Higher photophobia scores have been observed among individuals with migraine with aura (MwA) compared with those who have migraine without aura (MwoA), suggesting that MwA may be associated with visual hypersensitivity; however, no association has been found between migraine aura and higher interictal allodynia or hyperacusis scores, according to a study recently published in Headache. 

This cross-sectional study of the American Registry for Migraine Research data included 321 individuals with migraine (MwA, n=146; MwoA, n=175; 88.2% women). The 16-item Photosensitivity Assessment Questionnaire (PAQ),  14-item Hyperacusis Questionnaire, and 12-item Allodynia Symptom Checklist were used to measure photosensitivity, hyperacusis, and cutaneous allodynia, respectively. Widely distributed scores were treated as continuous variables in analysis, while scores from the Allodynia Symptom Checklist were treated as binary variables (scores from 0-2 considered normal, scores ≥3 considered positive for allodynia). The associations between MwA and hyperacusis scores, PAQ scores, and negative vs positive cutaneous allodynia scores were evaluated using regression models.

Individuals who had MwA were found to have significantly higher PAQ scores when compared to those who had MwoA (4.1±2.7 vs 3.0±2.5, respectively; =.0003). A significant association was identified between aura (P =.0003) and photophobia scores (P <.0001) after controlling for sex, age, and headache frequency. No associations were identified between MwA and either hyperacusis symptom severity (P =.346) or interictal allodynia (P =.381).

Limitations to this study include a potential lack of specificity in questionnaires; lack of restriction to visual aura in selecting the study participants; and use of a single center for enrollment, which may limit generalizability. 

The study researchers concluded that, “[compared with] MwoA, MwA is associated with higher photophobia symptoms scores.” Furthermore, “MwA is not associated with greater symptoms of hyperacusis or [cutaneous allodynia].” However, the MwA-photophobia association and lack of associations between MwA and other hypersensitivities “suggests that MwA is associated specifically with visual hypersensitivity as opposed to being associated with a multisensory hypersensitivity state.”

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Pearl TA, Dumkrieger G, Chong CD, Dodick DW, Schwedt TJ. Sensory hypersensitivity symptoms in migraine with vs without aura: results from the American Registry for Migraine Research [published online January 22, 2020]. Headache. doi: 10.1111/head.13745