Evidence map›Paper›PMID 34493620›Full record

ArticleNeurology2021

Reflexive Eye Closure in Response to Cone and Melanopsin Stimulation: A Study of Implicit Measures of Light Sensitivity in Migraine.

Eric A Kaiser, Harrison McAdams, Aleksandra Igdalova, Edda B Haggerty, Brett L Cucchiara, David H Brainard, Geoffrey K Aguirre

Open access · greenAbstract readClinical Study
In one paragraph

Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Blue Light-Ocular and Systemic Damaging Effects: A Narrative Review.International journal of molecular sciences · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Eric A KaiserFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia. aguirreg@upenn.edu.ORCID 0000-0001-9750-2434
Harrison McAdamsFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
Aleksandra IgdalovaFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
Edda B HaggertyFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
Brett L CucchiaraFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
David H BrainardFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
Geoffrey K AguirreFrom the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
University of Pennsylvania · US

Funding

Scientific TransparencyP30EY001583 · NEI · UNIVERSITY OF PENNSYLVANIA · PI CLAIRE H MITCHELL · 1985 to 2026
$19.5M
Training in Alzheimer’s and Age-Related Neurodegenerative DiseasesT32AG000255 · NIA · UNIVERSITY OF PENNSYLVANIA · PI ALICE S CHEN-PLOTKIN, VIRGINIA M LEE · 1997 to 2026
$12.5M
Research Training Program in Disease Oriented Neuroscience (R25)R25NS065745 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DETRE, JOHN A · 2009 to 2023
$3.0M
Melanopsin and cone signals in human visual processingR01EY024681 · NEI · UNIVERSITY OF PENNSYLVANIA · PI AGUIRRE, GEOFFREY KARL, BRAINARD, DAVID H. · 2015 to 2018
$1.6M
NEI NIH HHS P30 EY001583NEI NIH HHS R01 EY024681NIA NIH HHS T32 AG000255NINDS NIH HHS R25 NS065745
6 · The paper itself

Abstract

BACKGROUND AND

objectivesTo quantify interictal photophobia in migraine with and without aura using reflexive eye closure as an implicit measure of light sensitivity and to assess the contribution of melanopsin and cone signals to these responses.

methodsParticipants were screened to meet criteria for 1 of 3 groups: headache-free (HF) controls, migraine without aura (MO), and migraine with visual aura (MA). MO and MA participants were included if they endorsed ictal and interictal photophobia. Exclusion criteria included impaired vision, inability to collect usable pupillometry, and history of either head trauma or seizure. Participants viewed light pulses that selectively targeted melanopsin, the cones, or their combination during recording of orbicularis oculi EMG (OO-EMG) and blinking activity.

resultsWe studied 20 participants in each group. MA and MO groups reported increased visual discomfort to light stimuli (discomfort rating, 400% contrast, MA: 4.84 [95% confidence interval 0.33, 9.35]; MO: 5.23 [0.96, 9.50]) as compared to HF controls (2.71 [0, 6.47]). Time course analysis of OO-EMG and blinking activity demonstrated that reflexive eye closure was tightly coupled to the light pulses. The MA group had greater OO-EMG and blinking activity in response to these stimuli (EMG activity, 400% contrast: 42.9%Δ [28.4, 57.4]; blink activity, 400% contrast: 11.2% [8.8, 13.6]) as compared to the MO (EMG activity, 400% contrast: 9.9%Δ [5.8, 14.0]; blink activity, 400% contrast: 4.7% [3.5, 5.9]) and HF control (EMG activity, 400% contrast: 13.2%Δ [7.1, 19.3]; blink activity, 400% contrast: 4.5% [3.1, 5.9]) groups. DISCUSSION: Our findings suggest that the intrinsically photosensitive retinal ganglion cells (ipRGCs), which integrate melanopsin and cone signals, provide the afferent input for light-induced reflexive eye closure in a photophobic state. Moreover, we find a dissociation between implicit and explicit measures of interictal photophobia depending on a history of visual aura in migraine. This implies distinct pathophysiology in forms of migraine, interacting with separate neural pathways by which the amplification of ipRGC signals elicits implicit and explicit signs of visual discomfort.

Indexed as

AdultBlinkingElectromyographyFemaleHumansMaleMelanopsinMigraine DisordersPhotic StimulationPhotophobiaReflex, AbnormalRetinal Cone Photoreceptor CellsRetinal Ganglion CellsRod OpsinsMelanopsinRod Opsins

Identifiers

PMID34493620
PMCPMC8605618
OpenAlexW3198516792

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.