Format

Send to

Choose Destination
Brain. 2016 Jul;139(Pt 7):1971-86. doi: 10.1093/brain/aww119. Epub 2016 May 17.

Migraine photophobia originating in cone-driven retinal pathways.

Author information

1
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA Harvard Medical School, Boston, MA 02115, USA.
2
Department of Neurology, Rambam Health Care Campus, and Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel, 31096.
3
Harvard Catalyst Clinical Research Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
4
Harvard Medical School, Boston, MA 02115, USA Department of Ophthalmology, Children's Hospital Boston, Boston MA 02115, USA.
5
Harvard Medical School, Boston, MA 02115, USA Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
6
Harvard Medical School, Boston, MA 02115, USA Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
7
Harvard Medical School, Boston, MA 02115, USA Department of Neuro-ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
8
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA.
9
Harvard Medical School, Boston, MA 02115, USA Center for Pain and the Brain, Department of Anesthesia Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
10
Diagnosys LLC, Lowell, MA 01854, USA.
11
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA Harvard Medical School, Boston, MA 02115, USA rburstei@bidmc.harvard.edu.

Abstract

Migraine headache is uniquely exacerbated by light. Using psychophysical assessments in patients with normal eyesight we found that green light exacerbates migraine headache significantly less than white, blue, amber or red lights. To delineate mechanisms, we used electroretinography and visual evoked potential recording in patients, and multi-unit recording of dura- and light-sensitive thalamic neurons in rats to show that green activates cone-driven retinal pathways to a lesser extent than white, blue and red; that thalamic neurons are most responsive to blue and least responsive to green; and that cortical responses to green are significantly smaller than those generated by blue, amber and red lights. These findings suggest that patients' experience with colour and migraine photophobia could originate in cone-driven retinal pathways, fine-tuned in relay thalamic neurons outside the main visual pathway, and preserved by the cortex. Additionally, the findings provide substrate for the soothing effects of green light.

KEYWORDS:

electroretinography; headache; pain; thalamus; visual evoked potential

PMID:
27190022
PMCID:
PMC4939697
DOI:
10.1093/brain/aww119
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center