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September 29, 2020; 95 (13) ArticleOpen Access

Occipital cortex and cerebellum gray matter changes in visual snow syndrome

View ORCID ProfileFrancesca Puledda, View ORCID ProfileMuriel Bruchhage, View ORCID ProfileOwen O'Daly, View ORCID ProfileDominic Ffytche, View ORCID ProfileSteven C.R. Williams, View ORCID ProfilePeter J. Goadsby
First published August 5, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010530
Francesca Puledda
From the Headache Group, Department of Basic and Clinical Neuroscience (F.P., P.J.G.), Centre for Neuroimaging Sciences, Department of Neuroimaging (M.B., O.O., S.C.R.W.), and Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (D.F.), King's College London; NIHR–Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre (F.P., P.J.G.), King's College Hospital, London, UK; and Advanced Baby Imaging Laboratory (M.B.), Warren Alpert School of Medicine at Brown University, Providence, RI.
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Muriel Bruchhage
From the Headache Group, Department of Basic and Clinical Neuroscience (F.P., P.J.G.), Centre for Neuroimaging Sciences, Department of Neuroimaging (M.B., O.O., S.C.R.W.), and Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (D.F.), King's College London; NIHR–Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre (F.P., P.J.G.), King's College Hospital, London, UK; and Advanced Baby Imaging Laboratory (M.B.), Warren Alpert School of Medicine at Brown University, Providence, RI.
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Owen O'Daly
From the Headache Group, Department of Basic and Clinical Neuroscience (F.P., P.J.G.), Centre for Neuroimaging Sciences, Department of Neuroimaging (M.B., O.O., S.C.R.W.), and Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (D.F.), King's College London; NIHR–Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre (F.P., P.J.G.), King's College Hospital, London, UK; and Advanced Baby Imaging Laboratory (M.B.), Warren Alpert School of Medicine at Brown University, Providence, RI.
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Dominic Ffytche
From the Headache Group, Department of Basic and Clinical Neuroscience (F.P., P.J.G.), Centre for Neuroimaging Sciences, Department of Neuroimaging (M.B., O.O., S.C.R.W.), and Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (D.F.), King's College London; NIHR–Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre (F.P., P.J.G.), King's College Hospital, London, UK; and Advanced Baby Imaging Laboratory (M.B.), Warren Alpert School of Medicine at Brown University, Providence, RI.
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Steven C.R. Williams
From the Headache Group, Department of Basic and Clinical Neuroscience (F.P., P.J.G.), Centre for Neuroimaging Sciences, Department of Neuroimaging (M.B., O.O., S.C.R.W.), and Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (D.F.), King's College London; NIHR–Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre (F.P., P.J.G.), King's College Hospital, London, UK; and Advanced Baby Imaging Laboratory (M.B.), Warren Alpert School of Medicine at Brown University, Providence, RI.
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Peter J. Goadsby
From the Headache Group, Department of Basic and Clinical Neuroscience (F.P., P.J.G.), Centre for Neuroimaging Sciences, Department of Neuroimaging (M.B., O.O., S.C.R.W.), and Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (D.F.), King's College London; NIHR–Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre (F.P., P.J.G.), King's College Hospital, London, UK; and Advanced Baby Imaging Laboratory (M.B.), Warren Alpert School of Medicine at Brown University, Providence, RI.
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Occipital cortex and cerebellum gray matter changes in visual snow syndrome
Francesca Puledda, Muriel Bruchhage, Owen O'Daly, Dominic Ffytche, Steven C.R. Williams, Peter J. Goadsby
Neurology Sep 2020, 95 (13) e1792-e1799; DOI: 10.1212/WNL.0000000000010530

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Abstract

Objective To 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.

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). 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.

Results Compared 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.

Conclusion 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.

Glossary

DARTEL=
diffeomorphic anatomical registration through exponentiated lie algebra;
DMN=
default mode network;
FWE=
family-wise error;
GM=
gray matter;
ROI=
region of interest;
SPM=
statistical parametric mapping;
TIV=
total intracranial volume;
VBM=
voxel-based morphometry;
VSS=
visual snow syndrome;
WM=
white matter

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • The Article Processing Charge was funded by the authors.

  • Received January 17, 2020.
  • Accepted in final form May 11, 2020.
  • Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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