The purpose of this study is to determine whether the metabolite concentrations within the anterior cingulate cortex and periaqueductal gray matter predict the intensity and interference of neuropathic pain after the development of chronic whiplash syndrome.
Persistent chronic pain is a common symptom of whiplash leading to reduced quality of life. Little information is available regarding changes in brain processing areas and change in central sensitization to noxious input during the chronic phase of whiplash. Metabolite concentrations in the anterior cingulate cortex and periaqueductal gray matter may be predictors of neuropathic pain and these changes may explain the development of central sensitization in people with chronic whiplash. Until now, there is not any study that show this approach.
Study Type
OBSERVATIONAL
Enrollment
30
Spectroscopy is a noninvasive method to assess brain chemistry. The signal of the hydrogen atom attached to a certain molecule or metabolite has a particular frequency associated with a given metabolite. The utility of Spectroscopy is based on the fact thet the nuclei of atoms have magnetic properties that can be used to obtain chemical information regarding both the type of molecule and it is concentration. The subjects will be scanned on a 3-T Siemens system and an 12-channel phased-array coil will be used to provide an optimum signal-to-noise ratio for spectroscopy data.
Questionnaires are important to assess the chronic pain and their impact in the quality of life. For this reason, we will assess the Brief Pain Inventory (BPI), it is used to evaluate the subject's perception of pain severity and its interference. Moreover, we will assess neuropathic pain symptoms with the NPSI to detect paresthesia/dysaesthesia, evoked pain and paroxysmal pain. The catastrophizing score will be measured with the Pain Catastrophizing Helplessness Subscale. Also,we will assess the disability after whiplash using the Neck Disability Index.
Metabolite concentrations
The metabolite concentrations will be measured by magnetic resonance (spectroscopy)
Time frame: Baseline at 0 min
Conditioned Pain Modulation
Conditioned Pain Modulation will be measured by a Pathway system (Medoc Ltd)
Time frame: Baseline at 0 min
Brief Pain Inventory
Brief Pain Inventory (BPI), it is used to evaluate the subject's perception of pain severity and its interference.
Time frame: Baseline at 0 min
Neurophatic Pain Symptoms Inventory
Neurophatic Pain Symptoms Inventory (NPSI), it is used to detect paresthesia/dysaesthesia, evoked pain and paroxysmal pain.
Time frame: Baseline at 0 min
Pain Catastrophizing Helplessness Subscale
Pain Catastrophizing Helplessness Subscale it is used to assess the catastrophizing score
Time frame: Baseline at 0 min
Neck Disability Index
Neck Disability Index (NDI), it is used to assess the disability after whiplash syndrome
Time frame: Baseline at 0 min
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Conditioned Pain Modulation over the tenar eminence. The test will be a heat tonic stimulus which evoke a 3-pain intensity. The conditioning stimulus will be a cold water immersion (12ºC)