Photophobia during migraine: sensory, autonomic and emotional responses to light

描述(申请人提供)：这项申请的广泛目标是确定导致偏头痛患者在发作期间在黑暗中寻求庇护的神经机制，以努力逃避他们所说的“我的头更疼，当我暴露在阳光下时我感觉更糟”。长期目标是确定偏头痛期间光对感觉、情感和自主神经功能的影响(人类研究)，并发现光改变这些功能的神经通路(动物研究)。导致这项拨款提案的是多年来听取患者证词的经验，这告诉我们，接触不同的 与失明和色盲偏头痛相比，视力正常的偏头痛患者会出现不同的症状。根据我们所听到的，我们推测，光加剧头痛是偏头痛在偏头痛期间寻求黑暗的众多原因之一，不同颜色的光有能力触发不同的神经症状。从机制上讲，我们假设在偏头痛期间，负责调节感觉、情绪和自主神经对疼痛反应的不同方面的大脑区域的神经元活动，是通过三叉神经脊束核和视神经传递给它们的信号而受到头痛和光的调节的。在临床研究中，我们将确定不同颜色的光对偏头痛强度及其许多相关症状的影响。两组偏头痛患者(视力正常和视力受损)和一组对照组在无疼痛和发作期间将被暴露于不同强度的白、蓝、绿、黄和红光(通过FDA批准的光刺激器提供)。数据分析和解释将包括视网膜电信号和视觉诱发电位信号(波形)的强度以及对感觉、情感和生理变化的记录。在动物研究中，我们将确定在患者的神经症状中发挥作用的神经元是否从涉及的视网膜和大脑区域获得直接输入 在偏头痛的传播过程中。这些研究将结合人类受试者的心理物理观察与动物的轨迹追踪、免疫组织化学、分子和生理技术。

DESCRIPTION (provided by applicant): The broad objective of this application is to identify neural mechanisms that cause migraineurs to seek sanctuary in the dark during attacks in effort to escape what they describe as "my head hurts more and I feel worse when I am exposed to light". The long-term objectives are to identify the impact of light on sensory, affective and autonomic neurological functions during migraine (human study), and discover the neural pathways through which lights alter these functions (animal study). Leading up to this grant proposal are years of listening to patients' testimonies which taught us that exposure to different kind of lights can trigger different symptoms in migraineurs with normal eyesight as compared to blind and color-blind migraineurs. Based on what we heard, we postulated that exacerbation of headache by light is one of many reasons why migraineus seek the dark during migraine and that different colors of lights have the capacity to trigger different neurological symptoms. Mechanistically, we hypothesized that during migraine, activity of neurons in brain regions that mediate different aspects of sensory, emotional, and autonomic responses to pain is modulated by both headache and light through signals transmitted to them from the spinal trigeminal nucleus and the optic nerve. In the clinical study, we will determine the effects of different colos of light on the intensity of migraine headache and its many associated symptoms. Two groups of migraineurs (normal eyesight and visually-impaired) and a control group will be expose to different intensities of white, blue, green, yellow and red lights (delivered through an FDA-approved photic stimulator) when they are pain-free and during an attack. Data analysis and interpretation will include strength of electroretinography and visual evoked potential signals (waveforms) as well as documentation of sensory, affective and physiological changes. In the animal study, we will determine whether neurons that play a role in the neurological symptoms that are altered by light in patients receive direct input from the retina and brain areas involved in the transmission of migraine headache. These studies will combine psychophysical observations in human subjects with tract-tracing, immunohistochemical, molecular and physiological techniques in animals.