A PET study of photophobia during spontaneous migraine attacks

被引:129
作者
Denuelle, M. [1 ]
Boulloche, N. [1 ]
Payoux, P. [2 ]
Fabre, N. [1 ]
Trotter, Y. [3 ]
Geraud, G. [1 ]
机构
[1] CHU Rangueil, Serv Neurol & Explorat Fonct Syst Nerveux, F-31054 Toulouse, France
[2] Univ Toulouse 3, CHU Purpan, INSERM, U825, F-31062 Toulouse, France
[3] Univ Toulouse 3, Fac Med Rangueil, CNRS, Ctr Rech Cerveau & Cognit,UMR 5549, F-31062 Toulouse, France
关键词
PAIN; HEADACHE; LIGHT; HABITUATION; BRAIN; STIMULATION; PHONOPHOBIA; SENSITIVITY; POTENTIALS; ACTIVATION;
D O I
10.1212/WNL.0b013e3182074a57
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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. Neurology (R) 2011; 76:213-218
引用
收藏
页码:213 / 218
页数:6
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