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

偏头痛期间的畏光：对光的感觉、自主和情绪反应

• 批准号: 8343319
• 负责人: Rami Burstein
• 金额: $ 43.5万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8343319
• 关键词: Affective; Animal Experimentation; Animals; Anxiety; Applications Grants; Area; Attention; Brain; Brain Stem; Brain region; Cell Nucleus; Cephalic; Clinical; Clinical Research; Color; Color blindness; Control Groups; Crying; Data Analyses; Degenerative Disorder; Development; Diagnosis; Dizziness; Documentation; Dura Mater; Educational process of instructing; Electroretinography; Emotional; Emotions; Environment; Exposure to; FDA approved; Functional disorder; Future; Goals; Head; Headache; Hearing; Human; Hypothalamic structure; Individual; Light; Mediating; Medicine; Migraine; Molecular; Myalgia; Nausea; Nervous System Physiology; Neural Pathways; Neurologic; Neurons; Neurosciences; Neurosecretory Systems; Night Blindness; Nociception; Optic Nerve; Pain; Pain-Free; Panic; Pathway interactions; Patients; Perception; Photophobia; Physiological; Play; Psychophysiology; Reaction; Research; Retina; Retinal Cone; Retinal Degeneration; Retinitis Pigmentosa; Role; Sensory; Signal Transduction; Site; Spinal Cord; Structure of trigeminal nerve spinal tract nucleus; Sweat; Sweating; Symptoms; Techniques; Testing; Vertebrate Photoreceptors; Visual evoked cortical potential; Visual impairment; base; blind; emotional reaction; human study; human subject; insight; migration; neuromechanism; novel; novel strategies; novel therapeutics; prevent; response; retinal rods; transmission process

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. PUBLIC HEALTH RELEVANCE: Photophobia often renders migraineurs dysfunctional as they are force to seek dark environment. The proposed research holds the key to the development of novel therapeutic strategies for preventing photophobia during migraine. The findings are also likely to advance our understanding of photophobia in individuals diagnosed with different types of retinal degenerative diseases, thus leading us a step closer to alleviating it.

描述（由申请人提供）：本申请的主要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所的神经机制，以逃避他们所描述的“当我暴露在外时，我的头更疼，感觉更糟”来点亮”。长期目标是确定光对偏头痛期间感觉、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）。在提出这项拨款提案之前，我们经过多年倾听患者的证词，这告诉我们，接触不同的 与盲人和色盲偏头痛患者相比，不同类型的光会引发视力正常的偏头痛患者不同的症状。根据我们所听到的情况，我们推测光引起的头痛加剧是偏头痛患者在偏头痛期间寻求黑暗的众多原因之一，并且不同颜色的光有能力引发不同的神经症状。从机制上讲，我们假设在偏头痛期间，大脑区域中介导对疼痛的感觉、情绪和自主反应不同方面的神经元的活动受到头痛和光通过从三叉神经脊核和视神经传输到它们的信号的调节。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）和对照组将在无痛且感觉良好时接受不同强度的白光、蓝光、绿光、黄光和红光（通过 FDA 批准的光刺激器发出）。在攻击期间。数据分析和解释将包括视网膜电图和视觉诱发电位信号（波形）的强度以及感觉、情感和生理变化的记录。在动物研究中，我们将确定在患者因光而改变的神经系统症状中起作用的神经元是否接收到来自相关视网膜和大脑区域的直接输入 偏头痛的传播。这些研究将把人类受试者的心理物理学观察与动物的纤维追踪、免疫组织化学、分子和生理技术结合起来。 公众健康相关性：畏光常常导致偏头痛患者功能失调，因为他们被迫寻求黑暗环境。 这项研究是开发预防偏头痛期间畏光的新型治疗策略的关键。 这些发现也可能增进我们对被诊断患有不同类型视网膜退行性疾病的个体的畏光症的理解，从而使我们更接近缓解它。