Shifting Away From Pain: Neurocognitive Approach to Explain and Predict Recovery Following Whiplash Injury

Around half of the patients with neck pain after trauma (whiplash) will develop chronic pain. Understanding the transition from acute to chronic pain after whiplash is a priority since will help to identify those which patients are likely to fully recover and who do not. In the last years, there have been a call for an investigation of new biomarkers; particularly in brain structure and function. Alterations in the structure of the brain (gray matter, white matter and cortical thickness) as well as the brain function have been found in people with chronic WAD; which are also correlated with pain, disability and symptoms of central sensitization such as hyperalgesia. Previous research has found structural and functional brain differences between people who develop chronic low back pain compared to those who recovered; but research in this vein is still lacking in people with whiplash. Consequently, this study aims to examine the neural correlates of recovery following whiplash injury.

Study Overview

• Status: Terminated
• Conditions: Whiplash Injuries
• Intervention / Treatment: Diagnostic test: Brain MRI (neuroimaging)

Detailed Description

This study aims to investigate whether or not there are differences in brain structure and function between people who recover after whiplash and those who do not. Thus, patients with acute neck pain after whiplash will be recruited. Also, a pain-free age- and sex-matched control group will be recruited for comparison.

A longitudinal prospective study will be conducted with two follow-up measurements (3 and 6 months). All measurements will take place at University Hospital of Ghent (UZ Gent), Ghent (Belgium). MRI measures will be taken at baseline (<4 weeks after the accident) and 6-months follow-up. The 3-months follow-up will only consist of the assessment of the online questionnaires; so, patients will not be required to come to UZ Gent.

• Study Type: Observational
• Enrollment (Actual): 37

Contacts and Locations

Study Locations

• Belgium
  • Ghent, Belgium, 9000
    • Department of rehabilitation sciences (Ghent University)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Whiplash injury is a type of neck injury caused by sudden movement of the head forwards, backwards or sideways (i.e. motor vehicle accident)

Description

Whiplash patients

Inclusion Criteria:

• Neck pain within 4 weeks after the trauma
• Native Dutch speaker
• Refraining from consuming caffeine, alcohol and nicotine in the hour before the MRI scans in both measurement times

Exclusion Criteria:

• Neuropathic pain
• Being pregnant
• A history of a chronic pain syndrome
• Chronic fatigue syndrome
• Fibromyalgia
• Cardiovascular disorders
• Epilepsy
• Endocrinological disorders
• Rheumatic disorders
• Psychiatric disorders
• History of neck surgery
• Loss of consciousness during/after the whiplash trauma
• MRI incompatible health condition (e.g., pacemaker, metal prosthetic devices)
• Claustrophobia.

Healthy volunteers: (matched for age and gender). Additional exclusion criteria include for healthy volunteers

• a history of a chronic pain syndrome
• a pain condition in the last six months for which treatment was sought

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Recovered group; This will group will consists of people who have a remission of their symptoms at 6-months follow-up after whiplash injury.	Diagnostic test: Brain MRI (neuroimaging); Structural and functional brain scans will be taken.
non-recovered group; This will group will consists of people who develop persistent symptoms at 6-months follow-up after whiplash injury.	Diagnostic test: Brain MRI (neuroimaging); Structural and functional brain scans will be taken.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood oxygenation level dependent (BOLD) signal (functional MRI) during picture imagination task and during resting state	Change between baseline assessment (within 4 weeks after the trauma) and the 6-months follow-up assessment.	Baseline and 6-months follow-up
Structural MRI measures (i.e., grey and white matter)	Change between baseline assessment (within 4 weeks after the trauma) and the 6-months follow-up assessment.	Baseline and 6-months follow-up

Collaborators and Investigators

• Sponsor: University Ghent
• Investigators: Principal Investigator: Iris Coppieters, PhD, Vrije Universiteit Brussel, KU Leuven

Study record dates

Study Major Dates

• Study Start (Actual): January 6, 2020
• Primary Completion (Actual): January 10, 2024
• Study Completion (Actual): January 10, 2024

Study Registration Dates

• First Submitted: December 3, 2021
• First Submitted That Met QC Criteria: December 3, 2021
• First Posted (Actual): December 17, 2021

Study Record Updates

• Last Update Posted (Actual): January 12, 2024
• Last Update Submitted That Met QC Criteria: January 10, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: chronic pain; neuroimaging; whiplash
• Additional Relevant MeSH Terms: Neck Injuries; Wounds and Injuries; Whiplash Injuries
• Other Study ID Numbers: B670201941074

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No