Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders
There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing a...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-08-01
|
| Series: | EBioMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396416303139 |
| _version_ | 1829509322168598528 |
|---|---|
| author | David Vállez García Janine Doorduin Antoon T.M. Willemsen Rudi A.J.O. Dierckx Andreas Otte |
| author_facet | David Vállez García Janine Doorduin Antoon T.M. Willemsen Rudi A.J.O. Dierckx Andreas Otte |
| author_sort | David Vállez García |
| collection | DOAJ |
| description | There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing. |
| first_indexed | 2024-12-16T11:43:34Z |
| format | Article |
| id | doaj.art-629a51baea4946569148718235eaf898 |
| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-12-16T11:43:34Z |
| publishDate | 2016-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj.art-629a51baea4946569148718235eaf8982022-12-21T22:32:53ZengElsevierEBioMedicine2352-39642016-08-0110C24925710.1016/j.ebiom.2016.07.008Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated DisordersDavid Vállez García0Janine Doorduin1Antoon T.M. Willemsen2Rudi A.J.O. Dierckx3Andreas Otte4Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Huispostcode EB50, Postbus 30001, 9700 RB Groningen, The NetherlandsDepartment of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Huispostcode EB50, Postbus 30001, 9700 RB Groningen, The NetherlandsDepartment of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Huispostcode EB50, Postbus 30001, 9700 RB Groningen, The NetherlandsDepartment of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Huispostcode EB50, Postbus 30001, 9700 RB Groningen, The NetherlandsDivision of Biomedical Engineering, Department of Electrical Engineering and Information Technology, Offenburg University, D-77652 Offenburg, GermanyThere is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing.http://www.sciencedirect.com/science/article/pii/S2352396416303139Whiplash associated disordersPositron emission tomographyNon-painful electrical stimulationNeuropsychological questionnaires |
| spellingShingle | David Vállez García Janine Doorduin Antoon T.M. Willemsen Rudi A.J.O. Dierckx Andreas Otte Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders EBioMedicine Whiplash associated disorders Positron emission tomography Non-painful electrical stimulation Neuropsychological questionnaires |
| title | Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders |
| title_full | Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders |
| title_fullStr | Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders |
| title_full_unstemmed | Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders |
| title_short | Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders |
| title_sort | altered regional cerebral blood flow in chronic whiplash associated disorders |
| topic | Whiplash associated disorders Positron emission tomography Non-painful electrical stimulation Neuropsychological questionnaires |
| url | http://www.sciencedirect.com/science/article/pii/S2352396416303139 |
| work_keys_str_mv | AT davidvallezgarcia alteredregionalcerebralbloodflowinchronicwhiplashassociateddisorders AT janinedoorduin alteredregionalcerebralbloodflowinchronicwhiplashassociateddisorders AT antoontmwillemsen alteredregionalcerebralbloodflowinchronicwhiplashassociateddisorders AT rudiajodierckx alteredregionalcerebralbloodflowinchronicwhiplashassociateddisorders AT andreasotte alteredregionalcerebralbloodflowinchronicwhiplashassociateddisorders |