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Color-selective photophobia in ictal vs interictal migraineurs and in healthy controls

Nir, Rony-Reuvena,b; Lee, Alice J.c; Huntington, Shaelahc; Noseda, Rodrigoa,b; Bernstein, Carolyn A.b,d; Fulton, Anne B.b,e; Bertisch, Suzanne M.b,f; Hovaguimian, Alexandrab,g; Buettner, Catherineb,h; Borsook, Davidb,i; Burstein, Ramia,b,*

doi: 10.1097/j.pain.0000000000001303
Research Paper

Aversion to light is common among migraineurs undergoing acute attacks. Using psychophysical assessments in patients with episodic migraine, we reported that white, blue, amber, and red lights exacerbate migraine headache in a significantly larger percentage of patients and to a greater extent compared with green light. This study aimed at determining whether these findings are phase-dependent–namely, manifested exclusively during migraine (ictally) but not in its absence (interictally), or condition-dependent—ie, expressed uniquely in migraineurs but not in healthy controls. To determine whether the color preference of migraine-type photophobia is phase- or condition-dependent, we compared the effects of each color of light in each intensity between migraineurs during and in-between attacks and healthy controls. During the ictal and interictal phases, the proportion of migraineurs reporting changes in headache severity when exposed to the different colors of light increased in accordance with elevated light intensities. During the ictal phase, white, blue, amber, and red lights exacerbated headaches in ∼80% of the patients; however, during the interictal phase, light initiated headache in only 16% to 19%. Notably, green light exacerbated headaches in 40% and triggered headaches in 3% of the patients studied during the ictal and interictal phases, respectively. With one exception (highest red light intensity), no control subject reported headache in response to the light stimuli. These findings suggest that color preference is unique to migraineurs—as it was not found in control subjects—and that it is independent of whether or not the patients are in their ictal or interictal phase.

Migraineurs prefer green light because it hurts them less than other colors during migraine and is less likely to trigger a headache in between attacks.

aDepartment of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States

bHarvard Medical School, Boston, MA, United States

cHarvard Catalyst Clinical Research Center, Beth Israel Deaconess Medical Center, Boston, MA, United States

dDepartment of Neurology, Brigham and Women's Faulkner Hospital, Boston, MA, United States

eDepartment of Ophthalmology, Children's Hospital Boston, Boston, MA, United States

Departments of f Medicine and

gNeurology, Beth Israel Deaconess Medical Center, Boston, MA, United States

hDepartment of Medicine, Mount Auburn Hospital, Cambridge, MA, United States

iDepartment of Anesthesia, Center for Pain and the Brain, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States

Corresponding author. Address: Center for Life Sciences (CLS), Room 649, 3 Blackfan Circle st., Boston, MA, 02215. Tel.: 617 735-2832; fax: 617 735-2833. E-mail address: (R. Burstein).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received March 06, 2018

Received in revised form May 22, 2018

Accepted May 29, 2018

© 2018 International Association for the Study of Pain
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