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NIH grant 1R01NS146306-01A1: The impact of photophobia on daily light exposure in adolescents with migraine: a real-world study.
Institute: {'code': 'NS', 'abbreviation': 'NINDS', 'name': 'National Institute of Neurological Disorders and Stroke', 'admin_org_id': '12500053', 'admin_funding_url': ''}. PI: Carlyn Anne Patterson Gentile. Award: $708565.
Start: 2026-09-05T00:00:00.
PROJECT SUMMARY
Photophobia (i.e., light sensitivity) is one of the most common and disabling symptoms associated with
migraine that is present even in the absence of headache. Those with migraine report avoiding high-intensity
visual environments, which is further encouraged by healthcare providers to reduce symptoms. However, it is
unknown whether light avoidance is adaptive or maladaptive. Light avoidance may reduce symptoms in the
moment, but it is unclear if it also leads to physiologically relevant decreases in light exposure that negatively
impact sleep and worsen light intolerance over time. This is particularly important for younger populations
when lifelong habits are forming, and where early intervention may be more beneficial. To address this gap, we
will continuously track ambient light exposure and sleep during daily life in adolescents with and without
migraine using wearable digital biosensors. We hypothesize that migraine-related photophobia causes
maladaptive light avoidance, resulting in sleep disruption and worsened light intolerance. To test this
hypothesis, we will continuously measure daily light exposure and sleep habits in 75 adolescents (13 – 21
years old) with migraine-related photophobia and 75 age-, sex-, and time-of-year- matched migraine-free
controls. We will utilize two biosensors to simultaneously collect light and sleep data: 1) the chest-worn
ActLumus light dosimeter that takes high spectral resolution measurements allowing us to isolate “blue” light
that drives circadian photoentrainment, 2) GENEactiv actigraphy wristwatch that produces reliable
measurements related to sleep timing and quantity. Recordings will occur for two non-vacation 2-week periods
within 2 months of the winter and summer solstice. We will determine if photophobia results in reduced daily
light exposure by comparing adolescents with migraine-related photophobia to their migraine-free peers.
Furthermore, we will determine if daily fluctuations in photophobia precede reductions in light exposure (Aim
1). To evaluate if photophobia produces sleep disruption by reducing daily light exposure, we will compare
sleep midpoint and total sleep time across groups and determine if daily reductions in light exposure predict
delayed sleep time and shorter sleep durations (Aim 2). Finally, we will determine if seasonal reductions in light
exposure amplify the effects of migraine-related photophobia by comparing photophobia and light exposure
near the winter and summer solstice in those with and without migraine (Aim 3). Our combined expertise in
pediatric headache, vision neuroscience, and sleep research place us in an ideal position to pursue this work.
Regardless of the outcome, this project will provide fundamental measurements that will directly influence
patient guidance on whether light avoidance is helpful or harmful. It will also provide foundational
measurements needed to design clinical trials that either prioritize graded light exposure (e.g. increasing time
spent outdoors) or light avoidance (e.g. light blocking lens use).document fetched 2026-09-13 02:46