Occipital cortex and cerebellum gray matter changes in visual snow syndrome.

Francesca Puledda,Steven C.R Williams,Dominic Ffytche,Muriel Bruchhage,Peter J Goadsby,Owen O'Daly

doi:10.1212/wnl.0000000000010530

Francesca Puledda, Steven C.R Williams + Show 4 more

Open Access

https://doi.org/10.1212/wnl.0000000000010530

Copy DOI

Abstract

ObjectiveTo determine whether regional gray and white matter differences characterize the brain of patients with visual snow syndrome, a newly defined neurologic condition, we used a voxel-based morphometry approach.MethodsIn order to investigate whole brain morphology directly, we performed an MRI study on patients with visual snow syndrome (n = 24) and on age- and sex-matched healthy volunteers (n = 24). Voxel-based morphometry was used to determine volumetric differences in patients with visual snow. We further analyzed cerebellar anatomy directly using the high-resolution spatially unbiased atlas template of the cerebellum.ResultsCompared to healthy controls, patients with visual snow syndrome had increased gray matter volume in the left primary and secondary visual cortices, the left visual motion area V5, and the left cerebellar crus I/lobule VI area. These anatomical alterations could not be explained by clinical features of the condition.ConclusionPatients with visual snow syndrome have subtle, significant neuroanatomical differences in key visual and lateral cerebellar areas, which may in part explain the pathophysiologic basis of the disorder.

Highlights

In order to investigate whole brain morphology directly, we performed an MRI study on patients with visual snow syndrome (n = 24) and on age- and sex-matched healthy volunteers (n = 24)
Patients with visual snow syndrome have subtle, significant neuroanatomical differences in key visual and lateral cerebellar areas, which may in part explain the pathophysiologic basis of the disorder
Using a voxel-based whole-brain morphometry (VBM) approach, we studied the neuroanatomical differences between patients with Visual snow syndrome (VSS) compared to healthy volunteers

Summary

Methods

In order to investigate whole brain morphology directly, we performed an MRI study on patients with visual snow syndrome (n = 24) and on age- and sex-matched healthy volunteers (n = 24). Population and recruitment Twenty-four patients with a diagnosis of VSS2 and an equal number of age- and sex-matched healthy volunteers were selected for the study. Inclusion criteria for participants were age 20–60 years, no contraindications to MRI, no serious medical conditions including psychiatric comorbidities (as assessed by a trained neurologist), no recurrent use of medications with an action on the CNS, and no previous use of any recreational drugs. Healthy volunteers were selected based on matching age (±5 years) and sex of our patient population and had no ongoing medical condition or medication use. A full medical history and general and neurologic examinations were performed for each participant

Results

Discussion

Conclusion