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Published on: August 11, 2021
Hyperactivity of the medial thalamus in patients with photophobia-associated migraine
Yukihisa Suzuki1,2,3, Motohiro Kiyosawa4, Masato Wakakura5
1Japan Community Health Care Organization, Mishima General Hospital, Mishima, Shizuoka, Japan.
Objective:
To examine cerebral functional alterations associated with sensory processing in patients with migraine and constant photophobia.
Background:
Migraine is a common headache disorder that presents with photophobia in many patients during attacks. Furthermore, some patients with migraine experience constant photophobia, even during headache-free intervals, leading to a compromised quality of life.
Methods:
This prospective, case-control study included 40 patients with migraine (18 male and 22 female) who were recruited at an eye hospital and eye clinic. The patients were divided into two groups: migraine with photophobia group, consisting of 22 patients (10 male and 12 female) with constant photophobia, and migraine without photophobia group, consisting of 18 patients (eight male and 10 female) without constant photophobia. We used 18F-fluorodeoxyglucose and positron emission tomography to compare cerebral glucose metabolism between the two patient groups and 42 healthy participants (16 men and 26 women).
Results:
Compared with the healthy group, both the migraine with photophobia and migraine without photophobia groups showed cerebral glucose hypermetabolism in the bilateral thalamus (p < 0.05, family-wise error-corrected). Moreover, the contrast of migraine with photophobia minus migraine without photophobia patients showed glucose hypermetabolism in the bilateral medial thalamus (p < 0.05, family-wise error-corrected).
Conclusions:
The medial thalamus may be associated with the development of continuous photophobia in patients with migraine.
Insights
Migraine patients with constant photophobia show increased glucose metabolism in the medial thalamus. This finding suggests the medial thalamus plays a role in the persistent light sensitivity experienced by some migraine sufferers.
Area of Science:
- Neuroscience
- Medical Imaging
- Neurology
Background:
- Migraine is a prevalent neurological disorder characterized by severe headaches.
- Photophobia (light sensitivity) is a common symptom during migraine attacks.
- Some individuals with migraine experience persistent photophobia even between headaches, impacting their quality of life.
Purpose of the Study:
- To investigate cerebral functional differences in migraine patients with and without constant photophobia.
- To identify brain regions associated with sensory processing alterations in migraine with persistent photophobia.
Main Methods:
- A case-control study involving 40 migraine patients (22 with constant photophobia, 18 without) and 42 healthy controls.
- Utilized 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to measure cerebral glucose metabolism.
- Compared brain metabolism patterns between patient groups and healthy participants.
Main Results:
- Both migraine groups exhibited higher cerebral glucose metabolism in the bilateral thalamus compared to healthy controls.
- Patients with migraine and constant photophobia showed significantly greater glucose hypermetabolism in the bilateral medial thalamus compared to those without photophobia.
- Statistical significance was confirmed using family-wise error correction (p < 0.05).
Conclusions:
- The medial thalamus is implicated in the pathophysiology of continuous photophobia in migraine.
- Altered thalamic glucose metabolism may underlie persistent light sensitivity in migraineurs.
- Further research into thalamic function could reveal novel therapeutic targets for photophobia in migraine.
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