Quantifying aversion thresholds to light, sound, smell, and touch in migraine: A longitudinal study in migraine and non-headache controls

Abstract text (incl. figure legends and references)

Question

To prospectively and longitudinally quantify sensory aversion thresholds to light, sound, smell (smoked, lavender, vanilla), and brush touch in migraine patients and investigate whether they are modulated by headache intensity and phase of the migraine cycle.

Methods

In the laboratory, we precisely quantified sensory aversion thresholds on a daily basis over the course of 27 days. A 2AFC (decision whether the presented stimulus was perceived as bothersome or not) using an adaptive procedure or a rating scale, was used to estimate the aversion of each stimulus (white light, 1000 Hz sounds, smoked, lavender, and vanilla smells, and cutaneous light brush). Besides headache intensity, we also controlled for various factors daily such as menstruation, medication intake, sleep quality, and participant anxiety.

Results

We included six episodic migraine patients (between 2 and 13 headache days/month) and two headache-free controls that were gender-(100% females) and age-(W=1, p=0.12) matched. We found that aversion to light (p.adj<0.01), sound (p.adj<0.01), smell (smoked; p.adj=0.01, vanilla; p.adj<0.01, lavender; p.adj=0.01), and touch (p.adj<0.01) increased with headache intensity in migraine. However, aversion thresholds in migraine compared to controls were only differentially modulated at certain phases of the migraine cycle for the tested sensory modalities.

Conclusions

Aversion thresholds of various sensory modalities change alongside headache intensity in patients with migraine; enhancing our understanding of the presence of multiple sensory modality fluctuations throughout the migraine cycle.

Figure 1. Example of one participant's data. Z-scores of the measured aversion thresholds/scores, anxiety-state, and sleep quality over 27 days. Missing data was filled in black, while presence of menstruation/medication intake were filled in grey. Colours of the z-scores for the auditory/visual thresholds were inverted to ease interpretation.