Ictal and interictal phonophobia in migraine-a quantitative controlled study

Area of Science:

• Neurology
• Otolaryngology
• Pain Medicine

Background:

• Phonophobia is a common symptom in migraine, but its quantitative evaluation during different phases of the condition is not well-established.
• Understanding sound aversion thresholds (SATs) can provide objective measures of phonophobia in episodic migraine (EM).

Purpose of the Study:

• To quantitatively assess and compare ictal (during attack) and interictal (between attacks) phonophobia in patients with episodic migraine (EM).
• To compare sound aversion thresholds (SATs) in EM patients with those in healthy controls.

Main Methods:

• The study included 60 individuals with EM and 52 age- and gender-matched controls.
• Sound stimuli (pure tones at 1000, 4000, 8000 Hz) were used to determine sound aversion thresholds (SATs), the intensity at which sound becomes unpleasant or painful.
• SATs were measured in EM patients both between and during migraine attacks, and compared to controls.

Main Results:

• Interictal SATs in EM patients were significantly lower than in controls (mean 90.4 dB vs. 105.9 dB, P < 0.0001), indicating heightened sound aversion between attacks.
• Ictal SATs in EM patients were significantly lower than their interictal SATs (mean 76.0 dB vs. 91.0 dB, P < 0.0001), demonstrating further augmentation of sound aversion during attacks.

Conclusions:

• Patients with episodic migraine (EM) exhibit significantly increased sound aversion (phonophobia) even between attacks compared to healthy individuals.
• This sound aversion is further and significantly intensified during an acute migraine attack.
• Quantitative measurement of SATs provides objective evidence of the severity of phonophobia in EM and its fluctuation with disease activity.