Headache-associated photophobia is more prevalent during winter: a cross-sectional study from a pediatric headache clinic

Aim Sensitivity to light and noise is commonly associated with headache. It is unclear if exposure to more intense sensory environments, or exposure to more restricted sensory environments leading to intolerance, worsens sensory sensitivity more over time. We aimed to determine if photophobia is more common during the winter months when daily light exposure is reduced.

We conducted a single-center cross-sectional study from a pediatric headache clinic in the Philadelphia area assessing patient-reported headache-related photophobia and phonophobia from an outpatient headache intake questionnaire. Rates were compared in the 3 months surrounding the winter and summer solstice, which has an average daylight difference of 5 hours between these time windows. Monthly symptom rates were fitted to a sinusoid across the 12-month calendar to characterize seasonal variation.

A total of 2,040 headache intake questionnaires were included in the analysis. Headache-associated photophobia was significantly more common in the winter compared to summer (OR 1.38, p = 0.018), but this seasonal variation was not observed for phonophobia (p = 0.698).

Headache-related photophobia is more prevalent near the winter, compared to the summer, solstice. Competing Interest Statement C.P.G.: Dr. Patterson Gentile is currently funded by the National Institutes of Health/National Institute of Neurological Disorders and Stroke (K23 NS124986) and the CHOP Foerderer Institutional grant. A.D.H.: Dr. Hershey or his institution have received compensation for serving as a consultant for AbbVie, Amgen, Biohaven, Eli Lilly, Lundbeck, Supernus, Teva, Theranica and Upsher-Smith. His institution has also received research support from Amgen, Biohaven, Eli Lilly, Theranica, Upsher-Smith, and the NIH NINDS/NICHDS. G.K.A.: Dr. Aguirre receives funding/grant support from the National Institute of Neurological Disorders and Stroke, the National Eye Institute, and the Binational Science Foundation. C.L.S.: Dr. Szperka has received research/grant support from the PCORI. Dr. Szperka or her institution have received compensation for her consulting work for Eli Lilly; Teva Pharmaceutical Industries Ltd; Upsher-Smith Laboratories, LLC; Abbvie; and Lundbeck. Funding Statement This work was supported by the National Institutes of Health National Institute of Neurological Disorders and Stroke (K23NS124986 to C.P.G). Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Children's Hospital of Philadelphia Institutional Review Board approved the extraction of the data from the electronic health record into a research registry, with a waiver of consent and assent to maximize generalizability. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes Financial support: This work was supported by the National Institutes of Health National Institute of Neurological Disorders and Stroke (K23NS124986 to C.P.G). Data Availability All data produced in the present study are available upon reasonable request to the authors. Abbreviations - CHOP - Children’s Hospital of Philadelphia - ICHD-3 - International Classification of Headache Disorders 3rd Edition - IQR - Interquartile range