental health has increased 14-fold. Conclusions: A cognitive flexibility virtual environment can alter delusional perception by ex-posing the person to different scenarios that require them to question their assumptions, test their hypotheses, and revise their beliefs. Commonly used biosensors measure heart rate, skin con-ductance and body temperature in relation to different emotional states. Recently, there has been a major shift towards the use of neuroimaging techniques to better understand the pathophysiology of mental disorders. This is where the new wave of biosensor-integrated virtual reality (VR) sys-tems comes in.