Abstract
Background:
Visual snow syndrome (VSS) is associated with functional connectivity (FC) dysregulation of visual networks (VNs). We hypothesized that mindfulness-based cognitive therapy, customized for visual symptoms (MBCT-vision), can treat VSS and modulate dysfunctional VNs.
Methods:
An open-label feasibility study for an 8-week MBCT-vision treatment program was conducted. Primary (symptom severity; impact on daily life) and secondary (WHO-5; CORE-10) outcomes at Week 9 and Week 20 were compared with baseline. Secondary MRI outcomes in a subcohort compared resting-state functional and diffusion MRI between baseline and Week 20.
Results:
Twenty-one participants (14 male participants, median 30 years, range 22–56 years) recruited from January 2020 to October 2021. Two (9.5%) dropped out. Self-rated symptom severity (0–10) improved: baseline (median [interquartile range (IQR)] 7 [6–8]) vs Week 9 (5.5 [3–7], P = 0.015) and Week 20 (4 [3–6], P < 0.001), respectively. Self-rated impact of symptoms on daily life (0–10) improved: baseline (6 [5–8]) vs Week 9 (4 [2–5], P = 0.003) and Week 20 (2 [1–3], P < 0.001), respectively. WHO-5 Wellbeing (0–100) improved: baseline (median [IQR] 52 [36–56]) vs Week 9 (median 64 [47–80], P = 0.001) and Week 20 (68 [48–76], P < 0.001), respectively. CORE-10 Distress (0–40) improved: baseline (15 [12–20]) vs Week 9 (12.5 [11–16.5], P = 0.003) and Week 20 (11 [10–14], P = 0.003), respectively. Within-subject fMRI analysis found reductions between baseline and Week 20, within VN-related FC in the i) left lateral occipital cortex (size = 82 mL, familywise error [FWE]-corrected P value = 0.006) and ii) left cerebellar lobules VIIb/VIII (size = 65 mL, FWE-corrected P value = 0.02), and increases within VN-related FC in the precuneus/posterior cingulate cortex (size = 69 mL, cluster-level FWE-corrected P value = 0.02).
Conclusions:
MBCT-vision was a feasible treatment for VSS, improved symptoms and modulated FC of VNs. This study also showed proof-of-concept for intensive mindfulness interventions in the treatment of neurological conditions.
Funder
EyeHope
Guy's and St Thomas' Charity
Visual Snow Initiative
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Neurology (clinical),Ophthalmology
Cited by
3 articles.
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