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The patient variably recognizes these images as hallucinations, being rarely irritated or frightened and more often amused as a bystander. Although studies on VH in PD focus on several research domains, no comprehensive, unified theory has been developed to study their pathophysiology. We have adapted Hobson's work on the states of consciousness and propose a model integrating seemingly disparate data on VH. We suggest that VH should be considered as a dysregulation of the gating and filtering of external perception and internal image production. Contributive elements and anatomical links for the model include poor primary vision, reduced activation of primary visual cortex, aberrant activation of associative visual and frontal cortex, lack of suppression or spontaneous emergence of internally generated imagery through the ponto\u2010geniculo\u2010occipital system, intrusion of rapid eye movement dreaming imagery into wakefulness, errative changes of the brainstem filtering capacities through fluctuating vigilance, and medication\u2010related overactivation of mesolimbic systems. Different etiologies likely produce different phenomenologies and the prognosis may not be uniform. This new conceptual framework permits an anatomical view of VH and suggests new, testable hypotheses regarding their pathophysiology and therapy. \u00a9 2004 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.20308","type":"journal-article","created":{"date-parts":[[2004,10,14]],"date-time":"2004-10-14T19:01:41Z","timestamp":1097780501000},"page":"130-140","source":"Crossref","is-referenced-by-count":248,"title":["Repeated visual hallucinations in Parkinson's disease as disturbed external\/internal perceptions: Focused review and a new integrative model"],"prefix":"10.1002","volume":"20","author":[{"given":"Nico J.","family":"Diederich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Goetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn T.","family":"Stebbins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,14]]},"reference":[{"key":"e_1_2_10_2_2","first-page":"13","article-title":"Hallucinations in Parkinson's disease: a population study","volume":"14","author":"Tanner CM","year":"1983","journal-title":"Ann Neurol"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-11619"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.70.6.734"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.70.6.727"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10450"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002826-198205020-00003"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(199901)14:1<117::AID-MDS1019>3.0.CO;2-0"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/123.4.733"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.64.4.533"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.11.2078"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.4.669"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb06891.x"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X00003976"},{"key":"e_1_2_10_15_2","volume-title":"Chemically altered states of consciousness. 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