title: Migraine photophobia originating in cone-driven retinal pathways.
abstract: Migraine headache is uniquely exacerbated by light. Using psychophysical assessments in patients with normal eyesight we found that green light exacerbates migraine headache significantly less than white, blue, amber or red lights. To delineate mechanisms, we used electroretinography and visual evoked potential recording in patients, and multi-unit recording of dura- and light-sensitive thalamic neurons in rats to show that green activates cone-driven retinal pathways to a lesser extent than white, blue and red; that thalamic neurons are most responsive to blue and least responsive to green; and that cortical responses to green are significantly smaller than those generated by blue, amber and red lights. These findings suggest that patients' experience with colour and migraine photophobia could originate in cone-driven retinal pathways, fine-tuned in relay thalamic neurons outside the main visual pathway, and preserved by the cortex. Additionally, the findings provide substrate for the soothing effects of green light.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Noseda
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Bernstein
authors.affiliation: Department of Neurology, Rambam Health Care Campus, and Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel, 31096.
authors.forename: Rony-Reuven
authors.initials: RR
authors.lastname: Nir
authors.affiliation: Harvard Catalyst Clinical Research Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Lee
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA Department of Ophthalmology, Children's Hospital Boston, Boston MA 02115, USA.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Fulton
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Bertisch
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hovaguimian
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA Department of Neuro-ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
authors.forename: Dean M
authors.initials: DM
authors.lastname: Cestari
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Saavedra-Walker
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA Center for Pain and the Brain, Department of Anesthesia Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
authors.forename: David
authors.initials: D
authors.lastname: Borsook
authors.affiliation: Diagnosys LLC, Lowell, MA 01854, USA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Doran
authors.affiliation: Harvard Medical School, Boston, MA 02115, USA Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Buettner
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston MA 02215, USA Harvard Medical School, Boston, MA 02115, USA rburstei@bidmc.harvard.edu.
authors.forename: Rami
authors.initials: R
authors.lastname: Burstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D004596:Electroretinography / Q000379:methods*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000503:physiopathology*; D009474:Neurons / Q000502:physiology*; D010775:Photic Stimulation; D020795:Photophobia / Q000209:etiology / Q000503:physiopathology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D017949:Retinal Cone Photoreceptor Cells / Q000502:physiology*; D013788:Thalamus / Q000503:physiopathology*; D014795:Visual Pathways / Q000503:physiopathology*; D055815:Young Adult
keywords: electroretinography; headache; pain; thalamus; visual evoked potential