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Investigation of structural brain changes in Charles Bonnet Syndrome

Lookup NU author(s): Dr Michael FirbankORCiD, Daniel Collerton, Dr Greg Elder, Dr Jehill Parikh, Kirsty OlsenORCiD, Julia Schumacher, Professor John-Paul TaylorORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background and Objectives: In Charles Bonnet Syndrome (CBS), visual hallucinations (VH)are experienced by people with sight loss due to eye disease or lesional damage to early visualpathways. The aim of this cross-sectional study was to investigate structural brain changesusing magnetic resonance imaging (MRI) in CBS.Methods: Sixteen CBS patients, 17 with eye disease but no VH, and 19 normally sighted peopletook part. Participants were imaged on a 3T scanner, with 1mm resolution T1 weightedstructural imaging, and diffusion tensor imaging with 64 diffusion directions.Results: The three groups were well matched for age, sex and cognitive scores (MMSE). Thetwo eye disease groups were matched on visual acuity. Compared to the sighted controls, wefound reduced grey matter in the occipital cortex in both eye disease groups. We also foundreductions of fractional anisotropy and increased diffusivity in widespread areas, includingoccipital tracts, the corpus callosum, and the anterior thalamic radiation. We did not find anysignificant differences between the eye disease participants with VH versus without VH, butdid observe a negative association between hippocampal volume and VH severity in the CBSgroup.Discussion: Our findings suggest that although there are cortical and subcortical effectsassociated with sight loss structural changes do not explain the occurrence of VHs. CBS mayrelate instead to connectivity or excitability changes in brain networks linked to vision.

Publication metadata

Author(s): Firbank MJ, daSilva Morgan K, Collerton D, Elder GJ, Parikh J, Olsen K, Schumacher J, ffytche D, Taylor JP

Publication type: Article

Publication status: Published

Journal: NeuroImage: Clinical

Year: 2022

Volume: 35

Online publication date: 11/05/2022

Acceptance date: 06/05/2022

Date deposited: 06/05/2022

ISSN (electronic): 2213-1582

Publisher: Elsevier BV


DOI: 10.1016/j.nicl.2022.103041


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Funder referenceFunder name
24TP172Fight for Sight
Esme’s Umbrella / Fight for Sight
NIHR Newcastle Biomedical Research Centre (BRC) based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University
RP-PG-0610-10100 - SHAPED
SLaM Mental Health BRC