Purpose: To assess contrast-discrimination thresholds in patients with migraine who have manifest visual field loss. This study was undertaken to determine whether contrast processing abnormalities in migraineurs are more readily identified by using stimuli that elicit a response from the subject that depends, at least in part, on adaptation mechanisms, and if so, whether deficits appear more pronounced in magnocellular (M) or parvocellular (P) visual pathways.
Methods: Ten patients with migraine who had abnormal visual fields measured with flicker perimetry but had normal standard automated perimetry (SAP) thresholds participated, along with 15 age-matched control subjects. Contrast-discrimination performance was assessed with the steady-pedestal (magnocellular) and pulsed-pedestal (parvocellular) stimuli of Pokorny and Smith for seven pedestal luminances between 15 and 60 cd/m(2) on a background of 30 cd/m(2). Subjects were tested foveally and midperipherally at 12.5 degrees. Migraineurs were tested in the quadrant of worst visual field performance. Control subjects were assessed in locations matched to those of the migraine group.
Results: Foveal performance was not significantly different between the migraine and control groups for either task. At 12.5 degrees the migraine group had significantly raised thresholds for both conditions. Effect size statistics revealed similar deficit magnitudes for each test (steady pedestal, -1.06; pulsed pedestal, -1.04).
Conclusions: Dysfunction in both the M and P pathways was identified in the midperipheral visual field of the migraine group. The P pathway dysfunction was not identified by SAP. These findings support the possibility of nonselective neural adaptation abnormalities in some subjects with migraine.