Functional connectivity alterations in migraineurs with Alice in Wonderland syndrome.
Claudia Piervincenzi, Nikolaos Petsas, Alessandro Viganò, Valentina Mancini, Giulio Mastria, Marta Puma, Costanza Giannì, Vittorio Di Piero, Patrizia Pantano
Neurological Sciences January 2023 DOI: 10.1007/s10072-022-06404-1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational case-control study Peer reviewed |
|---|---|
| Sample size | 48 |
| Population | Adults with Alice in Wonderland syndrome, migraine patients with typical aura, and healthy controls |
| Keywords | Functional connectivity fc Resting-State Functional MRI |
| Key findings | AIWS and migraine-with-aura patients showed similar resting-state functional connectivity alterations in several networks, though to different extents, suggesting common pathophysiological underpinnings. AIWS patients showed additional connectivity changes in basal ganglia and executive control networks, and AIWS-specific executive control network alterations positively correlated with migraine frequency. |
Abstract
Alice in Wonderland syndrome (AIWS) is a neurological disorder characterized by erroneous perception of the body schema or surrounding space. Migraine is the primary cause of AIWS in adults. The pathophysiology of AIWS is largely unknown, especially regarding functional abnormalities. In this study, we compared resting-state functional connectivity (FC) of migraine patients experiencing AIWS, migraine patients with typical aura (MA) and healthy controls (HCs). Twelve AIWS, 12 MA, and 24 HCs were enrolled and underwent 3 T MRI scanning. Independent component analysis was used to identify RSNs thought to be relevant for AIWS: visual, salience, basal ganglia, default mode, and executive control networks. Dual regression technique was used to detect between-group differences in RSNs. Finally, AIWS-specific FC alterations were correlated with clinical measures. With respect to HCs, AIWS and MA patients both showed significantly lower (p < 0.05, FDR corrected) FC in lateral and medial visual networks and higher FC in salience and default mode networks. AIWS patients alone showed higher FC in basal ganglia and executive control networks than HCs. When directly compared, AIWS patients showed lower FC in visual networks and higher FC in all other investigated RSNs than MA patients. Lastly, AIWS-specific FC alterations in the executive control network positively correlated with migraine frequency. AIWS and MA patients showed similar FC alterations in several RSNs, although to a different extent, suggesting common pathophysiological underpinnings. However, AIWS patients showed additional FC alterations, likely due to the complexity of AIWS symptoms involving high-order associative cortical areas.