Skip to main content

Advertisement

Log in

Perceptive aspects of visual aura

  • Review Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Visual aura is the most common feature associated with migraine, though it can occur separately. In both cases it often represents a dramatic event, especially for patients who experience it for the first time. Besides, its subjective characteristics may illuminate on the functional architecture of the visual cortex. Repetitive events of migraine and visual aura have been suggested to affect the visual system in the long run, both on the cortical and precortical level. In effect, objective investigation of visual functions in patients support the idea that a selective damage does occur, so that more attention to visual examination seems to be justified. In this paper, subjective and psychophysical aspects of visual aura are examined, lastly highlighting and discussing the interesting correlations found between this condition and normal-tension glaucoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Olesen J, Bes A, Kunkel R, Lance VG, Nappi G, Pfaffenrath V, Clifford Rose F, Schoenberg BS, Soyka D, Tfelt-Hansen P, Welch KMA, Wlkinson M (2004) The international classification of headache disorders. Cephalalgia 24(Suppl 1):26–31

    Google Scholar 

  2. Wijmar CA, Wolf PA, Kase CS, Kelly-Hayes M, Beiser AS (1998) Migrainous visual accompaniments are not rare in late life: the Framingham Study. Stroke 291:1539–1543

    Google Scholar 

  3. Russell MB, Olesen J (1996) A nosographic analysis of the migraine aura in the general population. Brain 119:355–361

    Article  PubMed  Google Scholar 

  4. Mattsson P, Lundberg PO (1999) Characteristics and prevalence of transient visual disturbances indicative of migraine visual aura. Cephalalgia 19:479–498

    Article  CAS  PubMed  Google Scholar 

  5. Airy HG (1870) Distinct form of transient hemianopia. Philos Trans R Soc Lond B Biol Sci 160:247–270

    Article  Google Scholar 

  6. Schott GD (2007) Exploring the visual hallucinations of migraine aura: the tacit contribution of illustration. Brain 130:1690–1703

    Article  CAS  PubMed  Google Scholar 

  7. Dahlem MA, Chronicle EP (1994) A computational perspective on migraine aura. Prog Neurobiol 74:351–361

    Article  Google Scholar 

  8. Welch KM, D’Andrea G, Tepley N, Barkley G, Ramadan NM (1990) The concept of migraine as a state of central neuronal hyperexcitability. Neurol Clin 8:817–828

    CAS  PubMed  Google Scholar 

  9. Chronichle EP, Mulleners WM (1996) Visual system dysfunction in migraine: a review of clinical and psychophysical findings. Cephalalgia 16:525–535

    Article  Google Scholar 

  10. Aurora SK, Welch KM (1998) Brain excitability in migraine: evidence from transcranial magnetic stimulation studies. Curr Opin Neurol 11:205–209

    Article  CAS  PubMed  Google Scholar 

  11. Aurora SDK, Kao Y, Bowyer SM, Welch KM (1999) The occipital cortex is hyperexcitable in migraine. Headache 39:469–476

    Article  CAS  PubMed  Google Scholar 

  12. Dahlem MA, Chronicle EP (2004) A computational perspective on migraine aura. Prog Neurobiol 74:351–361

    Article  CAS  PubMed  Google Scholar 

  13. Hadjikhani N, Sanchez del Rio M, Wu O, Schwartz D, Bakker D, Fischl B, Kwong KK, Cutrer FM, Rosen BR, Tootell RBH, Sorensen AG, Moskowitz MA (1998) Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proc Natl Acad Sci USA 98:4687–4692

    Article  Google Scholar 

  14. Vincent M, Pedra E, Mourao-Miranda J, Bramati IE, Henrique AR, Moll J (2003) Enhanced interictal responsiveness of the migraineous visual cortex to incongruent bar stimulation: a functional MRI visual activation study. Cephalalgia 23:860–868

    Article  CAS  PubMed  Google Scholar 

  15. Leao AA (1944) Spreading depression of activity in cerebral cortex. J Neurophysiol 7:359–390

    Google Scholar 

  16. Grüsser OJ (1995) Migraine phosphenes and the retino-cortical magnification factor. Vis Res 35:1125–1134

    Article  PubMed  Google Scholar 

  17. Hare EH (1966) Personal observations on the spectral march of Migraine. J Neurol Sci 3:259–264

    Article  CAS  PubMed  Google Scholar 

  18. Richards W (1971) The fortification illusion of migraines. Sci Am 224:89–96

    Google Scholar 

  19. Aring CD (1972) The migrainous scintillating scotoma. JAMA 220:519–522

    Article  CAS  PubMed  Google Scholar 

  20. Plant GT (1986) The fortification spectra of migraine. BMJ 293:1613–1617

    Article  CAS  PubMed  Google Scholar 

  21. Gutteridge IF, Cole BL (2000) The prevalence and symptoms of migraine in a consecutive series of patients attending an optometric practice. Optom Vis Sci 77:402–411

    Article  CAS  PubMed  Google Scholar 

  22. Queiroz LP, Rapoport AM, Weeks RE, Heftell FD, Siegel SE, Baskin SM (1997) Characteristics of migraine visual aura. Headache 37:137–141

    Article  CAS  PubMed  Google Scholar 

  23. Burger SK, Saul RF, Selhorst JB, Thurston SE (1991) Transient monocular blindness caused by vasospasm. N Engl J Med 325:870–873

    Article  CAS  PubMed  Google Scholar 

  24. Jehn A, Dettwiler B, Fleischhauer J, Sturzenegger M, Mojon DS (2002) Exercise induced vasospastic amaurosis fugax. Arch Ophthalmol 120:220–222

    PubMed  Google Scholar 

  25. Winterkorn JMS, Kupersmith MJ, Wirtschafter JD, Forman S (1993) Treatment of vasospastic amaurosis fugax with calcium channel blockers. N Engl J Med 329:396–399

    Article  CAS  PubMed  Google Scholar 

  26. Hupp SL, Kline LB, Corbett JJ (1989) Visual disturbances in migraine. Surv Ophthalmol 33:221–236

    Article  CAS  PubMed  Google Scholar 

  27. Buchholz DW, Reich SG (1996) The menagerie of migraine. Semin Neurol 16:83–93

    Article  CAS  PubMed  Google Scholar 

  28. Lawden MC, Cleland PG (1993) Achromatopsia in the aura of migraine. J Neurol Neurosurg Psychiatry 56:708–709

    Article  CAS  PubMed  Google Scholar 

  29. Drummond PD, Anderson M (1992) Visual field loss after attack of migraine with aura. Cephalalgia 12:349–355

    Article  CAS  PubMed  Google Scholar 

  30. Johnson CA (1994) Selective versus nonselective losses in glaucoma. J Glaucoma 3:s32–s34

    PubMed  Google Scholar 

  31. Lewis RA, Vijayan N, Watson C, Keltner J, Johnson CA (1989) Visual field loss in migraine. Ophthalmology 96:321–326

    CAS  PubMed  Google Scholar 

  32. Salemi E, D’Aurizio C, Marrelli A (1987) Automated visual field perimetry during intercritic phase in classic migraine patients. Cephalalgia 7:206–207

    Google Scholar 

  33. De Natale R, Polimeni D, Narbone MC, Scullica MG, Pelicano M (1994) Visual field defects in migraine patients. In: Mills RP (ed) Perimetry update 93/94. Kugler, Amsterdam, pp 283–284

  34. McKendrick AM, Vingrys AJ, Badcock DR, Heywood JT (2000) Visual field losses in patients with migraine headaches. Invest Ophthalmol Vis Sci 41:1239–1247

    CAS  PubMed  Google Scholar 

  35. Shibata K (2007) Neurophysiology of visual aura in migraine. Brain Nerve 59:961–970

    PubMed  Google Scholar 

  36. Bowerman LS (1989) Transient visual field loss secondary to migraine. J Am Optom Assoc 60:912–916

    CAS  PubMed  Google Scholar 

  37. Ebner R (1991) Visual field examination during transient migrainous visual loss. J Clin Neuroophtalmol 11:114–117

    CAS  Google Scholar 

  38. Wakakura M, Ichibe Y (1992) Permanent homonymous hemianopias following migraine. J Clin Neuroophthalmol 12:198–202

    CAS  PubMed  Google Scholar 

  39. McKendrick AM, Badcock DR (2004) Decreased visual field sensitivity measured 1 day, then 1 week, after migraine. Invest Ophthalmol Vis Sci 45:1061–1070

    Article  PubMed  Google Scholar 

  40. Khalil NM, Legg NJ (1989) Pathophysiology of migraine: a study using VEP and contrast sensitivity. In: Rose FC (ed) New advances in headache research. Smith-Gordon, London, pp 57–61

  41. McKendrick AM, Badcock DR, Vingrys A, Heywood JT (1998) Migraine effects on visual function. Aust NZ J Ophthalmol 26:111–113

    Article  Google Scholar 

  42. Coleston DM, Kennard C (1993) Visual changes in migraine: indications of cortical dysfunction. Cephalalgia 13(Suppl):396–398

    Google Scholar 

  43. McKendrick AM, Cioffi GA, Johnson CA (2002) Short wavelength sensitivity deficits in patients with migraine. Arch Ophthalmol 120:154–161

    PubMed  Google Scholar 

  44. Wilkins A, Nimmo-Smith I, Tait A, McManus C, Della Sala S, Tylley A, Arnold K, Barrie M, Scott SA (1984) Neurological basis for visual discomfort. Brain 107:989–1017

    Article  PubMed  Google Scholar 

  45. Marcus DA, Soso MJ (1989) Migraine and stripe-induced visual discomfort. Arch Neurol 46:1129–1132

    CAS  PubMed  Google Scholar 

  46. Huang J, Cooper TG, Satana B, Kaufman DJ, Cao Y (2003) Visual distortion provoked by a stimulus in migraine associated to hyperneuronal activity. Headache 43:664–671

    Article  PubMed  Google Scholar 

  47. Chronicle EP, Wilkins AJ, Coleston DM (1995) Thresholds for detection of a target against a background grating suggest visual dysfunction in migraine with aura but not migraine without aura. Cephalalgia 15:117–122

    Article  CAS  PubMed  Google Scholar 

  48. Hay KM, Mortimer MJ, Barker DC, Debney LM, Good PA (1994) 1044 women with migraine: the effect of environmental stimuli. Headache 34:166–168

    Article  CAS  PubMed  Google Scholar 

  49. McKendrick AM, Badcock DR (2004) Motion processing deficits in migraine. Cephalalgia 24:363–372

    Article  CAS  PubMed  Google Scholar 

  50. McKendrick AM, Vingrys A, Badcock DR, Heywood JT (2001) Visual dysfunction between migraine events. Invest Ophthalmol Vis Sci 42:626–633

    CAS  PubMed  Google Scholar 

  51. McKendrick AM, Badcock DR, Gurgone M (2006) Vernier acuity is normal in migraine, whereas global form and global motion perception are not. Invest Ophthalmol Vis Sci 47:3213–3219

    Article  PubMed  Google Scholar 

  52. Antal A, Temme J, Nitsche MA, Varga ET, Lang N, Paulus W (2005) Altered motion perception in migraineurs:evidence for interictal cortical hyperexcitability. Cephalalgia 25:788–794

    Article  CAS  PubMed  Google Scholar 

  53. Ditchfield JA, McKendrick AM, Badcock DR (2006) Processing of global form and motion in migraineurs. Vis Res 46:141–148

    Article  PubMed  Google Scholar 

  54. Mulleners WM, Chronicle EP, Je Palmer, Koehler PJ, Vredeveld JW (2001) Suppression of perception in migraine: evidence for reduced inhibition in the visual cortex. Neurology 56:178–183

    CAS  PubMed  Google Scholar 

  55. Chronicle EP, Pearson AJ, Mulleners WM (2006) Objective assessment of cortical excitability in migraine with and without aura. Cephalalgia 26:801–808

    Article  CAS  PubMed  Google Scholar 

  56. Valverde F (1985) The organizing principles of the primary visual cortex in the monkey. In: Peters A, Jones EG (eds) Cerebral cortex. Plenum Press, New York, pp 207–257

    Google Scholar 

  57. Chronicle E, Mulleners W (1994) Might migraine damage the brain? Cephalalgia 14:415–418

    Article  CAS  PubMed  Google Scholar 

  58. Je Palmer, Chronicle EP, Rolan P, Mulleners WM (2000) Cortical hyperexcitability is cortical under-inhibition. Evidence from a novel functional test of migraine patients. Cephalalgia 20:525–532

    Article  Google Scholar 

  59. McColl SL, Wilkinson F (2000) Visual contrast gain control in migraine: measures of visual cortical excitability and inhibition. Cephalalgia 20:74–84

    Article  CAS  PubMed  Google Scholar 

  60. Huang J, De Lano M, Cauo Y (2006) Visual cortical inhibitory function in migraine is not generally impaired: evidence from a combined psychophysical test with an fMRI study. Cephalalgia 26:554–560

    Article  CAS  PubMed  Google Scholar 

  61. Macknik SL, Livingstone MS (1998) Neuronal correlates of visibility and invisibility in the primate visual system. Nat Neurosci 1:144–149

    Article  CAS  PubMed  Google Scholar 

  62. Corbett JJ, Phelps CD, Eslinger P, Montague PR (1985) The neurologic evaluation of patients with low-tension glaucoma. Invest Ophthalmol Vis Sci 26:1101–1104

    CAS  PubMed  Google Scholar 

  63. Phelps CD, Corbett JJ (1985) Migraine and low-tension glaucoma. A case–control study. Invest Ophthalmol Vis Sci 26:1105–1108

    CAS  PubMed  Google Scholar 

  64. Gasser P, Meienberg O (1991) Finger microcirculation in classical migraine. Eur Neurol 31:168–171

    Article  CAS  PubMed  Google Scholar 

  65. Hegyalijai T, Meienberg O, Dubler B, Gasser P (1997) Cold-induced acral vasospasm in migraine as assessed by nailfold video-microscopy: prevalence and response to migraine prophylaxis. Angiology 48:345–349

    Article  CAS  PubMed  Google Scholar 

  66. Wang JJ, Mitchell P, Smith W (1997) Is there an association between migraine headache and open-angle glaucoma? Findings from the Blue Mountains eye study. Ophthalmology 104:1714–1719

    CAS  PubMed  Google Scholar 

  67. Cursiefen C, Wisse M, Cursiefen S, Junemann A, Martus P, Korth M (2000) Migraine and tension headache in high-pressure and normal pressure glaucoma. Am J Ophthalmol 129:102–104

    Article  CAS  PubMed  Google Scholar 

  68. Flammer J, Pache M, Resnik T (2001) Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. Prog Retin Eye Res 20:319–349

    Article  CAS  PubMed  Google Scholar 

  69. Drance SM, Douglas GR, Wijsman K, Schulzer M, Britton RJ (1988) Response to blood flow to warm and cold in normal and low-tension glaucoma patients. Am J Ophthalmol 105:235–239

    Google Scholar 

  70. Flammer J (1992) Psychophysical mechanisms and treatment of vasospastic disorders in normal-tension glaucoma. Bull Soc Belge Ophthalmol 244:129–134

    CAS  Google Scholar 

  71. Drance SM, DR Anderson, Schulzer M (2001) Risk factors for progression of visual field abnormalities in normal-tension glaucoma. Am J Ophthalmol 131:699–708

    Article  CAS  PubMed  Google Scholar 

  72. Gupta VK (2006) Migrainous scintillating scotoma and headache is ocular in origin: a new hypothesis. Med Hypotheses 66(3):454–460

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlo Aleci.

Additional information

The authors state that the paper has not been published (in part or in full) or submitted for publication elsewhere.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aleci, C., Liboni, W. Perceptive aspects of visual aura. Neurol Sci 30, 447–452 (2009). https://doi.org/10.1007/s10072-009-0137-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-009-0137-4

Keywords

Navigation