A web-based, branching logic questionnaire for the automated classification of migraine

Kaiser, Eric A.; Igdalova, Aleksandra; Aguirre, Geoffrey K.; Cucchiara, Brett

doi:10.1101/369827

Cited by 8 publications

(19 citation statements)

References 23 publications

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“…From all participants, we collected information about age, gender and employment status. We then asked participants (point prevalence), if they had frequent headaches; if yes, if these headaches could last longer than 4 h, suggesting moderate to severe tension‐type headache or migraine and if headaches were associated with visual or non‐visual aura, lasting at least 5 min, suggesting migraine aura . We then went on to inquire about symptoms compatible with visual snow and visual snow syndrome, following the criteria for visual snow syndrome as proposed by Goadsby and co‐workers , including the presence or absence of competing neurological and ophthalmological diagnoses (Table ).…”

Section: Materials and Methodsmentioning

confidence: 99%

Prevalence of visual snow syndrome in the UK

Kondziella

Olsen

Dreier

2020

Euro J of Neurology

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44.8 AE 15 years), although this was not statistically different (P = 0.06). Of 22 participants with visual snow syndrome, 16 had mood symptoms (72.7%; P = 0.01), 12 had headache (54.5%; P = 0.06), including five with visual migraine aura (22.7%; P = 0.15) and 13 had tinnitus (59.1%; P < 0.001). No participant had diabetes or a cleft lip (control questions). Following a multivariable regression analysis to adjust for age and gender, only the association between visual snow syndrome and tinnitus remained significant (odds ratio, 3.93; 95% CI, 1.63-9.9; P = 0.003). Conclusions: The UK prevalence of visual snow syndrome is around 2%. We confirmed an association with tinnitus, but unprimed laypeople with visual snow syndrome are on average older than those seeking medical attention.

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Section: Materials and Methodsmentioning

confidence: 99%

Prevalence of visual snow syndrome in the UK

Kondziella

Olsen

Dreier

2020

Euro J of Neurology

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“…Participants were between 25 and 40 y old and were recruited via digital social media. Headache classification was established using the Penn Online Evaluation of Migraine, which implements the International Classification of Headache Disorders-3-beta criteria (84). Participants with migraine were also required to endorse interictal photophobia (85).…”

Section: Methodsmentioning

confidence: 99%

Selective amplification of ipRGC signals accounts for interictal photophobia in migraine

McAdams

Kaiser

Igdalova

et al. 2020

Proc. Natl. Acad. Sci. U.S.A.

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Second only to headache, photophobia is the most debilitating symptom reported by people with migraine. While the melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs) are thought to play a role, how cone and melanopsin signals are integrated in this pathway to produce visual discomfort is poorly understood. We studied 60 people: 20 without headache and 20 each with interictal photophobia from migraine with or without visual aura. Participants viewed pulses of spectral change that selectively targeted melanopsin, the cones, or both and rated the degree of visual discomfort produced by these stimuli while we recorded pupil responses. We examined the data within a model that describes how cone and melanopsin signals are weighted and combined at the level of the retina and how this combined signal is transformed into a rating of discomfort or pupil response. Our results indicate that people with migraine do not differ from headache-free controls in the manner in which melanopsin and cone signals are combined. Instead, people with migraine demonstrate an enhanced response to integrated ipRGC signals for discomfort. This effect of migraine is selective for ratings of visual discomfort, in that an enhancement of pupil responses was not seen in the migraine group, nor were group differences found in surveys of other behaviors putatively linked to ipRGC function (chronotype, seasonal sensitivity, presence of a photic sneeze reflex). By revealing a dissociation in the amplification of discomfort vs. pupil response, our findings suggest a postretinal alteration in processing of ipRGC signals for photophobia in migraine.

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“…Subjects were ages 25 to 41 years and recruited from the greater Philadelphia area and University of Pennsylvania campus, in many cases using advertising on digital social media services. All candidate subjects underwent screening using the Penn Online Evaluation of Migraine ( Kaiser, Igdalova, Aguirre, & Cucchiara, 2019 ), which implements an automated diagnostic survey using the International Classification of Headache Disorders (ICHD)–3 criteria. We identified 10 subjects who met criteria for a diagnosis of MwA.…”

Section: Methodsmentioning

confidence: 99%

A neural correlate of visual discomfort from flicker

Gentile

Aguirre

2020

Journal of Vision

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The theory of "visual stress" holds that visual discomfort results from overactivation of the visual cortex. Despite general acceptance, there is a paucity of empirical data that confirm this relationship, particularly for discomfort from visual flicker. We examined the association between neural response and visual discomfort using flickering light of different temporal frequencies that separately targeted the LMS, L-M, and S postreceptoral channels. Given prior work that has shown larger cortical responses to flickering light in people with migraine, we examined 10 headache-free people and 10 migraineurs with visual aura. The stimulus was a uniform field, 50 degrees in diameter, that modulated with high-contrast flicker between 1.625 and 30 Hz. We asked subjects to rate their visual discomfort while we recorded steady-state visually evoked potentials (ssVEPs) from early visual cortex. The peak temporal sensitivity ssVEP amplitude varied by postreceptoral channel and was consistent with the known properties of these visual channels. There was a direct, linear relationship between the amplitude of neural response to a stimulus and the degree of visual discomfort it evoked. No substantive differences between the migraine and control groups were found. These data link increased visual cortical activation with the experience of visual discomfort.

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A web-based, branching logic questionnaire for the automated classification of migraine

Cited by 8 publications

References 23 publications

Prevalence of visual snow syndrome in the UK

Prevalence of visual snow syndrome in the UK

Selective amplification of ipRGC signals accounts for interictal photophobia in migraine

A neural correlate of visual discomfort from flicker

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