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
First published August 5, 2020, 
DOI: https://doi.org/10.1212/WNL.0000000000010530

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.

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