A PET study of photophobia during spontaneous migraine attacks.

Abstract:

BACKGROUND:Photophobia is an abnormal sensitivity to light experienced by migraineurs during attacks. The pathophysiology of photophobia is poorly understood. Nevertheless, 2 facts appear to have a link with photophobia: visual cortex hyperexcitability on the one hand and interactions between visual pathway and trigeminal nociception on the other. METHODS:We used H(2)(15)O PET to study photophobia induced by continuous luminous stimulation covering the whole visual field in 8 migraineurs during spontaneous migraine attacks, after headache relief by sumatriptan and during attack-free interval. The intensity of the luminous stimulation provoking photophobia with subsequent headache enhancement was specifically determined for each patient. RESULTS:We found that low luminous stimulation (median of 240 Cd/m(2)) activated the visual cortex during migraine attacks and after headache relief but not during the attack-free interval. The visual cortex activation was statistically stronger during migraine headache than after pain relief. CONCLUSION:These findings suggest that ictal photophobia is linked with a visual cortex hyperexcitability. The mechanism of this cortical hyperexcitability could not be explained only by trigeminal nociception because it persisted after headache relief. We hypothesize that modulation of cortical excitability during migraine attack could be under brainstem nuclei control.

journal_name

Neurology

journal_title

Neurology

authors

Denuelle M,Boulloche N,Payoux P,Fabre N,Trotter Y,Géraud G

doi

10.1212/WNL.0b013e3182074a57

subject

Has Abstract

pub_date

2011-01-18 00:00:00

pages

213-8

issue

3

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e3182074a57

journal_volume

76

pub_type

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