Phonophobia and brainstem excitability in migraine.

Area of Science:

• Neuroscience
• Audiology
• Migraine Research

Background:

• Phonophobia, a common migraine symptom, is hypothesized to stem from reduced hearing thresholds and heightened brainstem neuronal excitability.
• Understanding these auditory processing differences is crucial for managing migraine-related sensory sensitivities.

Purpose of the Study:

• To investigate the correlation between phonophobia in migraineurs and their hearing threshold (HT), brainstem auditory evoked potential (BAEP) findings, and auditory triggers.
• To explore the relationship between HT, BAEP characteristics, and clinical features like headache frequency and trigger types.

Main Methods:

• Sixty-one migraineurs and 101 controls underwent hearing threshold measurements.
• Brainstem auditory evoked potential (BAEP) studies were performed on 59 migraineurs and 31 controls, measuring wave amplitudes.
• Clinical data, including migraine triggers and headache frequency, were collected.

Main Results:

• Migraineurs exhibited significantly lower hearing thresholds compared to controls (p < 0.001), particularly those with chronic migraine.
• Hearing threshold was correlated with headache frequency and auditory, visual, and tactile triggers (p < 0.05).
• Higher amplitudes of BAEP waves II, III, and IV were observed in migraineurs, with waves II and III correlating with HT (p < 0.05).

Conclusions:

• Migraineurs demonstrate a lower hearing threshold, especially in chronic cases and those experiencing multiple sensory triggers.
• Elevated BAEP wave amplitudes in migraineurs, linked to headache frequency and HT, suggest sensitization of brainstem auditory neurons.
• These findings support the role of altered auditory processing and brainstem excitability in the pathophysiology of phonophobia in migraine.