Chronic whiplash symptoms are related to altered regional cerebral blood flow in the resting state
From: European Journal of Pain. 2008 May 15; [Epub ahead of print]
The neural pathogenic mechanisms involved in mediating chronic pain and whiplash associated disorders after rear impact car collisions are largely unknown. This study’s first objective was to compare resting state regional cerebral blood flow by means of positron emission tomography with (15)O labelled water in 21 whiplash associated disorders patients with 18 healthy, pain-free controls. A second objective was to investigate the relations between brain areas with altered regional cerebral blood flow to pain experience, somatic symptoms, posttraumatic stress symptoms and personality traits in the patient group. Patients had heightened resting state regional cerebral blood flow bilaterally in the posterior parahippocampal and the posterior cingulate gyri, in the right thalamus and the right medial prefrontal gyrus as well as lowered tempero-occipital blood flow compared with healthy controls. The altered regional cerebral blood flow in the patient group was correlated to neck disability ratings. We thus suggest an involvement of the posterior cingulate, parahippocampal and medial prefrontal gyri in whiplash associated disorders and speculate that alterations in the resting state are linked to an increased self-relevant evaluation of pain and stress.
