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Abstract

Objective

To determine whether changes to cortical processing of visual information can be evaluated objectively using 3 simple ocular motor tasks to measure performance in patients with visual snow syndrome (VSS).

Methods

Sixty-four patients with VSS (32 with migraine and 32 with no migraine) and 23 controls participated. Three ocular motor tasks were included: prosaccade (PS), antisaccade (AS), and interleaved AS-PS tasks. All these tasks have been used extensively in both neurologically healthy and diseased states.

Results

We demonstrated that, compared to controls, the VSS group generated significantly shortened PS latencies (p = 0.029) and an increased rate of AS errors (p = 0.001), irrespective of the demands placed on visual processing (i.e., task context). Switch costs, a feature of the AS-PS task, were comparable across groups, and a significant correlation was found between shortened PS latencies and increased AS error rates for patients with VSS (r = 0.404).

Conclusion

We identified objective and quantifiable measures of visual processing changes in patients with VSS. The absence of any additional switch cost on the AS-PS task in VSS suggests that the PS latency and AS error differences are attributable to a speeded PS response rather than to impaired executive processes more commonly implicated in poorer AS performance. We propose that this combination of latency and error deficits, in conjunction with intact switching performance, will provide a VS behavioral signature that contributes to our understanding of VSS and may assist in determining the efficacy of therapeutic interventions.

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Information & Authors

Information

Published In

Neurology®
Volume 95Number 13September 29, 2020
Pages: e1784-e1791
PubMed: 32675081

Publication History

Received: January 16, 2020
Accepted: April 6, 2020
Published online: July 16, 2020
Published in print: September 29, 2020

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Disclosures

E.J. Solly and Dr. Clough report no disclosures. Dr. McKendrick receives research support from Heidelberg Engineering GmbH (Germany), CenterVue PdA (Italy), and Haag-Streit AG (Switzerland), has research funding from the Australian Research Council, and is an editorial board member of the following journals: Graefe's Archive of Clinical & Experimental Ophthalmology, Scientific Reports, and Translational Vision Science and Technology. P. Foletta reports no disclosures. Dr. White receives discretionary research funding from Merck and is an Associate Editor for Frontiers in Neuro-ophthalmology. Dr. Fielding receives funding for other research from Biogen and Genzyme. Go to Neurology.org/N for full disclosures.

Study Funding

This study was funded by a donation from the Visual Snow Initiative.

Authors

Affiliations & Disclosures

Emma J. Solly, BA (Hons) https://orcid.org/0000-0002-5241-6572
From the Department of Neuroscience (E.J.S., M.C., P.F., O.B.W., J.F.), Central Clinical School, Monash University, Melbourne; and Department of Optometry & Vision Sciences (A.M.M.) and Department of Medicine, Royal Melbourne Hospital (O.B.W.), The University of Melbourne, Australia.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
(1) Visual Snow Initiative
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neuroscience (E.J.S., M.C., P.F., O.B.W., J.F.), Central Clinical School, Monash University, Melbourne; and Department of Optometry & Vision Sciences (A.M.M.) and Department of Medicine, Royal Melbourne Hospital (O.B.W.), The University of Melbourne, Australia.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Received travel allowance from Biogen Idec for conference attendance
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Allison M. McKendrick, PhD https://orcid.org/0000-0003-1972-1222
From the Department of Neuroscience (E.J.S., M.C., P.F., O.B.W., J.F.), Central Clinical School, Monash University, Melbourne; and Department of Optometry & Vision Sciences (A.M.M.) and Department of Medicine, Royal Melbourne Hospital (O.B.W.), The University of Melbourne, Australia.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
1) Graefe’s Archive of Clinical & Experimental Ophthalmology, editorial board member, 2008-present, 2) Translational Vision Science and Technology, editorial board member, 2016-present 3) Scientific Reports, editorial board member, 2018- present
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
(1) Heidelberg Engineering GmBH (Germany), (2) CenterVue PdA (Italy), (3) Haag-Streit AG (Switzerland)
Research Support, Government Entities:
1.
(1) Australian Research Council, ARC DP180102596, Chief Investigator, 2018-2020 (2) Australian National Health and Medical Research Council, APP1081874, Chief Investigator, 2015-2017.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Paige Foletta, BSc (Hons) https://orcid.org/0000-0003-2093-2801
From the Department of Neuroscience (E.J.S., M.C., P.F., O.B.W., J.F.), Central Clinical School, Monash University, Melbourne; and Department of Optometry & Vision Sciences (A.M.M.) and Department of Medicine, Royal Melbourne Hospital (O.B.W.), The University of Melbourne, Australia.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
1) Australian Government Research Training Program Scholarship
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neuroscience (E.J.S., M.C., P.F., O.B.W., J.F.), Central Clinical School, Monash University, Melbourne; and Department of Optometry & Vision Sciences (A.M.M.) and Department of Medicine, Royal Melbourne Hospital (O.B.W.), The University of Melbourne, Australia.
Disclosure
Scientific Advisory Boards:
1.
Merck - Cladribine (Mavenclad) Advisory Board
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Bayer travel grant to attend ECTRIMS Novartis travel grant to attend ECTRIMS
Editorial Boards:
1.
Frontiers in Neurology, Associate Editor, 2013-2020
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
Novartis, Educational talk Genzyme, Educational talk Biogen-Idec, chairing meeting
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
From the Department of Neuroscience (E.J.S., M.C., P.F., O.B.W., J.F.), Central Clinical School, Monash University, Melbourne; and Department of Optometry & Vision Sciences (A.M.M.) and Department of Medicine, Royal Melbourne Hospital (O.B.W.), The University of Melbourne, Australia.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Sanofi Genzyme, grant funding Biogen, grant funding
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence Dr. Fielding [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

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  2. Visual Snow: A Review on Pathophysiology and Treatment, Journal of Clinical Medicine, 12, 12, (3868), (2023).https://doi.org/10.3390/jcm12123868
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  3. Differential Diagnosis of Visual Phenomena Associated with Migraine: Spotlight on Aura and Visual Snow Syndrome, Diagnostics, 13, 2, (252), (2023).https://doi.org/10.3390/diagnostics13020252
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