Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
Pain. 2018 Oct;159(10):2030-2034. doi: 10.1097/j.pain.0000000000001303.
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.
对光的厌恶在偏头痛发作期间很常见。我们在发作性偏头痛患者中使用心理物理评估报告称,与绿光相比,白光、蓝光、琥珀光和红光会使更大比例的患者偏头痛头痛加重,且程度更严重。本研究旨在确定这些发现是与相位相关的,即仅在偏头痛发作期间(发作期)表现出来,而不在其缺失期间(间歇期)表现出来,或者与状态相关,即仅在偏头痛患者中表现出来,而不在健康对照者中表现出来。为了确定偏头痛型畏光的颜色偏好是与相位相关还是与状态相关,我们比较了偏头痛患者在发作期和间歇期之间,以及健康对照组在每个强度下每种颜色光的影响。在发作期和间歇期,当暴露于不同颜色的光时,报告头痛严重程度变化的偏头痛患者的比例随着光强度的升高而增加。在发作期,约 80%的患者报告暴露于白光、蓝光、琥珀光和红光会加重头痛;然而,在间歇期,只有 16%至 19%的光会引发头痛。值得注意的是,在发作期和间歇期,绿光分别使 40%和 3%的患者头痛加重,并引发头痛。除了一个例外(红光最高强度),没有对照受试者报告对光刺激有头痛反应。这些发现表明,颜色偏好是偏头痛患者特有的,因为在对照组中没有发现,并且与患者处于发作期还是间歇期无关。