1
|
Chen S, Zhong H, Mei G. Stable abnormalities of contrast discrimination sensitivity in subthreshold depression: A longitudinal study. Psych J 2022; 11:194-204. [PMID: 35168295 DOI: 10.1002/pchj.525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 12/11/2022]
Abstract
Subthreshold depression (StD), as a subclinical state, is highly prevalent and increases the risk for developing major depressive disorder (MDD). Although several studies have reported deficits of contrast sensitivity in MDD patients, it is unclear whether individuals with StD could demonstrate deficits of contrast sensitivity and whether the deficits could remain stable over time. Here we used a contrast discrimination task (a suprathreshold task) and a contrast detection task (a near-threshold task) to compare contrast sensitivity of the StD group with that of matched non-depressed controls. For each task, a spatial four-alternative forced-choice method and a psychophysical QUEST procedure were used to measure contrast discrimination threshold or contrast detection threshold. Participants performed an initial assessment and a follow-up assessment 4 months later. Compared to the non-depressed controls, individuals with StD demonstrated reduced contrast discrimination sensitivity, not only at the initial assessment but also at the follow-up assessment, indicating a stable abnormality. Contrast discrimination thresholds at the initial assessment did not predict changes of depression symptom severity over time. For contrast detection sensitivity, there was no significant difference between the StD group and non-depressed controls. We concluded that contrast discrimination testing might provide a trait-dependent biomarker for depression.
Collapse
Affiliation(s)
- Shiyu Chen
- School of Psychology, Guizhou Normal University, Guiyang, China.,Department of Education, Guiyang Ninth High School, Guiyang, China
| | - Han Zhong
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Gaoxing Mei
- School of Psychology, Guizhou Normal University, Guiyang, China
| |
Collapse
|
2
|
Karvounides D, Marzouk M, Ross AC, VanderPluym JH, Pettet C, Ladak A, Ziplow J, Patterson Gentile C, Turner S, Anto M, Barmherzig R, Chadehumbe M, Kalkbrenner J, Malavolta CP, Clementi MA, Gerson T, Szperka CL. The intersection of COVID-19, school, and headaches: Problems and solutions. Headache 2021; 61:190-201. [PMID: 33382459 PMCID: PMC8086994 DOI: 10.1111/head.14038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/12/2020] [Accepted: 11/12/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To equip clinicians with recommendations specific to concerns related to the novel coronavirus disease 2019 (COVID-19), which impact the physical, emotional, and social health of youth with headache disorders. BACKGROUND COVID-19 has affected societies on a global scale including children and youth with chronic headache disorders. Many concerns are predicted to arise in the 2020-2021 school year, whether classes are conducted in-person or virtually. METHODS Clinical impressions were combined with a review of the literature, although limited due to the recent nature of this issue. RESULTS We describe recommendations to support caregivers and youth as they face changes expected with the return to school in the fall of 2020. CONCLUSION Although there are significant concerns for caregivers and youth with migraine given the context of changes related to the pandemic, there are many recommendations that can help minimize exacerbations of the physical, emotional, and social health of youth with chronic migraine.
Collapse
Affiliation(s)
- Dina Karvounides
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maya Marzouk
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Alexandra C Ross
- UCSF Benioff Children's Hospital, University of California, San Francisco, CA, USA
| | | | | | - Ali Ladak
- Penn Therapy & Fitness, University City, Philadelphia, PA, USA
| | - Jason Ziplow
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carlyn Patterson Gentile
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Scott Turner
- Department of Neurology, University of Alabama at Birmingham, School of Medicine, Birmingham, AL, USA
| | - Marissa Anto
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rebecca Barmherzig
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Madeline Chadehumbe
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jocelyn Kalkbrenner
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carrie P Malavolta
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michelle A Clementi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA
| | - Trevor Gerson
- Division of Child Neurology, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Christina L Szperka
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
3
|
Shepherd AJ, Patterson AJK. Exploration of anomalous perceptual experiences in migraine between attacks using the Cardiff Anomalous Perceptions Scale. Conscious Cogn 2020; 82:102945. [PMID: 32422548 DOI: 10.1016/j.concog.2020.102945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 02/04/2023]
Abstract
Distortions in sensory experiences that precede a migraine attack have been extensively documented, the most well-known being the visual aura. Distortions in the experience of other senses are also reported as part of an aura, albeit less frequently, together with changes in the perception or ownership of the body or body parts. There are many examples of differences in aspects of visual perception between migraine and control groups, between attacks, but not as much on unusual experiences involving other senses, the sense of the body or the experience of the environment. Seventy-seven migraine (33 with aura) and 74 control participants took part. Anomalous perceptions were experienced by both migraine and control groups, but more with migraine experienced them and rated them as more distressing, intrusive and frequent. Associations with reports of visual triggers of migraine and visual discomfort are presented. This study is the first to show relationships between these factors.
Collapse
Affiliation(s)
- Alex J Shepherd
- Department of Psychological Sciences, Birkbeck College, University of London, UK.
| | - Adam J K Patterson
- Department of Psychological Sciences, Birkbeck College, University of London, UK
| |
Collapse
|
4
|
Vision and Hyper-Responsiveness in Migraine. Vision (Basel) 2019; 3:vision3040062. [PMID: 31735863 PMCID: PMC6969908 DOI: 10.3390/vision3040062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 12/14/2022] Open
Abstract
: We investigated contrast processing in relation to visual comfort from coloured light in individuals with migraine. In Experiment 1, 24 individuals who experienced migraine with aura (MA), 15 migraine without aura (MO), and 23 healthy controls, identified which of four patterns, one in each quadrant, had the greatest contrast. Although there were no significant differences between groups, contrast discrimination was superior in the visual field affected by aura in all eight participants in whom the aura was consistently lateralised. In Experiment 2, 20 participants without aura and 20 controls selected comfortable light with a chromaticity close to the daylight (Planckian) locus, whilst 20 individuals with aura chose more strongly saturated colours, mostly distant from the locus. In Experiment 3, nine participants with consistently unilateral aura undertook the contrast discrimination task wearing (a) lenses that provided a comfortable colour of light and (b) grey lenses of similar transmission. With grey lenses, seven of the nine individuals with unilateral aura showed a superior performance in the affected field, as before. With lenses providing a comfortable colour, however, the performance was relatively poor for the nine individuals with unilateral aura, but not for the 10 controls. This was the case in both visual fields. The cortical hyper-responsiveness with which migraine is associated may improve the perception of contrast. The perception is poorer (and more normal) with ophthalmic lenses having a comfortable colour.
Collapse
|
5
|
Haigh SM, Chamanzar A, Grover P, Behrmann M. Cortical Hyper‐Excitability in Migraine in Response to Chromatic Patterns. Headache 2019; 59:1773-1787. [DOI: 10.1111/head.13620] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Sarah M. Haigh
- Department of Psychology, Institute for Neuroscience University of Nevada Reno NV USA
- Department of Psychology, Center for the Neural Basis of Cognition Carnegie Mellon University Pittsburgh PA USA
| | - Alireza Chamanzar
- Department of Electrical and Computer Engineering Carnegie Mellon University Pittsburgh PA USA
| | - Pulkit Grover
- Department of Electrical and Computer Engineering Carnegie Mellon University Pittsburgh PA USA
| | - Marlene Behrmann
- Department of Psychology, Center for the Neural Basis of Cognition Carnegie Mellon University Pittsburgh PA USA
| |
Collapse
|
6
|
Shepherd AJ. A Review of Motion and Orientation Processing in Migraine. Vision (Basel) 2019; 3:E12. [PMID: 31735813 PMCID: PMC6802770 DOI: 10.3390/vision3020012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/07/2019] [Indexed: 11/24/2022] Open
Abstract
Visual tests can be used as noninvasive tools to test models of the pathophysiology underlying neurological conditions, such as migraine. They may also be used to track changes in performance that vary with the migraine cycle or can track the efficacy of prophylactic treatments. This article reviews the literature on performance differences on two visual tasks, global motion discrimination and orientation, which, of the many visual tasks that have been used to compare differences between migraine and control groups, have yielded the most consistent patterns of group differences. The implications for understanding the underlying pathophysiology in migraine are discussed, but the main focus is on bringing together disparate areas of research and suggesting those that can reveal practical uses of visual tests to treat and manage migraine.
Collapse
Affiliation(s)
- Alex J Shepherd
- Department of Psychological Sciences, Birkbeck, University of London, Malet St, London WC1E 7HX, UK
| |
Collapse
|
7
|
Anagnostou E, Gerakoulis S, Voskou P, Kararizou E. Postural instability during attacks of migraine without aura. Eur J Neurol 2018; 26:319-e21. [PMID: 30295375 DOI: 10.1111/ene.13815] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 10/03/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Migraine has long been associated with unsteadiness and dizziness but postural control has not been studied in the ictal state. Here, the stability of upright stance during migraine attacks was measured. METHODS Static balance was assessed prospectively in migraine patients (n = 30) during quiet stance for 40 s on a posturographic force platform. Recordings were performed both ictally and in the pain-free interval. Subjects were assessed under four different conditions yielding different visual and proprioceptive feedback environments. Both ictal and interictal data were compared with age-matched healthy controls (n = 30). RESULTS Postural instability increased significantly under all experimental conditions during migraine attacks. Whilst standing on a foam pad with eyes closed, median sway area was 353 mm2 in control subjects, 318 mm2 in migraineurs in the pain-free period and 618 mm2 in the ictal state. However, Romberg and vestibular Romberg quotients were not altered during migraine attacks. Spectral analyses of postural sway also showed similar profiles in migraineurs and controls. The severity of headache was inversely correlated to Romberg quotients. CONCLUSIONS The demonstrated pattern of balance disorder during migraine attacks suggests a transient cerebellar dysfunction. Our findings also indicate that intense headache induces a re-weighting of sensory processing toward less dependence on visual and proprioceptive information.
Collapse
Affiliation(s)
- E Anagnostou
- Department of Neurology, Eginition Hospital, University of Athens, Athens, Greece
| | - S Gerakoulis
- Department of Neurology, Eginition Hospital, University of Athens, Athens, Greece
| | - P Voskou
- Department of Neurology, Eginition Hospital, University of Athens, Athens, Greece
| | - E Kararizou
- Department of Neurology, Eginition Hospital, University of Athens, Athens, Greece
| |
Collapse
|
8
|
|
9
|
O'Hare L. Temporal Integration of Motion Streaks in Migraine. Vision (Basel) 2018; 2:E27. [PMID: 31735890 PMCID: PMC6836222 DOI: 10.3390/vision2030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 11/16/2022] Open
Abstract
Migraine is associated with differences in visual perception, specifically, deficits in the perception of motion. Migraine groups commonly show poorer performance (higher thresholds) on global motion tasks compared to control groups. Successful performance on a global motion task depends on several factors, including integrating signals over time. A "motion streak" task was used to investigate specifically integration over time in migraine and control groups. The motion streak effect depends on the integration of a moving point over time to create the illusion of a line, or "streak". There was evidence of a slower optimum speed for eliciting the motion streak effect in migraine compared to control groups, suggesting temporal integration is different in migraine. In addition, performance on the motion streak task showed a relationship with headache frequency.
Collapse
Affiliation(s)
- Louise O'Hare
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
| |
Collapse
|
10
|
Abstract
Background Migraine is a common neurological condition that often involves differences in visual processing. These sensory processing differences provide important information about the underlying causes of the condition, and for the development of treatments. Review of psychophysical literature Psychophysical experiments have shown consistent impairments in contrast sensitivity, orientation acuity, and the perception of global form and motion. They have also established that the addition of task-irrelevant visual noise has a greater effect, and that surround suppression, masking and adaptation are all stronger in migraine. Theoretical signal processing model We propose utilising an established model of visual processing, based on signal processing theory, to account for the behavioural differences seen in migraine. This has the advantage of precision and clarity, and generating clear, falsifiable predictions. Conclusion Increased effects of noise and differences in excitation and inhibition can account for the differences in migraine visual perception. Consolidating existing research and creating a unified, defined theoretical account is needed to better understand the disorder.
Collapse
Affiliation(s)
- Louise O'Hare
- School of Psychology, College of Social Science, University of Lincoln, UK
| | - Paul B Hibbard
- Department of Psychology, University of Essex, UK
- School of Psychology and Neuroscience, University of St Andrews, UK
| |
Collapse
|
11
|
Shepherd AJ, Joly-Mascheroni RM. Visual motion processing in migraine: Enhanced motion after-effects are related to display contrast, visual symptoms, visual triggers and attack frequency. Cephalalgia 2016; 37:315-326. [PMID: 27106927 DOI: 10.1177/0333102416640519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Visual after-effects are illusions that occur after prolonged viewing of visual displays. The motion after-effect (MAE), for example, is an illusory impression of motion after viewing moving displays: subsequently, stationary displays appear to drift in the opposite direction. After-effects have been used extensively in basic vision research and in clinical settings, and are enhanced in migraine. Objective The objective of this article is to assess associations between ( 1 ) MAE duration and visual symptoms experienced during/between migraine/headache attacks, and ( 2 ) visual stimuli reported as migraine/headache triggers. Methods The MAE was elicited after viewing motion for 45 seconds. MAE duration was tested for three test contrast displays (high, medium, low). Participants also completed a headache questionnaire that included migraine/headache triggers. Results For each test contrast, the MAE was prolonged in migraine. MAE duration was associated with photophobia; visual triggers (flicker, striped patterns); and migraine or headache frequency. Conclusions Group differences on various visual tasks have been attributed to abnormal cortical processing in migraine, such as hyperexcitability, heightened responsiveness and/or a lack of intra-cortical inhibition. The results are not consistent with hyperexcitability simply from a general lack of inhibition. Alternative multi-stage models are discussed and suggestions for further research are recommended, including visual tests in clinical assessments/clinical trials.
Collapse
Affiliation(s)
- Alex J Shepherd
- 1 Department of Psychological Sciences, Birkbeck, University of London, UK
| | - Ramiro M Joly-Mascheroni
- 1 Department of Psychological Sciences, Birkbeck, University of London, UK.,2 Department of Psychology, City University, London, UK
| |
Collapse
|
12
|
Nguyen BN, Lek JJ, Vingrys AJ, McKendrick AM. Clinical impact of migraine for the management of glaucoma patients. Prog Retin Eye Res 2015; 51:107-24. [PMID: 26232725 DOI: 10.1016/j.preteyeres.2015.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 12/19/2022]
Abstract
Migraine is a common and debilitating primary headache disorder that affects 10-15% of the general population, particularly people of working age. Migraine is relevant to providers of clinical eye-care because migraine attacks are associated with a range of visual sensory symptoms, and because of growing evidence that the results of standard tests of visual function necessary for the diagnosis and monitoring of glaucoma (visual fields, electrophysiology, ocular imaging) can be abnormal due to migraine. These abnormalities are measureable in-between migraine events (the interictal period), despite patients being asymptomatic and otherwise healthy. This picture is further complicated by epidemiological data that suggests an increased prevalence of migraine in patients with glaucoma, particularly in patients with normal tension glaucoma. We discuss how migraine, as a co-morbidity, can confound the results and interpretation of clinical tests that form part of contemporary glaucoma evaluation, and provide practical evidence-based recommendations for the clinical testing and management of patients with migraine who attend eye-care settings.
Collapse
Affiliation(s)
- Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia.
| | - Jia Jia Lek
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison M McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
13
|
Nguyen BN, McKendrick AM, Vingrys AJ. Abnormal inhibition-excitation imbalance in migraine. Cephalalgia 2015; 36:5-14. [DOI: 10.1177/0333102415576725] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/02/2015] [Indexed: 12/17/2022]
Abstract
Background People with migraine show increased surround suppression of perceived contrast, a perceptual analogue of centre-surround antagonistic interactions in visual cortex. A proposed mechanism is that cortical ‘hyperexcitability’ or ‘hyperresponsivity’, a prominent theory in the migraine literature, drives abnormal excitatory-inhibitory balance to give increased local inhibition. The purpose of this cross-sectional study was to determine whether cortical hyperresponsivity and excitatory-inhibitory imbalance manifests in the visual cortical response of migraine sufferers. Methods Interictal steady-state visual evoked potentials (VEPs) in response to 0 to 97% contrast were recorded in 30 migraine participants (15 without aura, 15 with aura) and 21 non-headache controls. Monotonicity indices were calculated to determine response saturation or supersaturation. Contrast gain was modelled with a modified saturating hyperbolic function to allow for variation in excitation and inhibition. Results A greater proportion of migraine participants (43%) than controls (14%) exhibited significant VEP supersaturation at high contrast, based on monotonicity index (chi-square, p = 0.028). Supersaturation was also evident by the trend for greater suppressive exponent values in migraine compared to control individuals (Mann-Whitney rank sum, p = 0.075). Conclusions Supersaturation in migraine is consistent with excess excitation (hyperresponsivity) driving increased network inhibition and provides support for excitatory-inhibitory imbalance as a pathophysiological disturbance in migraine.
Collapse
Affiliation(s)
- Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison M McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
14
|
Nguyen RH, Ford S, Calhoun AH, Holden JK, Gracely RH, Tommerdahl M. Neurosensory assessments of migraine. Brain Res 2013; 1498:50-8. [PMID: 23298830 DOI: 10.1016/j.brainres.2012.12.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 12/17/2012] [Accepted: 12/29/2012] [Indexed: 11/26/2022]
Abstract
Headache medicine is primarily dependent on patients' subjective reports of pain, which are assessed at diagnosis and throughout the duration of treatment. There is a need for an objective, quantitative biological measurement of headache pain severity. In this study, quantitative sensory testing (QST) was conducted via multi-site vibrotactile stimulation in patients with migraine. The purpose was to investigate the sensitivity of the method and to determine if the metrics obtained from migraineurs could be differentiated from controls. Metrics reflecting sensory percepts of baseline measures of stimulus amplitude discrimination, temporal order judgment, and duration discrimination were significantly different. Additional measures previously demonstrated to be sensitive to alterations in centrally-mediated information processing features such as adaptation and synchronization were also significantly different from control values. In contrast, reaction times and vibrotactile detection thresholds of migraineurs failed to differentiate them from controls, indicating that the results are not due to peripheral neuropathy or some other primary afferent mechanism. The long-term objective of the study is to develop methods that can improve diagnosis and enable more accurate assessments of treatment efficacy in migraine.
Collapse
Affiliation(s)
- R H Nguyen
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, USA
| | - S Ford
- Carolina Headache Institute, USA
| | | | - J K Holden
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, USA
| | - R H Gracely
- School of Dentistry, University of North Carolina at Chapel Hill, USA
| | - M Tommerdahl
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, USA.
| |
Collapse
|
15
|
Thabet M, Wilkinson F, Wilson HR, Karanovic O. The locus of flicker adaptation in the migraine visual system: a dichoptic study. Cephalalgia 2012; 33:5-19. [PMID: 23147164 DOI: 10.1177/0333102412462640] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Flickering light has been shown to sensitize the migraine visual system at high stimulus contrast while elevating thresholds at low contrast. The present study employs a dichoptic psychophysical paradigm to ask whether the abnormal adaptation to flicker in migraine occurs before or after the binocular combination of inputs from the two eyes in the visual cortex. METHODS Following adaptation to high contrast flicker presented to one eye only, flicker contrast increment thresholds were measured in each eye separately using dichoptic viewing. RESULTS Modest interocular transfer of adaptation was seen in both migraine and control groups at low contrast. Sensitization at high contrast in migraine relative to control participants was seen in the adapted eye only, and an unanticipated threshold elevation occurred in the non-adapted eye. Migraineurs also showed significantly lower aversion thresholds to full field flicker than control participants, but aversion scores and increment thresholds were not correlated. CONCLUSIONS The results are simulated with a three-stage neural model of adaptation that points to strong adaptation at monocular sites prior to binocular combination, and weaker adaptation at the level of cortical binocular neurons. The sensitization at high contrast in migraine is proposed to result from stronger adaptation of inhibitory neurons, which act as a monocular normalization pool.
Collapse
|
16
|
Nguyen BN, McKendrick AM, Vingrys AJ. Simultaneous retinal and cortical visually evoked electrophysiological responses in between migraine attacks. Cephalalgia 2012; 32:896-907. [PMID: 22800915 DOI: 10.1177/0333102412453953] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE People with migraine often report aversion to flickering lights and show abnormal results on behavioural tasks that require the processing of temporal visual information. Studies have reported that the cortically evoked electrophysiological response to a flickering visual stimulus is abnormal; however, none have considered whether there is an underlying pre-cortical abnormality. In this cross-sectional study, we consider whether people with migraine have retinal and cortical electrophysiological abnormalities to flickering stimuli. METHODS Monocular transient (1 Hz) and steady-state (8.3 Hz) pattern reversal electroretinograms (PERGs) and pattern visual evoked responses (PVERs) were measured simultaneously in 45 people with migraine (26 without aura, 19 with aura) and 30 non-headache controls at a time between migraine attacks. RESULTS PERG amplitude and timing did not differ significantly between groups. Transient PVER amplitude was significantly reduced (28%) in the migraine with aura group compared to the controls F(2,72) = 3.6, p = 0.03). Both migraine groups showed significant reductions (32%, 39%) in steady-state PVER amplitude relative to controls (F(2,70) = 4.3, p = 0.02). CONCLUSIONS This study finds normal retinal processing of flickering stimuli in the presence of abnormal cortical function between migraine attacks.
Collapse
Affiliation(s)
- Bao N Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Australia
| | | | | |
Collapse
|
17
|
Shepherd AJ, Beaumont HM, Hine TJ. Motion processing deficits in migraine are related to contrast sensitivity. Cephalalgia 2012; 32:554-70. [DOI: 10.1177/0333102412445222] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: There are conflicting reports concerning the ability of people with migraine to detect and discriminate visual motion. Previous studies used different displays and none adequately assessed other parameters that could affect performance, such as those that could indicate precortical dysfunction. Methods: Motion-direction detection, discrimination and relative motion thresholds were compared from participants with and without migraine. Potentially relevant visual covariates were included (contrast sensitivity; acuity; stereopsis; visual discomfort, stress, triggers; dyslexia). Results: For each task, migraine participants were less accurate than a control group and had impaired contrast sensitivity, greater visual discomfort, visual stress and visual triggers. Only contrast sensitivity correlated with performance on each motion task; it also mediated performance. Conclusions: Impaired performance on certain motion tasks can be attributed to impaired contrast sensitivity early in the visual system rather than a deficit in cortical motion processing per se. There were, however, additional differences for global and relative motion thresholds embedded in noise, suggesting changes in extrastriate cortex in migraine. Tasks to study the effects of noise on performance at different levels of the visual system and across modalities are recommended. A battery of standard visual tests should be included in any future work on the visual system and migraine.
Collapse
|
18
|
Abstract
Photophobia is a common yet debilitating symptom seen in many ophthalmic and neurologic disorders. Despite its prevalence, it is poorly understood and difficult to treat. However, the past few years have seen significant advances in our understanding of this symptom. We review the clinical characteristics and disorders associated with photophobia, discuss the anatomy and physiology of this phenomenon, and conclude with a practical approach to diagnosis and treatment.
Collapse
Affiliation(s)
- Kathleen B Digre
- Department of Ophthalmology, University of Utah, Salt Lake City, UT 84108, USA.
| | | |
Collapse
|