Abnormal Connectivity and Brain Structure in Patients With Visual Snow

• Published in: Frontiers in human neuroscience Vol. 14; p. 582031
• Main Authors: Aldusary, Njoud, Traber, Ghislaine L, Freund, Patrick, Fierz, Fabienne C, Weber, Konrad P, Baeshen, Arwa, Alghamdi, Jamaan, Saliju, Bujar, Pazahr, Shila, Mazloum, Reza, Alshehri, Fahad, Landau, Klara, Kollias, Spyros, Piccirelli, Marco, Michels, Lars
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Research Foundation 19.11.2020; Frontiers Media S.A
• Subjects: Attention; Brain mapping; Cognitive ability; Cortex (parietal); Cortex (temporal); Excitability; functional connectivity; Functional magnetic resonance imaging; Headache; Information processing; lingual gyrus; Memory; Migraine; Morphometry; Neural networks; Neuroimaging; Neuroscience; Prefrontal cortex; Snow; Spatial memory; Structure-function relationships; Substantia grisea; temporal cortex; Tinnitus; Visual cortex; Visual perception; visual snow; Visual system; Switzerland; visual system; visual snow; functional connectivity; lingual gyrus; temporal cortex
• ISSN: 1662-5161; 1662-5161
• DOI: 10.3389/fnhum.2020.582031

Visual snow (VS) is a distressing, life-impacting condition with persistent visual phenomena. VS patients show cerebral hypermetabolism within the visual cortex, resulting in altered neuronal excitability. We hypothesized to see disease-dependent alterations in functional connectivity and gray matter volume (GMV) in regions associated with visual perception. Nineteen patients with VS and 16 sex- and age-matched controls were recruited. Functional magnetic resonance imaging (fMRI) was applied to examine resting-state functional connectivity (rsFC). Volume changes were assessed by means of voxel-based morphometry (VBM). Finally, we assessed associations between MRI indices and clinical parameters. Patients with VS showed hyperconnectivity between extrastriate visual and inferior temporal brain regions and also between prefrontal and parietal (angular cortex) brain regions ( < 0.05, corrected for age and migraine occurrence). In addition, patients showed increased GMV in the right lingual gyrus ( < 0.05 corrected). Symptom duration positively correlated with GMV in both lingual gyri ( < 0.01 corrected). This study found VS to be associated with both functional and structural changes in the early and higher visual cortex, as well as the temporal cortex. These brain regions are involved in visual processing, memory, spatial attention, and cognitive control. We conclude that VS is not just confined to the visual system and that both functional and structural changes arise in VS patients, be it as an epiphenomenon or a direct contributor to the pathomechanism of VS. These neuroimaging biomarkers may hold potential as objective outcome measures of this so far purely subjective condition.