Based on: “Migraine with and without aura—two distinct entities? A narrative review” by Grodzka et al., on behalf of the European Headache Federation School of Advanced Studies (EHF-SAS), The Journal of Headache and Pain
In the recent narrative review by Grodzka et al., published in The Journal of Headache and Pain, researchers explored whether migraine with aura (MA) and migraine without aura (MO) are truly distinct conditions. This comprehensive analysis compared the two migraine types across neurobiological, genetic, and clinical dimensions, offering insights into their overlapping and diverging mechanisms.
A particularly relevant aspect of this study for the Visual Snow Syndrome (VSS) community is its inclusion of VSS in the broader migraine discussion. The authors noted that VSS has garnered increasing attention in migraine research due to its high prevalence in individuals with migraine, especially those with MA. Notably, neuroimaging and neurotransmitter connectivity studies supported by the Visual Snow Initiative revealed that although serotonergic system changes in VSS were independent of migraine, the patterns closely mirrored those seen in patients with MA. This finding suggests that VSS and MA may share a common pathophysiological basis, particularly at the level of brain network connectivity.
The review also emphasized how MA and MO differ not only quantitatively but qualitatively—with unique features that cannot be fully explained by diagnostic or methodological differences alone. Recognizing these distinctions is essential, as it influences both diagnosis and treatment strategies. For VSS, which is often misdiagnosed or misunderstood, these insights could lead to more refined diagnostic frameworks and potentially better tailored therapeutic approaches, especially for individuals presenting with both visual aura-like symptoms and migraine.
In summary, this research strengthens the emerging view that VSS may align more closely with MA than MO, further validating its inclusion in migraine-related investigations. Understanding these relationships is vital for identifying shared mechanisms, guiding future treatment development, and improving outcomes for those living with VSS.