Rodrigo Noseda1, Rami Burstein. 1. Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE OF REVIEW: Historically, photophobia was studied in patients and attempts to explain the underlying mechanisms have been speculative. Efforts to understand better the neural substrate of photophobia paved a way to the development of different animal models and the publication of several articles (all in 2010) on the mechanism by which light exacerbates migraine headache. RECENT FINDINGS: Observations made in blind migraine patients devoid of any visual perception and blind migraine patients capable of detecting light have led to the discovery of a novel retino-thalamo-cortical pathway that carries photic signal from the retina to thalamic trigeminovascular neurons believed to play a critical role in the perception of headache intensity during migraine. Evidence for modulation of the trigeminovascular pathway by light and identification of the pathway through which photic signals converge on the nociceptive pathway that mediates migraine headache provide first set of scientific data on the mechanism by which light intensifies migraine headache. SUMMARY: The findings provide a neural substrate for migraine-type photophobia. This may lead to identification and development of molecular targets for selective prevention of photophobia during migraine.
PURPOSE OF REVIEW: Historically, photophobia was studied in patients and attempts to explain the underlying mechanisms have been speculative. Efforts to understand better the neural substrate of photophobia paved a way to the development of different animal models and the publication of several articles (all in 2010) on the mechanism by which light exacerbates migraineheadache. RECENT FINDINGS: Observations made in blind migrainepatients devoid of any visual perception and blind migrainepatients capable of detecting light have led to the discovery of a novel retino-thalamo-cortical pathway that carries photic signal from the retina to thalamic trigeminovascular neurons believed to play a critical role in the perception of headache intensity during migraine. Evidence for modulation of the trigeminovascular pathway by light and identification of the pathway through which photic signals converge on the nociceptive pathway that mediates migraineheadache provide first set of scientific data on the mechanism by which light intensifies migraineheadache. SUMMARY: The findings provide a neural substrate for migraine-type photophobia. This may lead to identification and development of molecular targets for selective prevention of photophobia during migraine.
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