How similar are whiplash and mild traumatic brain injury? A systematic review

Gil, Charlotte; Decq, Philippe

doi:10.1016/j.neuchi.2021.01.016

Cited by 20 publications

(12 citation statements)

References 34 publications

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“…The vast majority (89%) of the recruited patients with mTBI in our cohort also fulfilled the diagnostic criteria for WAD, perhaps supporting the notion that referred neck pain contributes to post‐traumatic headache 32–34,40 . Whether co‐dependent or not, chronic post‐traumatic head and/or neck pain are common negative sequela of the highly prevalent injuries of mTBI and WAD following an MVC 35,38,46 .…”

Section: Discussionsupporting

confidence: 73%

“…In the present study, we focus on mild traumatic brain injury (mTBI) following a motor vehicle collision (MVC), commonly accompanied with whiplash injury, 32 , 33 , 34 where the majority of affected individuals experience acute pain of defined onset. 34 , 35 , 36 , 37 Of them, 30 to 50% will eventually develop chronic head and/or neck pain, 35 , 38 , 39 for which no adequate treatment exists.…”

mentioning

confidence: 99%

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Brain Connectivity Predicts Chronic Pain in Acute Mild Traumatic Brain Injury

Bosak

Branco

Kuperman

et al. 2022

Annals of Neurology

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Objectives: Previous studies have established the role of the cortico-mesolimbic and descending pain modulation systems in chronic pain prediction. Mild traumatic brain injury (mTBI) is an acute pain model where chronic pain is prevalent and complicated for prediction. In this study, we set out to study whether functional connectivity (FC) of the nucleus accumbens (NAc) and the periaqueductal gray matter (PAG) is predictive of pain chronification in early-acute mTBI. Methods: To estimate FC, resting-state functional magnetic resonance imaging (fMRI) of 105 participants with mTBI following a motor vehicle collision was acquired within 72 hours post-accident. Participants were classified according to pain ratings provided at 12-months post-collision into chronic pain (head/neck pain ≥30/100, n = 44) and recovery (n = 61) groups, and their FC maps were compared. Results: The chronic pain group exhibited reduced negative FC between NAc and a region within the primary motor cortex corresponding with the expected representation of the area of injury. A complementary pattern was also demonstrated between PAG and the primary somatosensory cortex. PAG and NAc also shared increased FC to the rostral anterior cingulate cortex (rACC) within the recovery group. Brain connectivity further shows high classification accuracy (area under the curve [AUC] = .86) for future chronic pain, when combined with an acute pain intensity report. Interpretation: FC features obtained shortly after mTBI predict its transition to long-term chronic pain, and may reflect an underlying interaction of injury-related primary sensorimotor cortical areas with the mesolimbic and pain modulation systems. Our findings indicate a potential predictive biomarker and highlight targets for future early preventive interventions.

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Section: Discussionsupporting

confidence: 73%

mentioning

confidence: 99%

Brain Connectivity Predicts Chronic Pain in Acute Mild Traumatic Brain Injury

Bosak

Branco

Kuperman

et al. 2022

Annals of Neurology

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“…Moreover, although our exclusion criteria were developed to avoid the inclusion of patients with concussion, this condition is highly variable in its presentation and usually very similar to whiplash symptomatology. Therefore, some patients with mild concussion could be included in our sample [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Higher Neck Pain Intensity and the Presence of Psychosocial Factors Are More Likely When Headache is Present after a Whiplash Injury: A Case-Control Study

et al. 2022

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Background Several factors such as neck pain intensity, disability, anxiety, depression, female sex or a previous history of headache, are associated with post-whiplash headache. However, the possible role of psychosocial factors contributing to the presence of headache or worsening of headache after a whiplash trauma remains unclear. To address this gap in knowledge, there is the need to assess psychosocial factors concerning headache shortly after a whiplash injury. Objective To evaluate psychological features, pain and disability in people with acute Whiplash Associated Disorders (WAD) and compare these features between those with and without headache. Design case-control study Setting A secondary care traumatology center Methods Forty-seven people with acute WAD were recruited; 28 with headache, and 19 without. All participants completed self-reported questionnaires including Visual Analogue Scale (VAS) for neck pain intensity, the Neck Disability Index (NDI), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia-11 (TSK-11) and State-Trait Anxiety Inventory. Results Neck pain intensity (p < 0.001), neck disability (p < 0.001), pain catastrophising (p < 0.001), kinesiophobia (p < 0.001) and anxiety state (p = 0.007) and trait (p = 0.05) were higher in those with headache when compared to those without. In addition, high levels of neck pain (p = 0.025), moderate levels of neck disability (p < 0.001), moderate levels of pain catastrophising (p = 0.015), and moderate (p = 0.002) and severe (p = 0.016) levels of kinesiophobia were related to the presence of headache. Conclusion The level of neck pain intensity and disability, kinesiophobia, catastrophising and anxiety were all greater in people with acute WAD who presented with a headache compared to those without headache.

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“…[ 24 ] Whiplash has been suggested to be a pathophysiological mechanism of concussion or mTBI. [ 25 , 26 ] Previous studies reported that mTBI due to whiplash was associated with more severe clinical features than mTBI from other causes. [ 27 ] The introduction of diffusion tensor imaging has revealed several pathophysiological mechanisms of brain injury by whiplash including traumatic axonal injury.…”

Section: Discussionmentioning

confidence: 99%

Incidence and characteristics of physical disabilities in patients with postconcussion syndromefollowing mTBI

2022

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This study aimed to examine the incidence and characteristics of physical disabilities in patients with postconcussion syndrome (PCS) after a mild traumatic brain injury (mTBI). Of 203 patients diagnosed with PCS after mTBI, 10 patients with definite physical disabilities (worse than moderate disability on the Glasgow outcome scale [GOS], <4 points and inability to walk independently on the Functional Ambulation Category [FAC], <3 points) were enrolled. Ten of the 203 patients included in the analysis based on prespecified inclusion criteria were further evaluated. Seven patients had moderate disability on the GOS, whereas the remaining 3 showed severe disability. On the Modified Barthel Index, 5 patients were moderately dependent, and 2 patients were severely dependent. By the Motricity Index, 9 patients showed mild quadriparesis, and 1 had mild hemiparesis. All 10 patients could grasp-release their fingers as per the Modified Brunnstrom Classification. By contrast, 7 patients required verbal supervision for independent gait by the FAC, and the remaining 3 patients needed intermittent support from 1 person for independent gait. Approximately 5% of patients with PCS after mTBI had a definite physical disability, and most of these patients showed mild quadriparesis. These results suggest that a definite physical disability can occur in patients with PCS after mTBI.

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How similar are whiplash and mild traumatic brain injury? A systematic review

Cited by 20 publications

References 34 publications

Brain Connectivity Predicts Chronic Pain in Acute Mild Traumatic Brain Injury

Brain Connectivity Predicts Chronic Pain in Acute Mild Traumatic Brain Injury

Higher Neck Pain Intensity and the Presence of Psychosocial Factors Are More Likely When Headache is Present after a Whiplash Injury: A Case-Control Study

Incidence and characteristics of physical disabilities in patients with postconcussion syndromefollowing mTBI

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