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
Neurologyjournal_title
Neurologyauthors
Denuelle M,Boulloche N,Payoux P,Fabre N,Trotter Y,Géraud Gdoi
10.1212/WNL.0b013e3182074a57subject
Has Abstractpub_date
2011-01-18 00:00:00pages
213-8issue
3eissn
0028-3878issn
1526-632Xpii
WNL.0b013e3182074a57journal_volume
76pub_type
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