ArticleFrontiers in neurology2023
Neuroimaging markers of Alice in Wonderland syndrome in patients with migraine with aura.
Article in Frontiers in neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Alice in Wonderland and Ekbom Syndromes in a Bipolar I Manic Episode: A Case Report With Neuroimaging Findings.Case reports in psychiatry · 2026Article
- Exploring Alice in Wonderland syndrome in adults with persistent headache after COVID-19: a cross-sectional study in Latin America.BMC neurology · 2025Article
- Migraine with and without aura-two distinct entities? A narrative review.The journal of headache and pain · 2025Review
- Migraine with brainstem aura with abnormal EEG discharges easily misdiagnosed as epilepsy: a case series study.Therapeutic advances in neurological disorders · 2025Article
- Alice in Wonderland Syndrome (AIWS): prevalence and characteristics in adults with migraine.Journal of neurology · 2024Article
- Beyond Vertigo: Vestibular, Aural, and Perceptual Symptoms in Vestibular Migraine.Current pain and headache reports · 2024Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The Alice in Wonderland syndrome (AIWS) is a transient neurological disturbance characterized by sensory distortions most frequently associated with migraine in adults. Some lines of evidence suggest that AIWS and migraine might share common pathophysiological mechanisms, therefore we set out to investigate the common and distinct neurophysiological alterations associated with these conditions in migraineurs. Methods: We conducted a case-control study acquiring resting-state fMRI data from 12 migraine patients with AIWS, 12 patients with migraine with typical aura (MA) and 24 age-matched healthy controls (HC). We then compared the interictal thalamic seed-to-voxel and ROI-to-ROI cortico-cortical resting-state functional connectivity between the 3 groups. Results: We found a common pattern of altered thalamic connectivity in MA and AIWS, compared to HC, with more profound and diffuse alterations observed in AIWS. The ROI-to-ROI functional connectivity analysis highlighted an increased connectivity between a lateral occipital region corresponding to area V3 and the posterior part of the superior temporal sulcus (STS) in AIWS, compared to both MA and HC. Conclusion: The posterior STS is a multisensory integration area, while area V3 is considered the starting point of the cortical spreading depression (CSD), the neural correlate of migraine aura. This interictal hyperconnectivity might increase the probability of the CSD to directly diffuse to the posterior STS or deactivating it, causing the AIWS symptoms during the ictal phase. Taken together, these results suggest that AIWS in migraineurs might be a form of complex migraine aura, characterized by the involvement of associative and multisensory integration areas.
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