Lack of a direct link between macular cones function and photophobia in interictal migraine

Cephalalgia. 2024 Sep;44(9):3331024241276501. doi: 10.1177/03331024241276501.

Abstract

Background: It is still debatable whether the mechanisms underlying photophobia are related to altered visual cortex excitability or specific abnormalities of colour-related focal macular retino-thalamic information processing.

Methods: This cross-sectional study examined Ganzfeld blue-red (B-R) and blue-yellow (B-Y) focal macular cone flash ERG (ffERG) and focal-flash visual evoked potentials (ffVEPs) simultaneously in a group of migraine patients with (n = 18) and without (n = 19) aura during the interictal phase, in comparison to a group of healthy volunteers (HVs) (n = 20). We correlate the resulting retinal and cortical electrophysiological responses with subjective discomfort from exposure to bright light verified on a numerical scale.

Results: Compared to HVs, the amplitude and phase of the first and second harmonic of ffERG and ffVEPs were non-significantly different in migraine patients without aura and migraine patients with aura for both the B-R and the B-Y focal stimuli. Pearson's correlation test did not disclose correlations between clinical variables, including the photophobia scale and electrophysiological variables.

Conclusions: These results do not favour interictal functional abnormalities in L-M- and S-cone opponent visual pathways in patients with migraine. They also suggest that the discomfort resulting from exposure to bright light is not related to focal macular retinal-to-visual cortex pathway.

Keywords: ERG; VEP; aura; colour; photophobia; retina.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Electroretinography*
  • Evoked Potentials, Visual* / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders* / physiopathology
  • Photic Stimulation / methods
  • Photophobia* / physiopathology
  • Retinal Cone Photoreceptor Cells* / physiology
  • Young Adult