The Visual Snow Initiative (VSI) has donated funds to support Visual Snow Syndrome (VSS) research at King’s College London, where pioneering researchers Dr. Francesca Puledda and Dr. Peter Goadsby, alongside PhD students Viviana Santoro, Samaksh Gupta, and other members of their clinical research team, are conducting multifaceted studies into this complex neurological condition. Their work uses cutting-edge neurophysiology and neuropathology methods to investigate the brain mechanisms underlying VSS and to advance the development of targeted treatment options, including medication and measuring effects through TMS/EEG before and after. Following collaborative discussions with VSI Founder Sierra Domb, Dr. Puledda will also explore a new area of study focused on genetic links.
VSI presented a $100,000 grant to the King’s research team, honoring the organization’s founding mission to support scientific research and advance understanding of Visual Snow Syndrome for the benefit of all those affected by the condition.
VSI is confident that at King’s College London, all facets of Visual Snow Syndrome will be explored, with careful attention to case variability, diverse symptom presentations, medical histories, and patient safety, ensuring a comprehensive and individualized understanding of the condition within the research it has supported. This approach reflects the ethos established by Founder Sierra Domb and upheld by Dr. Puledda and Dr. Goadsby, who have worked closely with VSI’s global research team to ensure that Visual Snow Syndrome research remains inclusive, far-reaching, and focused on improving outcomes for all those affected by the condition. Their collaboration with researchers worldwide underscores a commitment not only to advancing scientific understanding, but also to improving the lives of people living with VSS
Thank you, with our deepest and heartfelt gratitude, to all of VSI’s supporters whose incredible generosity has made this donation and ongoing research possible.
Aims of VSI & King’s Research Projects
Some of the key aims of the King’s College London Visual Snow Syndrome research projects supported by the Visual Snow Initiative include:
1. Identifying biomarkers of Visual Snow Syndrome
A key objective is to identify biomarkers of cortical connectivity and neuronal metabolism that characterize Visual Snow Syndrome (VSS) and explain altered sensory processing.
Building on previous imaging work, this includes analyzing changes in cortical metabolism using proton spectroscopy and assessing functional responses in visual areas through functional spectroscopy. The study will be conducted before and after administration of lamotrigine to investigate the role of glutamatergic neurotransmission in visual cortex metabolic function. Together, these complementary approaches aim to provide a detailed understanding of altered sensory processing and atypical visual perception in VSS.
2. Neurophysiological signatures and comparison with migraine
This research seeks to define neurophysiological changes associated with Visual Snow Syndrome and distinguish them from migraine biology, including differences in network function.
Using advanced non-invasive techniques such as TMS/EEG, high-density EEG, and visual evoked potentials, the study will examine cortical excitability and network function. This will help establish a distinct neurophysiological “fingerprint” of Visual Snow Syndrome and clarify differences from comorbid migraine conditions.
3. Pharmacology and GABAergic mechanisms
This objective investigates the role of GABAergic neurotransmission in cortical disinhibition and symptom expression in Visual Snow Syndrome.
By administering GABAA receptor agonists and antagonist medications, researchers will assess receptor-specific effects on symptoms and clinical and neuropsychological measures. TMS/EEG recordings before and after medication administration will help identify cortical biomarkers and support longitudinal assessment of neurophysiological change.
4. Genetics of Visual Snow Syndrome
In collaboration with TwinsUK, the team is collecting epidemiological and genetic data to better understand the genetic basis of Visual Snow Syndrome.
TwinsUK, the largest adult twin registry in the world, provides extensive clinical and biological datasets. A dedicated Visual Snow Syndrome questionnaire is being integrated into the cohort, with regulatory approvals currently underway.
5. Visual paradigms and perceptual processing (VISION Study)
The VISION Study investigates sensory filtering and perceptual processing in Visual Snow Syndrome using behavioral visual paradigms.
The study also includes a synesthesia questionnaire and the use of augmented reality to simulate Visual Snow Syndrome symptoms, enabling deeper characterization of perceptual phenomena and sensory processing. Pilot testing and task optimization are currently ongoing.
Together, these aims support the broader goal of identifying the biological mechanisms behind VSS and advancing more targeted, evidence-based approaches to treatment.
Innovative, Comprehensive Research
Dr. Puledda developed the REACT approach, a novel technique that helped identify the first biomarkers for VSS. She continues to innovate by applying a variety of research methods. Unlike studies that focus on a single aspect of the condition, Dr. Puledda’s work takes a comprehensive approach, investigating the full spectrum of Visual Snow Syndrome. Her research encompasses brain network processes, hereditary factors, epidemiological data, and both noninvasive and pharmacological treatment strategies.
Exploring Additional Treatment Possibilities
Many patients have found symptom relief through noninvasive treatment options, such as Neuro-Optometric Rehabilitation Therapy (NORT) and Mindfulness-Based Cognitive Therapy (MBCT-Vision). While these approaches are valuable, they remain supportive rather than curative. The King’s research team is focused on uncovering the precise brain mechanisms that drive VSS, aiming for treatments that directly target the root of the condition.
Among their tools is 7-Tesla Magnetic Resonance Spectroscopy (7T-MRS), the most powerful MRI technology currently available for human research. This allows researchers to study visual brain networks both at rest and during stimulation. In addition, advanced neurophysiology and neuropharmacology methods are being used to measure cortical brain activity and test the effects of medications on neural signalling.
By combining these methods, the team is developing a translational model of VSS, linking clinical symptoms to their biological mechanisms. This model not only drives forward the search for treatments but also provides an unprecedented framework for understanding how the brain processes visual information in people with the condition.
Broader Insights for Neuroscience
Beyond VSS, this research has the potential to improve scientific understanding of abnormal sensory processing, with implications for a wide range of neurological and psychiatric conditions. The insights gained at King’s College London could therefore extend far beyond those directly affected by Visual Snow Syndrome, contributing to progress in neuroscience more broadly.
Engaging the Next Generation
Dr. Francesca Puledda is actively creating opportunities and opening positions for students at King’s College London to participate in VSS research, providing hands-on experience in neuroscience and clinical study. This approach aligns with VSI’s mission to support the next generation of researchers and advocates for Visual Snow Syndrome, ensuring that future scientific leaders are equipped to continue advancing understanding and care for people affected by the condition.
A Partnership from the Beginning
King’s College London has been a key collaborator since VSI’s earliest days. Founder Sierra Domb first discovered Dr. Goadsby’s research online while searching for answers to her own “unexplained” symptoms, after repeatedly being told by medical professionals that they were not real or were attributed to other causes. After years of debilitating visual symptoms and sensory disturbances, misdiagnosis, medical dismissal, and no effective symptom relief, along with prescribed interventions that caused harmful side effects, she was eventually diagnosed with Visual Snow Syndrome by Dr. Goadsby. At that point, research funding had ended, leaving scientific progress stalled and patients worldwide still without answers or hope for meaningful advances.
Motivated to change that, Sierra organized the Visual Snow Conference, which led to the creation of VSI in 2018. From its inception, VSI has maintained a close relationship with King’s, supporting their groundbreaking research into Visual Snow Syndrome. This work has included identification of biomarkers, investigating neural system involvement across the brain, and providing objective evidence of VSS as a neurological condition distinct from migraine, contributing to its official scientific recognition. Research has also examined structural and functional brain differences between individuals with VSS and those without, alongside ongoing investigations into potential causes, treatments, and more. These advances have been made possible through VSI funding and the work of the university’s researchers and advanced neuroimaging technologies.
Reflecting on VSI’s Impact
This donation embodies the mission VSI was founded upon: to support scientific discovery, raise awareness, spread education, develop resources, and contribute to meaningful progress in understanding Visual Snow Syndrome.
The organization hopes its contribution to King’s College London research will advance the study of Visual Snow Syndrome and support meaningful progress for people affected by the condition for years to come.
Thank You
VSI extends its sincere appreciation to the researchers at King’s College London for their dedication, to the patients and families whose experiences continue to inspire this work, and to all supporters whose generosity has made this donation and ongoing research possible.
Aside from Dr. Francesca Puledda, Senior Clinical Lecturer and Neurologist, and Professor Peter J. Goadsby, Professor of Neurology (bottom), the team includes (L-R, top to bottom): Matthew Hanselman, MSc Physiotherapy student; Samaksh Gupta, MSc Neuroscience student ; Alison Worth, PA to Professor Goadsby; Stefania Maniataki, Nurse Specialist; Simone Braca, Neurologist Observer; and Viviana Santoro, PhD Neuroscience student.