Connection between right-to-left shunt and photosensitivity: a community-based cross-sectional study

Bosi Dong; Shuming Ji; Yajiao Li; Hua Li; Ruiqi Yang; Na Yang; Zhu Liu; Chenxing Zhu; Hui Wang; Yusha Tang; Anjiao Peng; Lei Chen

doi:10.3389/fneur.2023.1177879

Connection between right-to-left shunt and photosensitivity: a community-based cross-sectional study

Front Neurol. 2023 Apr 27:14:1177879. doi: 10.3389/fneur.2023.1177879. eCollection 2023.

Authors

Bosi Dong¹, Shuming Ji², Yajiao Li³, Hua Li¹, Ruiqi Yang¹, Na Yang², Zhu Liu¹, Chenxing Zhu², Hui Wang³, Yusha Tang¹, Anjiao Peng¹, Lei Chen¹

Affiliations

¹ Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
² Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Abstract

Background: Hypersensitivity to light is a common symptom associated with dysfunction of the occipital region. Earlier studies also suggested that clinically significant right-to-left shunt (RLS) could increase occipital cortical excitability associated with the occurrence of migraine. The aim of this study was to investigate the relationship between RLS and photosensitivity.

Methods: This cross-sectional observational study included the residents aged 18-55 years living in the Mianzhu community between November 2021 and October 2022. Photosensitivity was evaluated using the Photosensitivity Assessment Questionnaire along with baseline clinical data through face-to-face interviews. After the interviews, contrast-transthoracic echocardiography (cTTE) was performed to detect RLS. Inverse probability weighting (IPW) was used to reduce selection bias. Photosensitivity score was compared between individuals with and without significant RLS using multivariable linear regression based on IPW.

Results: A total of 829 participants containing 759 healthy controls and 70 migraineurs were finally included in the analysis. Multivariable linear regression analysis showed that migraine (β = 0.422; 95% CI: 0.086-0.759; p = 0.014) and clinically significant RLS (β = 1.115; 95% CI: 0.760-1.470; p < 0.001) were related to higher photosensitivity score. Subgroup analysis revealed that clinically significant RLS had a positive effect on hypersensitivity to light in the healthy population (β = 0.763; 95% CI: 0.332-1.195; p < 0.001) or migraineurs (β = 1.459; 95% CI: 0.271-2.647; p = 0.010). There was also a significant interaction between RLS and migraine for the association with photophobia (p_interaction = 0.009).

Conclusion: RLS is associated with photosensitivity independently and might exacerbate photophobia in migraineurs. Future studies with RLS closure are needed to validate the findings.

Trial registration: This study was registered at the Chinese Clinical Trial Register, Natural Population Cohort Study of West China Hospital of Sichuan University, ID: ChiCTR1900024623, URL: https://www.chictr.org.cn/showproj.html?proj=40590.

Keywords: community-based study; cross-sectional study; migraine; photosensitivity; right-to-left shunt.

Grants and funding

This research was supported by the National Natural Science Foundation of China [82271500].