Aeschlimann SA, Klein A, Zubler F, Schankin CJ, Ertl M. Electroencephalographic Resting-State Microstates are Unstable in Visual Snow Syndrome.
Brain Behav 2025;
15:e70374. [PMID:
40083312 PMCID:
PMC11907104 DOI:
10.1002/brb3.70374]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 12/08/2024] [Accepted: 02/11/2025] [Indexed: 03/16/2025] Open
Abstract
OBJECTIVE
To study large-scale network processing in visual snow syndrome (VSS) with and without migraine, we applied resting-state electroencephalographic microstate analysis.
BACKGROUND
VSS is characterized by a spectrum of visual symptoms, with the main symptom being perceived as flickering dots throughout the visual field. The syndrome is associated with migraine and tinnitus and is considered a network disorder, but the cause and pathophysiology are still largely unknown.
METHODS
In this case-control study, resting-state electroencephalography (EEG) recordings were selected from a cohort of 21 subjects with VSS (8 females, 33 ± 9.56 years, 14 migraines) and 21 matched controls (8 females, 33 ± 11.1 years, 14 migraines). An analysis of parameters between the four canonical microstate Classes A-D was performed.
RESULTS
VSS patients showed an overall shorter duration (p = 0.001, Cohen's d = -0.48) and lower mean amplitude (p < 0.001, Cohen's d = -0.76) of microstates compared to the controls. In addition, we found an aberrant syntax of microstate Class A (auditive and visual processing) with more (p = 0.001, Cohen's d = 0.57) transitions to Class B (visual) and less (p = 0.011, d = -0.71) to Class C (interoceptive, salience) compared to controls.
CONCLUSION
Visual snow syndrome (VSS) is a complex disorder, affecting widespread neural network activity. In VSS, electroencephalography (EEG) microstate analysis revealed unstable microstates as well as aberrant transition probabilities, indicating disturbed large-scale network activity. The analysis of microstate dynamics in VSS complements the results of imaging with high temporal resolution and could contribute to the development of future treatment approaches.
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