Preference for Lighting Chromaticity in Migraine With Aura

Alexandra Vieira, MSc; Ian van der Linde, PhD; Peter Bright, PhD; Arnold Wilkins, DPhil

Disclosures

Headache. 2020;60(6):1124-1131. 

In This Article

Abstract and Introduction

Abstract

Objective: We studied the color of lighting chosen as comfortable for reading by individuals with migraine and controls. We explored the effects of the chosen color on visual performance.

Background: It has been reported that individuals who experience migraine with aura (MWA) choose, as comfortable for reading, light that is more strongly saturated in color than that chosen by individuals without migraine.

Methods: A convenience sample of 18 individuals who experienced MWA, 18 without aura, and 18 controls without migraine participated in a cross-sectional laboratory study at Anglia Ruskin University. We used an Intuitive Colorimeter that illuminated text with colored light and permitted the separate control of hue (color) and saturation (strength of color) without a change in luminance. We selected individuals with migraine and healthy controls from the general population. They were headache-free in the 48 hours prior to testing. We used a routine that permitted the selection of the most comfortable hue from 12 alternatives and then alternately optimized the saturation and hue using small changes, thereby allowing for color adaptation. Visual performance at a word search task was measured under white light and under light of a color chosen as comfortable, using colored lenses.

Results: Healthy individuals chose light with chromaticity close to the Planckian locus, which approximates the chromaticities of daylight and most electric lighting. The distance from the locus averaged 0.029 (SD 0.021). Individuals who experienced MWA chose strongly saturated colors well away from the Planckian locus (average distance 0.056, SD 0.022). Individuals who experienced migraine without aura chose intermediate chromaticities (average distance 0.034, SD 0.022). Overall there was a large statistically significant difference between participant groups that explained 24% variance. Visual search time of individuals with migraine aura decreased from 22.5 to 16.8 s when light of the chosen color was provided using tinted lenses (the average increase in search speed was 45.7%). The lenses had no statistically significant effect on the performance of individuals without migraine aura.

Conclusions: Individuals who experienced MWA selected as comfortable colors that deviated from the lighting typically experienced in everyday life. Possibly, individuals who experience MWA may be more susceptible to photophobia under typical lighting. Visual performance was improved using lenses that provided light of the chosen comfortable color. The spectral power of that choice showed no evident relationship to melanopic energy (energy captured by the intrinsically photosensitive retinal ganglion cells).

Introduction

Photophobia is a common symptom of migraine with and without aura.[1] It is usually defined as an aversion to light, particularly bright light.[2] However, individuals with migraine are also averse to flicker, and to particular patterns, such as those that are epileptogenic in patients with photosensitive epilepsy.[3] Aversion has also been reported to particular colors of lighting.[4] Huang, et al[5] found an elevated cortical hemodynamic response to aversive patterns in patients with migraine relative to controls. They later showed that this elevated response can be normalized by optimally selected colored filters.[6] Similarly, a small-scale randomized controlled trial[7] found that colored filters decreased headache frequency, photophobia, eye pain, and medication reliance in some patients.

When given the opportunity to select a color of light that is comfortable for viewing text, healthy controls selected a chromaticity close to the Planckian locus, that is, they selected a color close to colors typically provided by daylight and artificial lighting.[4] Patients who experienced migraine with aura (MWA), however, tended to choose strongly saturated colors well away from the locus.[4] Although certain strongly saturated colors evidently make vision more comfortable for these individuals, little is known about the effect of such colors on visual performance. We examined the effect of the chosen color using a visual search task.

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