Visual Snow Syndrome Improves with Modulation of Resting State Functional MRI Connectivity of Visual Network Following Mindfulness-Based Cognitive Therapy Modified for Visual Symptoms (MBCT-Vision)
Sui Hsien Wong, Giuseppe Pontillo, Baris Kanber, Ferran Prados, Janet Wingrove, Marios Yiannakas, Indran Davagnanam, Claudia A.M. Gandini Wheeler-Kingshott, Ahmed T. Toosy
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective open-label treatment trial Cross-sectional |
|---|---|
| Sample size | 21 |
| Population | People with Visual Snow Syndrome (14 male, median age 30 years, SD 9.32) |
| Intervention | Mindfulness-Based Cognitive Therapy for visual symptoms (MBCT-vision) |
| Duration | 9-week intervention with follow-up to week 20 |
| Measures | WHO-5, CORE-10 |
| Topics | Meditation |
| Registration | NCT04184726 |
| Key findings | The authors report that MBCT-vision is a feasible treatment for Visual Snow Syndrome, with improvements in symptom severity, symptom impact, wellbeing, and psychological distress from baseline to weeks 9 and 20, alongside changes in resting-state functional connectivity of visual and default-mode networks. They suggest mindfulness interventions can modify brain functional connectivity with potential applications in neurological conditions. |
Abstract
Background: Visual Snow Syndrome (VSS) is a neurological disorder of functional network dysregulation, with no published treatment trials to date. We set out to assess the feasibility of Mindfulness-Based Cognitive Therapy for visual symptoms (MBCT-vision) for VSS.
Methods: A prospective open-label treatment trial. Primary
Outcomes: self-rated symptom questionnaires (baseline vs week-9, week-20) (1) symptom severity and (2) impact of symptoms on daily life. Secondary
Outcomes: (1) WHO-5 wellbeing and CORE-10 psychological distress questionnaire scores (baseline vs week-9, week-20); (2) resting-state functional and diffusion MRI (baseline vs week-20); (3) Cross-sectional fMRI (baseline) compared with healthy controls.
Findings: 21 participants (14M, median age 30y, SD9.32) recruited. Two dropped.Symptom severity improved: baseline (mean 6.95, SD 1.43) vs week-9 (mean 5.44, SD 2.38, p=0.0286), week-20 (mean 4.37, SD 2.31, p=0.0003).Impact of symptoms improved: baseline (mean 6.21, SD 2.04) vs week-9 (mean 4.11, SD 2.27, p=0.0057), week-20 (mean 2.65, SD 2.48, p=<0.0001).WHO-5 scores improved: baseline (mean 12.6, SD 3.76) vs week-9 (mean 15.9, SD 4.43, p=0.0009), week-20 (mean 16.0, SD 4.82, p=0.0003).CORE-10 scores improved: baseline (mean 15.4, SD 4.98) vs week-9 (mean 13.3, SD 3.74, p=0.0024), week-20 (mean 12.5, SD 4.57, p=0.0015).Within-subjects fMRI analysis (baseline vs week-20): Reduced clusters of VN-related FC within the left lateral occipital cortex (size=82 mL, cluster-level FWE-corrected p-value=0.006) and the left cerebellar lobules VIIb/VIII (size=65mL, cluster-level FWE-corrected p-value=0.02). Increased cluster of DMN-related FC within the precuneus/posterior cingulate cortex (size=69 mL, cluster-level FWE-corrected p-value=0.02).VSS (baseline) compared with healthy controls: reduced VN-related FC within the left lateral occipital cortex (cluster size=118 mL, cluster-level FWE-corrected p-value=0.01).
Interpretation: MBCT-vision is a feasible treatment for VSS, with improvements of symptoms and modulation in fMRI functional connectivity of visual networks. Mindfulness interventions can modify brain functional connectivity with potential applications in neurological conditions.
Trial Registration: Details: ClinicalTrials.gov (Identifier: NCT04184726).
Funding: Information: Eye Hope; Guy’s and St Thomas’ Trust Charity; Visual Snow Initiative. Declaration of Interests: The authors report no competing interests. Ethics Approval Statement: Written informed consent was obtained from all participants and the appropriate institutional forms have been archived. This study received ethics approval from the National Research Ethics Committee (LondonSouth East, 19/LO/1615).
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |