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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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    Figure 1 Gray matter (GM) volume increase in the left visual cortex in visual snow syndrome

    Left primary visual cortex increases in GM volume in patients with VSS with respect to controls (x = −2, y = −98, z = 3; k = 594; p = 0.007 uncorrected, p = 0.06 family-wise error). Results are from whole-brain analysis; GM volume differences between groups are outlined over T1 images. Bar represents T values.

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    Figure 2 Changes in cerebellar gray matter (GM) volume in visual snow syndrome (VSS)

    (A) Area of cerebellar gray matter volume increase in patients with VSS (x = −12, y = −62, z = −23; k = 25; p = 0.02 family-wise error). GM volume differences between groups are outlined over parcellated cerebellar T1 images. Bar represents T values. (B) Cerebellar flatmap of plotted T values from patients with VSS with respect to controls (obtained from SUIT within SPM12), with labels for anatomical regions. Bar represents T values.

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    Figure 3 Summary of cortical volumetric changes in patients with visual snow syndrome, as shown by voxel-based morphometry

    Render illustration of the 3 brain regions of increased gray matter volume in patients with visual snow syndrome with respect to healthy controls. Left V1 cluster is illustrated in green; left V5 cluster in blue; left cerebellum cluster in red. For statistical values of each area, see the text. Image was created in MRICroGL and superimposed on standard brain template.

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