• Milena De Marinis, Steno Rinalduzzi, and Neri Accornero.
• Department of Neurological Sciences, La Sapienza University, Rome, Italy.
• Headache. 2007 Jun 1; 47 (6): 895-904.

ObjectiveTo assess visual perception in 40 patients suffering from migraine with aura (MA), 40 patients suffering from migraine without aura (MO), and 40 controls.BackgroundVisual perception abnormalities are a common feature in both MA and MO.MethodsWe performed luminance and color central perimetry. Black and white pattern reversal visual-evoked potentials were also assessed.ResultsLuminance perimetry was similar in patients and controls. Color perimetry instead revealed an impairment in the perception of red ("quantitative perception index") in migraine patients; this impairment was more pronounced in patients with MA (P < .001) than in those with MO (P < .05) and was related to the degree of photophobia recorded before testing. A subgroup of MO patients who had a migraine attack shortly after being tested also displayed a marked impairment in the perception of blue. This subgroup of patients had a statistically significant (P < .001) lower perception of blue than the rest of the MO patients, who had a migraine attack later; they also had a high degree of unpleasant perceptions after testing. Black and white visual evoked potentials were similar in patients and controls.ConclusionThe impairment in visual perception of red, which was more marked in MA than in MO patients, may be related to the degree of photophobia recorded before testing. The reduced perception of blue, which only occurred in a subgroup of MO patients in the premonitory phase of the migraine attack, probably occurs through mechanisms that involve dopaminergic function. We cannot exclude the possibility that the visual stimulations induced the migraine attack in this subgroup of MO patients shortly after they were tested.

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