| 總結: | Whiplash injury is associated with high socioeconomic costs and poor prognosis. Most people are classified as having whiplash-associated disorder grade-II (WADII), with neck complaints and musculoskeletal signs, in the absence of frank neurological signs. However, evidence suggests that there is an underlying nerve pathology in WADII, such as peripheral neuroinflammation. This study aimed to investigate the presence of neuroinflammation in acute WADII using T2-weighted MRI of the brachial plexus, dorsal root ganglia (DRG) and median nerve, and clinical surrogates of neuroinflammation: heightened nerve mechanosensitivity, raised serum inflammatory mediators and gain of sensory function. Onehundred and twenty-two WADII participants within 4 weeks of whiplash and 43 healthy controls (HCs) were recruited. MRI T2 signal ratio was increased in the C5 root of the brachial plexus and the C5-C8 DRG in WADII participants compared to HCs, but not in the median nerve. Fifty-five percent of WADII participants had signs of heightened nerve mechanosensitivity. Inflammatory mediators were also raised compared to HCs, and 47% of WADII participants had changes to sensory function and significant reduction in thermal and mechanical measures on quantitative sensory testing. In those WADII individuals with heightened nerve mechanosensitivity, there was a gain of cold and pressure pain thresholds and an increase in the proportion of individuals with neuropathic pain. Many WADII individuals had multiple indicators of neuroinflammation. This study demonstrates the presence of peripheral neuroinflammation in a subgroup of acute WADII individuals, which suggests there is a need to reconsider the management of WADII.
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