Visual snow syndrome as a neuropsychiatric network disorder: clinical features, mechanisms, and therapeutic perspectives

Abstract Visual Snow Syndrome (VSS) is a neurological condition characterized by the persistent perception of dynamic, flickering, dot-like visual disturbances across the entire visual field, resembling television static. Increasing evidence indicates that VSS is frequently accompanied by a broad spectrum of psychiatric symptoms, including anxiety, depression, depersonalization, fatigue, and sleep disturbances, all of which substantially impair quality of life. Although the pathogenesis of VSS remains incompletely understood, Current evidence increasingly suggests that VSS may represent a multisystem neuropsychiatric network disorder involving visual cortical hyperexcitability, thalamocortical dysrhythmia, widespread abnormalities in functional connectivity, and limbic system dysfunction. Psychiatric symptoms may partly reflect intrinsic neurobiological mechanisms of the syndrome rather than being solely secondary psychological reactions to chronic visual disturbances. Current pharmacological therapies generally show limited efficacy. Preliminary evidence suggests that non-pharmacological approaches, including neuromodulation, tinted lenses, and mindfulness-based interventions, may offer therapeutic potential with relatively favorable tolerability, although larger controlled studies are still required. Future research should adopt multidisciplinary strategies integrating neurology, psychiatry, neuroimaging, and genetics to further elucidate the mechanisms underlying VSS and facilitate the development of precision diagnostic and therapeutic approaches.