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    Why Does Light Make Headaches Worse?
    By Mark Changizi | February 26th 2010 12:14 PM | 8 comments | Print | E-mail | Track Comments
    About Mark

    Mark Changizi is Director of Human Cognition at 2AI, and the author of The Vision Revolution (Benbella 2009) and Harnessed: How...

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    Migraine sufferers have long complained about how their headaches worsen with bright light, and in case you ever doubted their complaints, Rami Burstein and other researchers from Harvard Medical School and the Moran Eye Center at the University of Utah recently made a giant step in understanding the light-to-headache mechanism in Nature Neuroscience. They found neurons in the rat thalamus sensitive to both light and to the dura (the membrane surrounding the brain).

    More intriguing than the “how” of light and headaches is the “why”. Why should light be linked with pain mechanisms at all? Why should the retina be in the business of eliciting pain in your brain?

    Upon reflection, however, we all know of occasions where looking hurts. The most obvious case is when we look at the sun. And another obvious case is when someone shines a flashlight in our eyes in the dark. In each case we are likely to respond, “Ouch!” From these real-world links between light and pain can we discern what the link may be for?

    light aggravates headaches

    The example of the sun may coax us into suggesting that it is the retina-scorching amount of light that hurts. However, the fact that the same kind of discomfort occurs when someone shines a flashlight in our eyes shows it is not the intrinsic amount of light that is the source of the pain. A flashlight can be so dim that we can hardly see it in daytime, and yet hurt when shone in our eyes at night. The flashlight’s beam is not scorching anything, although the pain it elicits is every bit as real.

    Instead, I suggest that these light/pain phenomena are similar to pain in other domains of our life. The general role of pain is not merely to tell us that something has been damaged, but to motivate us to modify our behavior toward safer or smarter action (and to so without our having to consciously think about it). For example, subtle pain signals are constantly causing me to shift my weight as I sit here and type this, leading to healthier blood flow in my lower extremities. Our eye fixations are like fingertips, reaching out and touching things in the world; just as fingertips need a pain sense to help optimally guide their behavior, so do our eye fixations.

    In our normal viewing experiences there are very often wild fluctuations in brightness in our visual field, often due to the sun or to reflections of the sun. We are typically not interested in looking at objects having this full breadth of brightnesses, but, instead, at a range of “interesting objects” at a narrower range of brightnesses. To help us best see the objects of current interest, our visual system adapts to the brightness levels among them. If we were to fixate on a part of the scene that is much brighter than these interesting objects (perhaps a spot of glare), then our eyes would begin to adapt to the new brightness level, and when we look back at the objects of interest, we will be unable to see them well.

    “Eye pain” of this kind may be the principal unconscious mechanism that keeps us fixating in a smart fashion within our visual field; it is what keeps our eyes performing at their best given our interests at the time. Although this kind of mechanism is unconscious, it by no means needs to be stupid. Instead, it may be able to infer where the brightest parts of the scene are on the basis of global cues in the scene.

    For example, look at the earlier photograph of the glaring sun. It feels somewhat discomforting to look at this photograph, and our eyes want to steer clear from the sun. Yet the brightest spot at the center of the sun in the photograph is no brighter than the white elsewhere on this web page which causes us no discomfort to look at. Our brain seems to be able to recognize the sun-glare-like cues in the photograph, and elicits the glare-avoidance pain mechanisms for it but not for the white elsewhere on screen.

    In light of these ideas for the role of light in pain, could it be that migraine-like headaches are the normal kind of pain elicited for these light/pain mechanisms, and that the trouble for migraine sufferers is the overactivation of these usually-functional mechanisms?

    Comments

    Gerhard Adam
    ... we all know of occasions where looking hurts.
    Every time I look at my bank statements.
    logicman
    By far the most frequent causal chain for me is that I first get a migraine and then suffer if subjected to bright light.  The most frequent reversal of that is flickering light as e.g. driving past a fence in strong sunlight or watching any of about 99% of modern movies.

    Research in the late 1800s based on patient's descriptions of what they saw with their eyes closed suggested that waves of neural activity are interpreted as visual signals in error.  The research you cite, and your own remarks would seem to tie in rather nicely with that.

    Since bright light aggravates a pre-existing condition, could it be that the brain is adding a real signal to a fictitious one?


    @Gerhard:LOL
    Migraines aside, from which I do suffer occasionally, I have experienced on several occasions this overactivation of these usually-functional mechanisms. I'm not talking about sunlight. I'm talking about a hypersensitivity to indoor table lamps--to the the point where I have to wear sunglasses indoors at night.

    I talked to my physician about it and he seemed perplexed by the problem. I did some research on my own and didn't find any condition that could explain this peculiar phenomenon. Fortunately, it doesn't happen very often. But your article has got me thinking. It might be a good idea for me to see a neurologist.

    And that photo of the sun did hurt my eyes! LOL ;-)
    logicman
    hypersensitivity to indoor table lamps--to the the point where I have to wear sunglasses indoors at night.
    Eric, I sympathise entirely.  Worry ye not, there is a simple exercise that will cure this problem permanently.  You need never wear sunglasses indoors again.

    Stand facing the problem lamp.  Bend over until you are just about touching your toes.  Now pull out the plug.  There!  All better now.

    hth
    ;-)
    Gee, now why didn't I think of that? ;-)
    You're wrong. All the glaring white on your page is hurting my eyes. Are you trying to cause snow blindness?

    I have this wierd personal theory that excess glutamate as a neurotransmitter causes normal amounts of light to become overwhelming amounts of light, as well as making noise overwhelming, smells overwhelming, movement causing dizziness, etc. As one who suffers aura, not all the overwhelming sensations of a migraine are painful, so I tend to think it's either a glutamate issue, or one in which the brain's sensory filter is not functioning properly, or both. Our brain is wired to interpret too much light or sound as painful, but overwhelming smells and dizziness are not. I suspect the same mechanism is behind it all...a sort of nerve-impulse-storm.

    Mark Changizi
    Thanks. And interesting observation about the smell and noise. -Mark