Alterations in the visual system may underlie visual hallucinations in dementia with Lewy bodies (DLB). However, cortical excitability as measured by transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) activation of lower visual areas (V1–3) to visual stimuli appear normal in DLB. We explored the relationship between TMS-determined phosphene threshold and fMRI-related visual activation and found a positive relationship between the two in controls but a negative one in DLB. This double dissociation suggests a loss of inhibition in the visual system in DLB, which may predispose individuals to visual dysfunction and visual hallucinations.

When I started to think about what I would discuss in this piece, I realised that my favourite reading over the past few decades has been almost entirely non-medical and non-psychiatric. I have read a lot of plays and biographies, as well as a fair few novels and books on art or other themes. And of course there are all the books I have bought and still haven't read. I decided that I would choose books which I think about at least once a month, if not more, whether I read them 4 or 40 years ago. I structured the resulting list chronologically, in terms of when I first read them.