How Can we Treat Photophobia in Migraine

Medical University of Vienna

Status: Completed

Conditions: Photophobia; Migraine Disorders

Treatments: Behavioral: Light deprivation (Dark); Behavioral: Light exposure (Flash)

Study type: Interventional

Funder types: Other

Identifiers

NCT05369910

KLI 455

Details and patient eligibility

About

Photophobia, the aberrantly increased sensitivity to light, is a common symptom in migraine patients and light discomfort is frequently found as a trigger for migraine attacks. In behavioral studies, planned exposure to light was found to reduce headache in migraineurs with photophobia, potentially by increasing habituation to this migraine trigger. Here, neurophysiological mechanisms of light exposure versus light deprivation therapy in migraine patients are investigated using functional magnetic resonance imaging (fMRI).

Migraine patients and healthy controls receive light exposure therapy (Flash) and light deprivation therapy (Dark) for one hour daily on 7 consecutive days, in a crossover design with a wash-out period of three months. Study participants keep a diary including items on interictal and ictal photophobia, headache frequency and severity 7 days before, during, and 7 days after the interventions. One week before and one day after both interventions, fMRI using flickering light in a block design is applied. Functional activation is analyzed at whole-brain level and habituation of the visual cortex (V1) is modeled with the initial amplitude estimate and the corrected habituation slope.

Enrollment: 21 patients

Sex: All

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Patients:

• Migraine without aura according to the criteria of the International Classification of Headache Disorders (ICHD-3 beta)
• 1-4 days with migraine per month in the preceding last 3 months
• A score between 2 and 6 on a numeric rating scale for the intensity of interictal photophobia (range from 0 to 10 (= max. intensity))
• A score >4 for ictal photophobia

Controls

• No personal or family history of migraine
• A score <2 for photophobia

Exclusion criteria

• Current or previous circadian rhythm disorders
• Current or previous major depression
• Current or previous anxiety disorders
• Current or previous medication overuse
• Besides migraine in the patient group, participants should not suffer from any other recurrent headache apart from infrequent tension-type headaches

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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21 participants in 2 patient groups

Flash first

Experimental group

Description:

Light exposure (Flash) first, light deprivation (Dark) second: Both interventions (Flash and Dark) are administered for one hour on 7 consecutive days. During the light exposure, participants are seated 120 cm in front of a white curtain that is illuminated by an LED light source. During the light deprivation, participants are seated in the same room used for light exposure, but in complete darkness.

Treatment:

Behavioral: Light deprivation (Dark)

Behavioral: Light exposure (Flash)

Dark first

Experimental group

Description:

Light deprivation (Dark) first, Light exposure (Flash) second: Both interventions (Flash and Dark) are administered for one hour on 7 consecutive days. During the light exposure, participants are seated 120 cm in front of a white curtain that is illuminated by an LED light source. During the light deprivation, participants are seated in the same room used for light exposure, but in complete darkness.

Treatment:

Behavioral: Light deprivation (Dark)

Behavioral: Light exposure (Flash)