The purpose of this study was to investigate whether migraine with aura (MwA) is associated with greater symptoms of photophobia, phonophobia, and cutaneous allodynia compared to migraine without aura (MwoA).

MwA is associated with increased brain hyper-responsiveness to visual stimuli and increased visual network connectivity relative to MwoA. Despite this, prior studies have demonstrated conflicting results regarding whether MwA is associated with higher photophobia symptom scores compared to MwoA. The relationship between MwA and other types of sensory hypersensitivity, such as phonophobia and cutaneous allodynia, has not been previously investigated.

This analysis included 321 migraine patients (146 MwA; 175 MwoA) who had been enrolled into the American Registry for Migraine Research (ARMR). The diagnosis of either MwoA or MwA was determined by headache specialists using ICHD diagnostic criteria. Patients completed the Photosensitivity Assessment Questionnaire (PAQ), the Hyperacusis Questionnaire (HQ), and the Allodynia Symptom Checklist (ASC). Regression models were created to analyze the relationship between MwA with photophobia scores, hyperacusis scores, and the presence of interictal cutaneous allodynia.

Those with MwA had higher mean photophobia scores than those with MwoA (4.1 vs 3.0, p = .0003). MwA was positively associated with photophobia symptom severity (R² = .178, p = .0003), after controlling for age, patient sex, and headache frequency. Aura was not associated with hyperacusis symptom severity (p = .346) or the presence of interictal cutaneous allodynia (p = .381).

MwA is associated with higher photophobia symptom scores compared to MwoA. Aura is not associated with greater hyperacusis or interictal allodynia scores. These findings complement prior imaging and neurophysiologic studies that demonstrated MwA to be associated with hyper-responsiveness of brain visual processing regions. The findings suggest that MwA is associated specifically with visual hypersensitivity, as opposed to being associated with a general hypersensitivity to multiple types of sensory stimuli.