Freedom of conscience in the French Law

The French Law on Separation of the Churches and the State of December 9, 1905 is so related to historical French culture to the establishment of their famous "Laïcité", that this law was celebrated in 2005 as the "Laïcité Centenary", with hundreds of events and festivities all over the country. Some myths of origin, which remain necessary even in the best democracies, because they permit populations to share a common and valuable history, are undoubtedly at work in this celebration of the French "Laïcité Centenary," commemorating the Law of 1905. Myths have goals, but they do not have the power of law nor are they real texts. The Law of 1905 is one step in the slow legal process of building French Laïcité. One decisive step (among many, to be sure), but other steps have more recently and more deeply, interpreted and integrated this term of Laïcité into the French Constitution (article I, Constitution of 1958). They also interpreted Separation, as one way to organize relations between churches and the State in France, while other rules continue to exist on the French territory, like those in place in Alsace. The constitutional principle which characterizes the French State is less "separation" than neutrality, a term much more significant. Neutrality can include the principle of separation, i.e. lack of public (State-sponsored) worship services according to the terms of article II of the Law of 1905 (no more "recognized" official churches, no more religion directly affiliated to the State with public budget for clergy salaries and administrative expenses, no more direct financing of worship services). But the principle

of the Separation relating to the Law of 1905, remains circumscribed to a simple law, which does not work for the entire French territory and has many amendments, including financial (1). More importantly, the principle of neutrality never meant that the French State does not acknowledge religions or reject religious fact. On the contrary, neutrality of the French State is a link for a balanced relationship and serves as a welcomed and necessary counterweight to its absolute obligation to respect freedom of conscience, an untouchable treasure of each citizen whose State is a servant, preventing in that way and forever anyone from any compelled religious belief and preventing everyone at the same time from holding a belief far different from their most intimate conviction, this own belief being sacred and unreachable, whatever its contents are and even if its contents would be totally atheistic and anti-religious.

It is more because of this balance that the Law of 1905 should be celebrated: This law only cemented the association between neutrality of the State (the end of Gallican interventionism in life of religions and the end of its very old relation with Catholic Church) and its essential reason, freedom of conscience. It is indeed not so anecdotal to recall that the first words of this law, those of article I, are as follows: "the Republic shall ensure the freedom of conscience", quite simply because this assertion is constitutional today and that, as simple as that sentence seems, it underlies a definition which is not a definition inherited from French free-thinkers of previous centuries, making freedom of conscience the absolute right of free will, without religious feeling. On the contrary, freedom of conscience in the context of the Law of 1905 protects religious belief, whereas traditional French freedom of conscience had been until this date the right to an enlightened consciousness vis-à-vis religious or political obscurantism.

Therefore, the freedom of conscience ensured by the Law of 1905 is not at all what thinkers of the French public school system had in mind at the end of the 19th century, when they dreamed of a better educated youth, moralistic indeed, but certainly free from any religious yoke. When the legislator of 1905 uses this formula, he applied freedom of conscience to religious belief. Consequently, it is this religious direction-more inherited from French Protestant thought against catholic Church's power as well as against the confessionalism of the King-that one will find in French texts and jurisprudence, this imprescriptible right to maintain a religious belief which implies life choices and conducts. It is this religious direction of freedom of conscience which will be upheld as a fundamental which also logically upholds freedom of teaching as another similarly fundamental principle 1 .

However, after having tried in a first part to review the whole implication that the Law of 1905 impelled in French Law compared to the freedom of conscience, understood as the religious consciousness, we will see that another French tradition, less legal than philosophical, makes "conscience" a strengthened place for religious emancipation as well as the seat of autonomous judgement. This sense did not disappear, either from the "consciences" nor from the mind of lawyers, and it emerges strongly when it confronts "the freedom of religious conscience". Not only does freedom of "religious" conscience face many legal limits in France but it is also subordinated to the project of a liberated consciousness which spans French history and thought since 18th century. This taste for emancipation in lieu of religious requirements explains a number of contemporary restrictions, like the famous prohibition of the Islamic veil in French public schools, while the veil as a freedom of religious conscience asserted by some, is considered by others as an obvious attack against "enlightened consciousnesses"... beliefs, and 2) to ensure the equality of all citizens before the law without discrimination of origin, race, or religion. To some extent, these three conditions of Laïcité as constitutional in spirit are entangled, and under them, freedom of conscience holds an essential place. Indeed, if the French State no longer has religious legitimacy nor does it interfere in the life and organization of churches, the freedom of conscience of each citizen obliges the State to respect personal beliefs as well as to guarantee the free exercise of the religion as collective beliefs, and to apply, as equally as possible, its legal commitment in order to respect all beliefs without discrimination, this is all thanks to an equal and general law. The equality of the citizen in respect of his belief and exercise of that belief, requires that the State, while guaranteeing this right, never gives him any sign of inequality of treatment. The freedom of conscience thus implies the principle of neutrality as an absolute obligation of its public services to take no part in religious opinions and beliefs.

I. Thanks to the

"Neutrality is the common law of all public agents during their time in office". This does not mean ignorance of religion but implies equality between the traditions. 2002 relating to the right of the patients. However, in another case, Mr. X. had been hospitalized in a public hospital because of a renal insufficiency. In a written letter communicated with its medical file, he announced its refusal, as Jehovah Witness, on any blood product. He specified that he refused any transfusion of blood product "even on the assumption that this treatment would constitute the only means of saving its life". The EC estimated that the obligation made to the doctor to always respect the will of the patient finds its limit in the obligation the doctor has -in accordance with the goal of his activity -to protect health of his patients. Indeed, taking into account the extreme situation in which Mr. X. was, the doctor who cared of him, focused on trying to save him, was pressed to achieve an vital act proper to the survival and proportioned to the state of the patient. The doctor thus did not make a fault while he wanted to protect the life of Mr. X. (EC, Ass., October 26, 2001, Mr. X).

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II. The freedom of conscience remains nevertheless in France a value of "liberation" which re-appears in the conflicts of conscience and frequently dominates over the requirements of the religious conscience.

This manner of seeing the freedom of conscience prevails largely in the French education system and explains the strict attitude of public authorities (and of French public opinion which shares this way of seeing things) with the permissible scopes of freedom of (religious) conscience, as understood by the Law of 1905. We have for example, though of course this definition is not legal, the definition proposed on French National Assembly official website, page "Juniors", page "Laïcité" into an alphabetical list of related terms.

Freedom of conscience is defined as "moral autonomy." It is the right of an individual to determine his philosophical, religious, ideological, and political convictions (among others)

apart from any external pressure-familial, social or political ". The religious freedom defined in the same list, is then "the faculty of any individual to adhere to a chosen confession or to refuse any (freedom of conscience), but also to express and teach his convictions and beliefs (freedom of thought) and to exercise his religion publicly, according to his faith (freedom of worship)". These definitions are focused on self-determination and personal choice of intimate convictions which presuppose the complete autonomy of the person free will and can be regarded as an effort against educational, social, and cultural pressures.

So that freedom of conscience is not understood as a freedom which allows, in the name of one imperative conscience, minority groups or individual believers to claim their right to exist and to be equally protected by a common law or, on the contrary, by a specific law. It is an absolute right of conscience to act without external support, and to find in oneself the means of one's worldview. For those who have read the Discours de la Methode of René Descartes, the continuity of the Cartesian heritage and French subjective philosophy shines through in this understanding of the freedom of conscience. The French conscience is decidedly enlightened and independent.

It is in the name of this same enlightened freedom, that the obligation of public servants does not reach the academic level. In a famous decision of January 20, 1984, the Constitutional Council strongly reaffirmed that the principle of professorial independence was necessary in the interest of the service (DC. 83-135, Loi relative à l'enseignement supérieur).

It validated article 3 of the relevant law relating to the higher education (n° 84-52 of 24 January 1984) which stipulates that "the public utility of higher education is secular and

FREEDOM OF CONSCIENCE IN THE CENTURY OF RUSSIAN PARLAMENTARISM, COLLOQUIUM OF THE SCHOLARS OF RELIGION UNION-ST-PETERSBURG APRIL 2006

independent of any political, economic, religious or ideological influence; It tends to objective knowledge; it respects the diversity of opinions. It must guarantee to the teaching and researches their possibilities of free scientific creative and critical development ". Article 54 of the same law stipulates that "the professors-researchers, the professors, and the researchers enjoy full independence and complete freedom of expression in their professional performance, under the reserves imposed to them, in accordance with university traditions and the provisions of the present law, the principles of tolerance and objectivity ". The reason of this tradition of extreme confidence, granted to the academic level on which is exerted very few controls (except cases of genocide revisionism or incitement of racial hatred), is of course that their "scientific" example will educate French students to free conscience.

The deep influence which generations of philosophers gave to French culture explains why the education given by the public educational system, provides at the same time the fundamental knowledge and a civic spirit, attentive "to open the door" to a critical thinking.

Without debating the sensible bankruptcy of my country's school system, nor on the mitigated results of its method which contribute to overwhelm the streets with angry people in case of real or imaginary threats on social rights and freedoms, this free-conscience-impulse explains the strong French educational systems' (and public opinion's) mobilization against the wearing of the Islamic veil. How can one form free consciences if some students assert a religious imperative requirement as a freedom? This difficult question was in fact dealt with the logic of the French school system. The teachers and curricular neutrality regarding religion must be extended to pupils inside buildings.

Thus, if any freedom of (religious) conscience is recognized by pupils, it is not stricto sensu written in the last text of educational Orientation (Loi d'orientation 89-486 of July 10, 1989 6 ), but should take part in the freedom of expression, expressly recognized by pupils in this law (article 10). Nevertheless, this freedom of expression is strictly framed, and to some extent undervalued by the legal minority of pupils. Only specific authorizations for holy days absences are allowed. Public holidays of the school calendar are indeed often Catholic religious holy days, related to the Catholic historical heritage of the French population. The texts specify that these authorizations can only be granted "in exceptional circumstances and for certain particular days insofar as they correspond to holy days, fitting in a calendar established at the national level and as they do disturb the continuity of schooling" (CE, Ass, April 14, 1995, Consistoire Central des Israélites de France, Circulaire of December 12, 1989 of the Minister for national Education).

In the same manner, respect of a time dedicated to religious teaching during the schools' week is obligatory in public education, but must be done outside of the school building for primary education (Law of March 28, 1882) and the respect of the religious rules regarding in the school cafeterias is a recommended tolerance, though limited to another meat or protein substitute in the case of pork, but it is not a legal obligation of the public food service 7 .

The opinion of the Council of State of November 27, 1989, is very revealing of the freedom of conscience of pupils, because this highest court, guardian of the "religious" tradition of freedom of conscience, as it was built starting from the Law of 1905, could not ignore its existence. Questioned by the government about the compatibility of the wearing of religious signs with the principle of laïcité, the Council of State explained: "It results from the above that, in teaching establishments, the wearing by students of symbols by which they intend to manifest their religious affiliation is not by itself incompatible with the principle of laïcité, as it constitutes the free exercise of freedom of expression and of manifestation of religious creeds". In its opinion, the Council of State initially reiterated the distinction between the obligations made to the personnel and those to the pupils. Indeed, "it results from the constitutional and legislative texts and from the international engagements of France that the principle of the laïcité of public education, which is one of the elements of the States' laïcité and of the civil service systems' neutrality, imposes that teaching is dispensed in the respect of this neutrality by programs and teachers and in addition in respect of the freedom This one established a distinction between discrete signs (allowed), expressing the personal attachment of pupils to personal convictions, and the conspicuous signs (prohibited), constituting in themselves elements of proselytism or discrimination. The Council of State, through its jurisprudence, cancelled several internal rules of teaching establishments, which prohibited in a general and absolute way the wearing of any distinctive sign. In the same way, it cancelled decisions of pupils' exclusions. On the other hand, The Council of State admitted the legality of sanctions if justified by a disorder with the law and order, and in particular when girls refused to remove their scarf during sport lessons or to take part in other lessons for religious reasons. In these cases, the refusal, opposite with the obligation of assiduity, exceeds their right to express their religious convictions.

This jurisprudence however revealed its limits. On the one hand, the legal conduct retained by the opinion of the Council of State was debated since the application could appear different from one establishment to the next. In addition, decisions made by heads of teaching establishments were difficult to apply: Difficulties of interpretation what was conspicuous or not, difficulties of application, when parties refused dialogue. These difficulties led in a large part to the reflection preceding the Law n° 2004-228 of 15 March 2004, framing, in accordance to the principle of Laïcité, the wearing of signs or clothes expressing a religious affiliation at elementary schools, schools, and colleges 8 .

8 Article 1: "It is inserted, in the Code of Education, after the article L. 141-5, an article L. 141-5-1 thus written: "Art L. 141-5-1. -In the public elementary schools, schools and high schools, the wearing of signs or clothes by which the pupils express conspicuously a religious membership is prohibited",

FREEDOM OF CONSCIENCE IN THE CENTURY OF RUSSIAN PARLAMENTARISM, COLLOQUIUM OF THE SCHOLARS OF RELIGION UNION-ST-PETERSBURG APRIL 2006 principle

  of constitutional value, by a Constitutional Council Decision ofNovember 23, 1977,

Law of 1905, freedom of conscience applies, above all, to the religious belief in French legal system.

	exercise of the worships under the only restrictions enacted hereafter in the interest of the law
	and order". The first article of the 1958's Constitution instituting the 5th French Republic
	declares: «France shall be an indivisible, secular, democratic and social Republic. It shall
	ensure the equality of all citizens before the law, without distinction of origin, race or
	religion. It shall respect all beliefs ". We have here a perfect circle which defines the
	1 Decision n°77-87 about the eventual unconstitutionality of the Law n°59-1557 of December 31, 1959 relating
	to the freedom of teaching, article 5: Considering in addition that under article 10 of the Declaration of the
	Human and Citizen Rights of 1789 " No one shall be disquieted on account of his opinions, including his
	religious views, provided their manifestation does not disturb the public order established by law", that the
	Preamble to the Constitution of 1946 recalls that "Each person has the duty to work and the right to
	employment. No person may suffer prejudice in his work or employment by virtue of his origins, opinions, or
	beliefs"; that the freedom of conscience must thus be considered as one of the fundamental principles recognized
	by the laws of the Republic

The first article of the Law of December 9, 1905 affirms that "the Republic shall ensure the freedom of conscience" as a personal freedom. It is implemented by an additional sentence which protects collective dimension of religious practice as "it guarantees the free

FREEDOM OF CONSCIENCE IN THE CENTURY OF RUSSIAN PARLAMENTARISM, COLLOQUIUM OF THE SCHOLARS OF RELIGION UNION-ST-PETERSBURG APRIL 2006

	Republic in its constitutional spirit (Laïcité) -if I may make this comparison-as a Trinity:
	neutrality, freedom of conscience, and equality. The neutrality of the State is the first
	condition of Laïcité and emanates from the silence of the constitutional text about God or any
	divine principle, contrary to some older Constitutions or constitutional texts 2 .
	The Republic is self-referred, without transcendence at the top. Neutrality of the State
	imposed by the Republic means that the legal State resulting from the Constitution does not
	have a denominational agenda, nor that the common law is founded on particular religious
	standards nor that any of its powers can claim any religious legitimacy. The religious
	incompetence of the French State is understood as a two-fold task, which is 1) to ensure
	according to the first article of the Law of 1905, the freedom of conscience, specified in the
	first article of the 1958 Constitution, with the assertion that the Republic shall respect all

  If the legislator, in 1905, gave up recognized churches, and if the State is no longer able to recognize any religion as public or official, it never shall ignore any. Among the assets of the first article of 1905, of constitutional value, figure the assertion that all religions have the right to express themselves-what was not the case before-and as a counterpart of the preceding one, the assertion which there should not be, by one or more of them, entanglement with the State or negation of its fundamental principles.So, if the State does not profess any religion while applying a strict equality between its citizens in its public services, that means that users must be treated in the same way no matter what their religious beliefs might be. It is necessary and imperative that the administrative services, submitted to political power, assure not only complete neutrality but show this neutrality, so that users do not feel discriminated against. That is what the Council of State called the "duty of strict neutrality" which is obligatory for all public servants (Council of State May 3, 1950, Dlle Jamet and the contentious opinion of May 3, 2000 Dlle No employment, according to the Preamble of the 1946 Constitution, subparagraph 5, can be made ineligible because of race, origin or religion. The authorizations of absence of public agents for the religious holidays are granted each year by ministerial circulars. Freedom of conscience is also used to guarantee freedom of teaching and to allow existence to private and denominational schools. It is again used to justify that in confessional schools, if they are under an official contract with the State and if their teachers are salaried by the State as described by the Law Debré of December 31, 1959 (law n°59-1557), religious teaching is not obligatory and must respect freedom of conscience of children and parents. Confessional belonging of teachers in denominational private schools under contract with the State is not obligatory, in the name of their freedom of conscience, but at the same time, once engaged, they must respect the proper character of their establishment, and practise a "duty of reserve" vis-à-vis the expression of their own opinions and beliefs, if those differ from the religious culture transmitted there (Cour de Cassation, May 19, 1978, Dame Roy c/association Sainte Marthe). Thus, in many catholic schools, teachers, administrative staff, and children are non-religious or of another religion besides Catholicism, in particular Islam. Clause of conscience determined by the article L 2212-8 of the Code of Public Health.This article disposes that: "a doctor is never held to practise an voluntary pregnancy interruption" but, if he refuses to practise it, he must inform, without delay, the interested person and immediately communicate to her the name of experts suitable to make this intervention". 5 "The freedom of conscience consecrated by the European Convention on Human Rights also forces to respect the will of the patient", Council of State, Ordinance of the Judge "des référés" of August 16, 2002, N°249552, Mrs. Valerie FEUILLATEY and Mrs. Isabelle FEUILLATEY, in connection with the blood transfusion made in spite of the refusal on a Jehovah Witness, ordinance given on the basis of the Law n° 2002-3003 of March 4,

Marteaux). Outside their service, the civil servant is free to express religious opinions and beliefs, provided this expression does not influence the service given to the State

(Council of State April 28, 1938 Demoiselle Weiss)

. During their time in office, a strict duty of neutrality is required. Any demonstration of religious convictions during work is prohibited as well as the wearing of religious signs -the Islamic veil most recently-, even if the civil servant is not in direct interaction with the public. This requirement for neutrality of civil servants is particularly present in the Public Education system 3 (Constitutional Council Decision, 84-185 of January 18, 1985, Loi Chevènement and Council of State, opinion of May 3, 2000, Dlle Marteaux) and in the public Health service (Administrative Court of Paris, October 17, 2002, Mrs. Christine E, concerning the respect of the "freedom of conscience" of users in a state of weakness or dependence). The freedom of conscience is recognized for civil servants, their personal convictionspolitical as well as religious-cannot be displayed or made known, and are never registered in their candidates' files (Constitutional Council Decision n° 76-77 of July 15, 1977, Dossiers des fonctionnaires), except those made for the choice of a future Prefect by the President of the Republic. The access to public offices cannot be restricted for religious opinion (CE March 13, 1953, Tessier). In the name of the (religious) freedom of conscience, installed in French constitutional history by the Law of Separation of 1905, it is also prohibited to force a doctor or a medical worker to act against his conscience (Constitutional Council Decision n°74-75 of January 15, 1975, about abortion rights) 4 , neither it is possible to force a patient to pursue a treatment or a prescription he refuses 5 . The freedom of conscience is also used as a reason for conscientious objection (refusal to use weapons), integrated in 1963 in the Code of the National Service (articles L 116 -1 and 116-8) and replaced by a specific service, became, in 1983, a civil service affected to the Ministry for Social Affairs.

4

FREEDOM OF CONSCIENCE IN THE CENTURY OF RUSSIAN PARLAMENTARISM, COLLOQUIUM OF THE SCHOLARS OF RELIGION UNION-ST-PETERSBURG APRIL 2006 of conscience of the pupils".

  The Academy of The North's General Department of Supervisory (administrative unit of the Ministry for Education) made, trough its juridical service, a very instructive point on this question, on March 31, 2006, Taking account of religious requirements regarding school restoration, http://netia59a.aclille.fr/~siteia/espace_juridique/secondaire02.php Concerning the pupils, the principle of Laïcité not only "prohibits [... ] any discrimination in the access to teaching which would be founded on the pupils religious convictions or beliefs" but also "the freedom thus recognized included for

	them the right to express and to manifest their religious beliefs inside the teaching
	establishments."
	However the Council of State specified immediate limits on this freedom: "but this
	freedom should not allow students to wear signs of religious affiliation that, due to their
	nature, or the conditions in which they are worn individually or collectively, or due to their
	ostentatious and provocative character, would constitute an act of pressure, provocation,
	After this opinion, Lionel Jospin, then Minister for the national Education, spread a
	Circular, on December 12, 1989 declaring that "Laïcité as the constitutional principle of the
	French Republic, is one of the foundations of the public school. At school, like elsewhere,
	religious beliefs of each one is a question of individual conscience and thus belongs to
	freedom. But at school where all young people live together without any discrimination, the
	exercise of freedom of conscience, in the respect of pluralism and neutrality of public service,
	imposes that the entire educational community lives safe from any ideological or religious
	pressure." By doing this, if "any young person must be respected in his personality -this

7

proselytism or propaganda, or would harm the dignity or the freedom of the student or other members of the educational community, or would compromise their health or safety, or would perturb the educational activities or the educational role of the teaching personnel, or would trouble public order in the establishment or the normal functioning of the public service."

In the same way the exercise of the freedom of conscience must be limited "insofar as (it) constituted an obstacle to the achievement of the missions reserved by the legislator for educational public service, which must, in addition to allowing acquisition by children of cultural and professional background as well as sense of responsibility as (wo)men and citizen, contribute to the development of their personality, inculcate to them respect of individuals, origins and differences, guarantee and support equality between men and women." respect, being an integral part of the educational role of the school -the young person must learn and understand that respect of the freedom of conscience of others demands his own personal reserve."

FREEDOM OF

CONSCIENCE IN THE CENTURY OF RUSSIAN PARLAMENTARISM, COLLOQUIUM OF THE SCHOLARS OF RELIGION UNION-ST-PETERSBURG APRIL 2006 11

  Thus, administrative Justices examined cases based on this official declaration such as, since 1994, the ministerial circular of François Bayrou, then Minister for national Education.

Constitutional Chart of June 4 th , 1814, Constitutional Chart of August 14 th , 1830, Preamble of the Constitution of November 4 th , 1848, Constitution of January 14 th , 1852 and Senatus-Consulte of May 21 st , 1870, Constitutional Law of July 16 th , 1875

Decision 84-185 of the Constitutional Council of January 18, 1985, Law Chevènement, about the neutrality of teachers: "if it cannot be interpreted as a possibility to harm the freedom of conscience of teachers, which has constitutional value, forces these teachers to observe in their teaching a duty of reserve"

First Article (modified by the Law 94-665 of August 4, 1994 and by the Law 98-657 of July 29, 1998): -Education is the first national priority. The public service of education is conceived and organized for pupils and students. It contributes to equality of chance. The right to be educated is guaranteed for anyone, in order to permit him to develop his personality, to raise his initial and continuous level of knowledge, to share social and professional life, to exert his citizenship.Art 10: -The obligations of the pupils consist in the achievement of the duties inherent to their studies; they include assiduity and respect of rules concerning management and collective life inside the establishments. In the schools and high schools, the pupils lay out, in the respect of the pluralism and the principle of neutrality, the freedom of information and the freedom of expression. The exercise of these freedoms cannot harm the teaching activities.


Yohana Lévêque
email: yohana.leveque@inserm.fr

Rémy Masson

Lesly Fornoni

Annie Moulin

Aurélie Bidet-Caulet

Anne Caclin

Geneviève Demarquay

Attention difficulties associated with sensory hypersensitivity in migraine. Self-perceived attention difficulties are associated with sensory hypersensitivity in migraine

Keywords:

Background: Attention is the process which enables to preferentially select salient or relevant stimuli and to attenuate the response to irrelevant incoming stimuli. Migraine is characterized by both attentional alterations and an abnormal sensory processing to external stimulations. The aim of the study was to investigate potential interactions between self-perceived attentional difficulties and sensory hypersensitivity in migraine patients.

Methods: Forty-six episodic migraineurs without aura and 46 healthy controls filled out questionnaires on self-perceived attention difficulties and self-reported sensitivity to visual, auditory and olfactory stimulations.

Results: Compared to controls, migraineurs reported significantly higher levels of attention difficulty and sensory sensitivity. Sensory hypersensitivity correlated significantly with self-perceived attentional difficulties in migraineurs (p=0.002), but not with migraine disability or levels of anxiety or depression. Ictal and interictal sensory sensitivity were significantly correlated in migraineurs within visual (p<.001), auditory (p<.001) and olfactory (p=.001) modalities.

Conclusion:

This study shows for the first time an association between self-reported attentional difficulties and multimodal sensory hypersensitivity. Studies combining behavioral and physiological measures of sensory processing and attention processes are necessary to further understand the peculiar vulnerability of migraineurs to sensory stimuli.

Self-perceived attention difficulties are associated with sensory hypersensitivity in migraine 1. Introduction

Migraine is characterized by an abnormal sensory processing [START_REF] Goadsby | Pathophysiology of Migraine: A Disorder of Sensory Processing[END_REF] [START_REF] Brennan | A Systems Neuroscience Approach to Migraine[END_REF]. Enhanced sensitivity to unior multimodal stimuli such as an exacerbation of headache or discomfort is a striking feature of migraine which varies over the migraine cycle [3] [4]. Neurophysiological and neuroimaging studies also suggest that the migraine brain is hyperresponsive to sensory stimuli as evidenced by impaired habituation to stimuli and increased BOLD fMRI responses to photic stimuli [5].

In parallel, recent research has pinpointed attentional alterations in interictal migraineurs. Attention is the process which enables to preferentially select salient or relevant stimuli and to attenuate the response to irrelevant incoming stimuli. Neurophysiological and neuroimaging studies suggest an altered top-down attentional control of visual cortex [6] and an enhanced orienting response towards acoustic stimuli [7][8] in migraineurs. Behavioral and neuropsychological studies also report attentional impairments in migraineur children and adults (for a review, see [9]). However, distinction between executive functions and attention, or hyperactivity symptoms and attention, is not always possible given the tests employed [10] [11] and results are not always consistent overall. For instance, Gil-Gouveia et al. [12] and Lo Buono et al. [13] found no difference between migraineurs' and controls' performance in the Trail Making Test-A and -B. The study of Han et al. suggested that some components of attention may be impaired in migraineurs without aura, whilst other components are intact [START_REF] Han | Selective attention network impairment during the interictal period of migraine without aura[END_REF].

To our knowledge, no study has investigated the potential link between migraine enhanced sensory sensitivity and attentional alterations. Both point to abnormal sensory processing in migraine patients. The aim of our study was to investigate the interactions between sensitivity to light, sound, odor, and self-perceived attentional difficulties by means of questionnaires, in episodic migraineurs without aura and control participants.

Methods

Participants

Forty-six migraine patients without aura and forty-six healthy control participants matched for sex, age, education and music training participated in this study (Table 1). All migraine patients fulfilled the criteria of episodic migraine according to the International Headache Society [START_REF]Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition[END_REF], were aged 18 to 75 years and suffered from at least 1 attack per month. Exclusion criteria were migraine with aura, chronic migraine (>15 days of headache per month), other neurological or psychiatric disease, and use of preventive medication. Attack frequency was 3.8±1.9 per month. Twenty-three migraineurs and eleven control subjects were concomitantly participants to a magnetoencephalography (MEG) study investigating auditory attention [START_REF] Masson | Attentional alterations in migraine: a behavioral and M/EEG study[END_REF]. Participants gave their written informed consent, according to the Declaration of Helsinki.

Table 1: Demographic characteristics of the participants 2.2 Material

We created one questionnaire assessing self-perceived attentional difficulties in daily life. This questionnaire was inspired from the Attention self-assessment questionnaire [START_REF] Coyette | Questionnaire d'Auto-évaluation de l'Attention[END_REF] and the Wender Utah Rating Scale [START_REF] Ward | The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder[END_REF]. For each item, the participants rated on a 4-point scale the frequency with which they encounter difficulties in a particular situation. We also created three questionnaires to assess visual, auditory, and olfactory hypersensitivity. Each item presented a behavioral or emotional response to a sensory stimulation and a 4-point scale from 1 "Rarely" to 4 "Very often". These questionnaires were divided into two sections: "between attacks" and "during an attack" (see Appendix for the full version, with an English translation). The "between attacks" auditory questions were selected from the auditory sensitivity questionnaire of Khalfa (1999, French clinical test, published in English under the name HQ -Hyperacusis Questionnaire- [START_REF] Khalfa | Psychometric normalization of a hyperacusis questionnaire[END_REF]). The visual questions were adapted from Choi et al. [START_REF] Choi | Usefulness of a photophobia questionnaire in patients with migraine[END_REF]. The olfactory questions were inspired from the Glasgow Sensory Questionnaire [21][22]. Finally, migraineurs were requested to fill the HIT (Headache Impact Test, [START_REF] Kosinski | A six-item short-form survey for measuring headache impact: the HIT-6[END_REF]) and the MIDAS scale (Migraine Disability Assessment, [START_REF] Stewart | Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability[END_REF]) as a measure of migraine general severity, functional impact of migraines and migraine frequency. The 34 participants who underwent an additional MEG experiment also completed the HAD (Hospital Anxiety and Depression Scale [START_REF] Zigmond | The hospital anxiety and depression scale[END_REF]) to assess anxiety and depression levels.

Procedure

Participants (n=92) completed the attention and hypersensitivity questionnaires. For the hypersensitivity questionnaires, controls were asked to answer only the "between attacks" sections. The migraine patients also completed the HIT and the MIDAS (n=46). The HAD was completed only by the subjects participating to the MEG study (n=23 migraineurs).

Statistical analysis

Responses "rarely" were recoded as "1", "sometimes" as "2", "often" as "3" and "very often" as 4. Missing data in questionnaires were replaced by the group average score to the item. By averaging item scores, we got a total score for each questionnaire. Separate scores were computed for the sections "between attacks" and "during an attack" for the hypersensitivity questionnaires. Internal coherence of each questionnaire was assessed using Cronbach's alpha.

Group differences in the scores to the self-perceived attentional difficulties and the visual, auditory and olfactory interictal hypersensitivity questionnaires were assessed using independent t-tests. Pearson correlations between ictal and interictal scores and between modalities were then conducted on migraine patient data. Finally, a multiple linear regression assessed the relationship between interictal sensory hyperactivity with self-perceived attention difficulties, including age, sex, education level, MIDAS and HIT scores as covariates to control for confounding effects. Modeling assumptions were verified using the gvlma R-package [START_REF] Peña | Global Validation of Linear Model Assumptions[END_REF]: data fulfilled the statistical assumptions of independence, normality and homogeneity of variances (p>.05). The multicollinearity was not excessive with a Variance Inflation Factor (VIF) always inferior to 0.69, under the commonly accepted cutoff value of 5 or 10 [START_REF] O'brien Rm | A caution regarding rules of thumb for variance inflation factors[END_REF].

Causality questions ("Is your headache worsened by…?" and "Is your headache triggered by…?") were analyzed separately, with the aim to examine the link between the perception of a stimulation as a trigger and interictal hypersensitivity in migraineurs.

All the computed p-values were two-tailed and the cut-off for statistical significance was of 0.5.

Results

There was no missing data across the questionnaires for the control group. In the migraine group, the rate of unanswered items was <2% for all questionnaires. Internal coherence was high within each questionnaire (interictal part), as measured by the Cronbach's Alpha computed on the 92 participants: 0.73 for the attention questionnaire, 0.85 for the visual questionnaire, 0.84 for the auditory questionnaire. Olfactory questionnaire comprised only one question in the interictal part. Three migraineurs out of 23 tested showed an anxiety score superior to the pathological cut-off according to the HAD norms, but the depression score was not pathological and their data were retained for the main analyses.

Group comparisons

Migraineurs showed significantly higher scores of self-perceived attention difficulties than control participants (t(90)=2.64, p=.010, d=.53), as illustrated on Figure 1A. Ratings by items are illustrated on Figure 2.

Correlations in migraineurs

Visual and auditory hypersensitivity were correlated in migraineurs, slightly in interictal periods (r(44)=.30, p=.043) 1 , more strongly in ictal period (r(44)=.432, p=.003). Olfactory hypersensitivity did not correlate with the other modalities in interictal period (r(44)<.22, p>.141). In ictal period, the correlation of olfactory hypersensitivity with auditory hypersensitivity was significant (r(44)=.315, p=.033), but the correlation with visual hypersensitivity failed to show significance (r(44)=.24, p=.102). Note however that the olfactory questionnaire was shorter and hence likely to be less robust than the auditory and visual questionnaires.

In the analyses that follow, we used a composite score of interictal sensory hypersensitivity across visual and auditory modalities by averaging visual and auditory scores for each migraineur participant.

The multiple linear regression revealed a significant correlation between interictal sensory hypersensitivity and self-perceived attention difficulties (t=3.47, p=.001) with no significant contribution of the covariates (see Table 2). The model had a multiple R 2 of .38 and an adjusted R 2 of .28 (F(6,39)=3.95, p=.003). The relationship between sensory hypersensitivity and attention is illustrated in Figure 3.

Estimate

Table 2: Results of the multiple linear regression in migraineurs data (n=46) with the interictal audiovisual hypersensitivity as the dependent variable.

Self-perceived attention difficulties are significantly linked to hypersensitivity, while the demographic and migraine variables are not. Tested in a separate analysis because of a sample of lower size (n=23), the correlation between the anxiety and depression score (HAD total score) and self-perceived attentional difficulties revealed a significant association between both variables (r(21)=.45, p=.033). However, the anxiety and depression score was not significantly correlated to interictal sensory hypersensitivity (r(21)=.09, p=.674).

Attack-related questions in migraineurs

Sensory hypersensitivity was strongly enhanced during ictal periods compared to interictal periods (During attack composite score: 2.8±0.6; Between-attack composite score: 2.30±0.6; t(45)=-7.8, p<.001). Ictal and interictal scores were also significantly correlated within each modality (visual: r(44)=.57, p<.001; auditory: r(44)=.72, p<.001; olfactory: r(44)=.47, p=.001).

To the question "Is your headache worsened by…?"(see Appendix), 70% of migraineur participants answered "often" or "very often" for lights, 65% for sounds, 43% for odors. To the question "Is your headache triggered by…?", 15% of migraineur participants answered "often" or "very often" for lights, 11% for sounds, 22% for odors. Scores to the question "Is your headache triggered by…?" were significantly correlated to interictal sensory hypersensitivity for visual and auditory modalities (visual: r(44)=.43; p=.003; auditory: r(44)=.38 ; p<.010), and marginally for olfactory modality (r(44)=.26 ; p=.077).

Discussion

Compared with controls, migraine patients reported significantly higher levels of sensory sensitivity and attention difficulties. Both variables were positively correlated among migraineurs, after controlling for background variables (age, sex, education, HIT and MIDAS scores). Ictal and interictal sensory sensitivity were significantly correlated in migraineurs within visual, auditory and olfactory modalities. The correlation between visual and auditory hypersensitivity was slight in interictal period in migraineurs, and reinforced in ictal periods.

Multimodality of sensory hypersensitivity

In this study, migraine patients reported a higher self-reported sensitivity to light, sound and odor between and during migraine attacks. A recent study showed that patients with ictal photophobia were more likely to complain from interictal photosensitivity as well as visual stimuli as triggers than headache patients without ictal photophobia or controls [START_REF] Hayne | Relating Photophobia, Visual Aura, and Visual Triggers of Headache and Migraine[END_REF]. Our results corroborate this finding within the visual modality and show that these correlations between ictal and interictal states are also observed within auditory and olfactory modalities. A limit of the current study is that ictal and interictal allodynia was not evaluated.

Migraineurs reporting interictal hypersensitivity to a given modality also complained that these stimulations could trigger migraine attacks. This link is however difficult to draw up since answers to the hypersensitivity questionnaires may reflect preventive behaviors set up by patients toward a supposed trigger. Moreover, attribution of a causal role to certain sensory stimulations may be misinterpretation by patients of a simple co-occurrence of hypersensitivity and migraine attacks. Indeed, patients pay an exacerbated attention to certain stimuli in the premonitory phase of the attack [START_REF] Schulte | Photo-, osmo-and phonophobia in the premonitory phase of migraine: mistaking symptoms for triggers?[END_REF].

Correlation between self-reported visual and auditory sensitivity in migraineurs are in line with a set of data linking sensitivities across modalities. For instance, lower sound aversion thresholds were observed in patients with allodynia compared with non-allodynic patients [START_REF] Ashkenazi | Is phonophobia associated with cutaneous allodynia in migraine?[END_REF] and patients with olfactory hypersensitivity were more likely to complain of photophobia [START_REF] Demarquay | Rating of olfactory judgements in migraine patients[END_REF]. This multimodal sensitivity would reflect the hypothesis that migraine is "a paroxysmal disorder of pan-sensory gain" [START_REF] Brennan | A Systems Neuroscience Approach to Migraine[END_REF].

Self-reported attentional difficulties in migraine

The present findings of self-reported attentional difficulties in migraineurs complement a set of studies objectivating complex attentional alterations between attacks [START_REF] Masson | Attentional alterations in migraine: a behavioral and M/EEG study[END_REF] for electrophysiology; and more contrasting results for behavioral performances [32][14]. Our results suggest that attentional difficulties are not only detected by fine electrophysiology measures in experimental sets-up, but are consciously experienced by migraineurs in daily life, even in patients with episodic migraine. Recently, a cross-sectional study among university students showed an association between self-perceived attention difficulties and hyperactivity symptoms levels in students suffering from migraine [11]. Attention deficit is also reported in both children and adult patients with migraine (see [9] for a review). A comorbidity between migraine and Attention Deficit and Hyperactivity Disorder (ADHD) has been described, possibly because the same neurotransmitters might be involved in both conditions (see [START_REF] Salem | ADHD is associated with migraine: a systematic review and meta-analysis[END_REF] for a review and meta-analysis; in particular migraine with aura [START_REF] Hansen | Comorbidity of migraine with ADHD in adults[END_REF]; see also [START_REF] Kutuk | Migraine and associated comorbidities are three times more frequent in children with ADHD and their mothers[END_REF]). However, the item in our attention questionnaire which could be considered as typical of ADHD (distraction at school during childhood), did not yield a difference in rating by migraineurs and controls (questionnaire in annex and figure 2). Items revealing the greatest group differences concern the sensitivity to exogeneous and endogenous distractors, fatigability in sustained attention tasks and attention to detail. Migraineurs do not report making more errors than do controls when divided attention or sustained attention is required. Migraineurs might pay a superior cost in attention to reach the same performance, leading to fatigue. More detailed explorations of the different components of attention are needed to better understand this attentional profile.

Correlations between self-reported attentional difficulties and sensory sensitivity in migraine

The pathophysiological mechanism of ictal and interictal non-painful symptoms in migraine is still poorly understood. Three hypotheses may be proposed as possible explanations for the association we found between self-perceived attentional difficulties and sensory hypersensitivity.

First, attentional difficulties may be caused by an increased sensitivity to environmental stimuli. Migraine is characterized by a sensory amplification that occurs both during and between attacks and that implies multimodal sensory systems (see above). External stimuli may engage attention in an exacerbated manner in migraineurs [7], yielding distraction, and thus attentional difficulties in daily life. According to this hypothesis, migraine would generate sensory hypersensitivity, which, as a consequence, would disturb attentional processes.

Second, hypersensitivity could be caused by attentional difficulties linked to migraine. An altered bottom-up (involuntary capture of attention by an unexpected salient stimulus) and/or topdown (voluntary attention to sensory stimuli) processes could lead to an abnormal sensory modulation management. For instance, an association between attentional deficit and abnormal sensitivity to sensory stimuli has been reported in patients with ADHD [36][37]. According to this hypothesis, migraine generates attentional imbalances, which expose patients to multimodal sensory hypersensitivity. However, migraine disease is not primarily an attention deficit disorder.

Third, both self-reported attentional difficulties and enhanced sensory responsiveness could originate from individual predisposition to develop migraine. Neurochemical imbalances (noradrenaline, dopamine) could underly the attentional difficulties as well as the ictal and interictal pathophysiology of the migraineur brain (e.g [START_REF] Villa | Visual attention in children with migraine: a controlled comparative study[END_REF]. This hypothesis could explain that both sensory and attentional anomalies have been reported in adults but also in children with migraine (see above): they would not be consequences of several years of migraine damaging the cognitive functions, but reflects of a source dysfunction. Longitudinal studies are required to enlighten causal relationships and disentangle anomalies which are at the core of migraine disease, and anomalies secondary to the source dysfunctions. One could for instance investigate engagement of attention in external stimuli processing in children, and how predictive it is for later migraine disease.

Importantly, the association we found here between self-perceived attentional difficulties and sensory hypersensitivity cannot be explained by anxiety and depression nor by the severity of migraine, as both variables were not correlated to sensory hypersensitivity. A personality factor as neuroticism [START_REF] Ashina | Neuroticism, depression and pain perception in migraine and tension-type headache[END_REF] could underlie a higher level of complaint in migraineurs than controls and association between both complaints (hypersensitivity and attention difficulties). However, in that case, we would probably have observed a level of complaint across all scales (including HAD score) proportional to the migraine severity (HIT score), which is not the case. In line with these observations, interictal photosensitivity has been found to be unrelated to duration of migraine, frequency of attacks and mood disorder [START_REF] Vingen | Phonophobia in migraine[END_REF] [START_REF] Chong | Interictal photosensitivity associates with altered brain structure in patients with episodic migraine[END_REF].

Conclusion

This study highlights the association between multimodal hypersensitivity and self-perceived attentional difficulties in migraine patients. Studies combining behavioral and physiological measures of sensory processing and attention processes are necessary to further understand the peculiar vulnerability of migraineurs to sensory stimuli. Funding: This work was supported by a grant from "Agence Nationale de la Recherche" (ANR) of the French Ministry of Research: ANR-14-CE30-0001-01. This work was conducted in the framework of the LabEx CeLyA ("Centre Lyonnais d'Acoustique", ANR-10-LABX-0060) and of the LabEx Cortex ("Construction, Function and Cognitive Function and Rehabilitation of the Cortex", ANR-11-LABX-0042) of Université de Lyon, within the program "Investissements d'avenir" (ANR-11-IDEX-0007) operated by the French National Research Agency (ANR).

Annex

QUESTIONNAIRES

The French version was used in the present study. The English translation is provided between brackets for the readership of this article. The scale is the same across the questionnaires: "rarely", "sometimes", "often" or "very often".

Echelle d'attention [Attention scale]

Figure 1 :Figure 2 :

 12 Figure 1: Average score to the attention questionnaire (panel A) and the sensory hypersensitivity questionnaires ("between attacks" questions) in control and migraine participants (panels B, C, D). *p <.05, ** p<.01, *** p<.001

Figure 3 :

 3 Figure 3: Interictal sensory hypersensitivity correlates significantly with self-perceived attentional difficulties in migraineurs (left) but not with migraine disability (HIT score, right)

  Si vous présentez des migraines, répondez aux questions suivantes en vous basant sur votre vécu en dehors des crises : [If you use to have migraines, answer the following questions based on your experience between attacks:] Si vous présentez des migraines, répondez à la question suivante en vous basant sur votre vécu en dehors des crises : [If you use to have migraines, answer the following questions based on your experience between attacks:] Cherchez-vous à éviter les lieux avec des odeurs fortes ? (odeurs de cuisine, de friture, de parfum, d'essence). [Do you seek to avoid places with strong odors? (kitchen, frying, perfume, petrol smells)] Ne répondez aux questions suivantes que si vous présentez des migraines : [Answer the following questions only if you have migraines:] 2. Pendant votre migraine, les odeurs fortes (odeurs de cuisine, de friture, de parfum, d'essence) vous dérangent-elles ? ⃝ ⃝ ⃝ ⃝ 3. Votre migraine empire-t-elle en présence d'odeurs fortes ? [Is your headache worsened by strong odors?] ⃝ ⃝ ⃝ ⃝ 4. Votre migraine est-elle déclenchée par une odeur forte ? [Is your headache triggered by strong odors?] ⃝ ⃝ ⃝ ⃝

	9. Quand je mène une activité, je commets des erreurs si on me parle en même temps. [When I am carrying on an activity, I make mistakes if one talks to me at the same time.] 8. Lorsque vous avez la migraine, vous arrive-t-il d'utiliser des bouchons (boules Quiès) pour limiter votre perception du bruit ? [During your headache, do you ever use earplugs to reduce ⃝ ⃝ ⃝ ⃝	⃝ ⃝ ⃝ ⃝ Très rarement Parfois Souvent	Très souvent
	Très rarement ⃝ ⃝ ⃝ ⃝ Parfois Souvent Très souvent 1. ⃝ ⃝ ⃝ ⃝ 1. Au cours de mes activités (lecture, télévision, conversation,...), je me.] 2. Avez-vous des difficultés à ne plus faire attention aux sons [During your headache, do loud noises bother you?] thread because I am distracted by external noises and/or coming and going around vous dérangent ? ⃝ ⃝ ⃝ ⃝ [During/throughout my activities (reading, television, conversation,…), I lose the [Do you ever use earplugs to reduce your noise perception?] 10. Lorsque vous avez la migraine, est-ce que les bruits forts autour de moi. limiter votre perception du bruit ? ⃝ ⃝ ⃝ ⃝ perds le fil parce que je suis distrait(e) par les bruits extérieurs et/ou le va-et-vient Si vous présentez des migraines, répondez aux questions suivantes en vous basant sur votre vécu en dehors des crises : [If you have migraines, answer the following questions based on your experience between attacks:] Très rarement Parfois Souvent 1. Vous arrive-t-il d'utiliser des bouchons (boules Quiès) pour situations de la vie quotidienne ? [During your headache, do you find it hard to not pay attention anymore to sounds around you in everyday situations?] ⃝ ⃝ ⃝ ⃝ Très souvent ne plus faire attention aux sons qui vous entourent dans les [Phonophobia questionnaire] 9. Lorsque vous avez la migraine, avez-vous des difficultés à Questionnaire de gêne au bruit your noise perception?]
	2. Au cours de mes activités (lecture, télévision, conversation,...), je qui vous entourent dans les situations de la vie quotidienne ? [Do you find it hard to not pay attention anymore to sounds ⃝ ⃝ ⃝ ⃝ 11. Lorsque vous avez la migraine, trouvez-vous certains perds le fil parce que mon esprit vagabonde et que je ne peux pas m'empêcher de penser à autre chose. thread because my mind wanders and I cannot keep from thinking to something 3. Etes-vous gêné(e) pour vous concentrer dans un irritating?] [During/throughout my activities (reading, television, conversation,…), I lose the around you in everyday situations?] bruits ou sons agaçants, irritants ? [During your headache, do you find certain sounds or noises ⃝ ⃝ ⃝ ⃝
	else.] environnement bruyant ?	⃝ ⃝ ⃝ ⃝	⃝ ⃝ ⃝ ⃝
	[Do you have trouble concentrating in noisy surroundings?] 12. Votre migraine empire-t-elle quand il y a du bruit ou
	3. Quand je mène une activité simple, répétitive et monotone de certains sons ? ⃝ ⃝ ⃝ ⃝
	longue durée, je commets beaucoup d'erreurs. [Is your headache worsened by noise or certain sounds?] 4. Si l'on vous propose une activité (sortie, cinéma, concert), [When I am carrying on a simple, repetitive, monotonous activity on a long time, I commit a lot of mistakes.] pensez-vous tout de suite au bruit que vous aurez à [When I am carrying on an activity and I am interrupted by something unexpected, I noise you are going to have to put up with?] quelque chose d'imprévu, j'oublie d'y revenir pour la terminer. cinema, to a concert), do you immediately think about the [Is your headache triggered by noise or certain sounds?] 4. Quand je mène une activité et que je suis interrompu(e) par supporter ? [When someone suggests doing something (going out, to the 13. Votre migraine est-elle déclenchée par le bruit ou certains ⃝ ⃝ ⃝ ⃝ sons ? ⃝ ⃝ ⃝ ⃝	⃝ ⃝ ⃝ ⃝
	forget to come back and finish it.] Questionnaire de gêne à la lumière		⃝ ⃝ ⃝ ⃝
	5. Quand je mène une activité qui comporte plusieurs étapes (comme faire du café), j'en omets une. [When I am carrying on an activity that include several steps (like making coffee), I omit one.] 5. Est-ce que le bruit vous fatigue ? [Does noise make you tired?] ⃝ ⃝ ⃝ ⃝ 6. Trouvez-vous certains bruits ou sons agaçants, irritants ? [Do you find certain sounds or noises irritating?] ⃝ ⃝ ⃝ ⃝ [Photophobia questionnaire]	⃝ ⃝ ⃝ ⃝ Très rarement Parfois Souvent Très souvent
	6. Je me fatigue lors d'un effort soutenu d'attention. [I get tired when making a sustained attention effort.] 7. A l'école j'avais tendance à rêvasser plutôt qu'à suivre les cours [At school, I had the tendency to daydream rather that attend the courses.] 1. Est-ce que la lumière vous fatigue ? [Does light make you tired?] 7. Est-ce que les bruits forts vous dérangent ? ⃝ ⃝ ⃝ ⃝ [Do loud noises bother you?] 2. Quand la lumière est vive, vous sentez-vous ébloui(e) ou aveuglé(e) ? [Do you have a sense of glare or dazzle in your eyes by bright light?]	⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝ ⃝
	Ne répondez aux questions suivantes que si vous présentez
	8. Je ne prête pas attention aux détails. des migraines :
	[I don't pay attention to details.] [Answer the following questions only if you have migraines:]		⃝ ⃝ ⃝ ⃝

3. Etes-vous dérangé(e) par des lumières vacillantes ou éblouissantes, certaines couleurs, ou des rayures très contrastées ? [Do flickering lights, glare, specific colours or high contrast striped patterns bother you?] ⃝ ⃝ ⃝ ⃝

While visual and auditory sensitivity did not correlate in control participants: r(44)=.08; p=.61)

Acknowledgments:

We thank Cécile Graven for help in recruitment and data collection.

Conflict of Interest:

The Authors declare no conflict of interest.