Advanced magnetic resonance imaging of chronic whiplash patients: a clinical practice-based feasibility study.
Cerebrospinal fluid
Imaging study
Magnetic resonance imaging
Neck pain
Whiplash injury
Journal
Chiropractic & manual therapies
ISSN: 2045-709X
Titre abrégé: Chiropr Man Therap
Pays: England
ID NLM: 101551481
Informations de publication
Date de publication:
07 01 2022
07 01 2022
Historique:
received:
10
08
2021
accepted:
30
12
2021
entrez:
8
1
2022
pubmed:
9
1
2022
medline:
27
1
2022
Statut:
epublish
Résumé
Whiplash injury is common following road traffic crashes affecting millions worldwide, with up to 50% of the injured developing chronic symptoms and 15% having a reduced working capability due to ongoing disability. Many of these patients receive treatment in primary care settings based upon clinical and diagnostic imaging findings. Despite the identification of different types of injuries in the whiplash patients, clinically significant relationships between injuries and chronic symptoms remains to be fully established. This study investigated the feasibility of magnetic resonance imaging (MRI) techniques including quantitative diffusion weighted imaging and measurements of cerebrospinal fluid (CSF) flow as novel non-invasive biomarkers in a population of healthy volunteers and chronic whiplash patients recruited from a chiropractic clinic for the purpose of improving our understanding of whiplash injury. Twenty chronic whiplash patients and 18 healthy age- and gender matched control subjects were included [mean age ± SD (sex ratio; females/males), case group: 37.8 years ± 9.1 (1.22), control group: 35.1 years ± 9.2 (1.25)]. Data was collected from May 2019 to July 2020. Data from questionnaires pertaining to the car crash, acute and current symptoms were retrieved and findings from clinical examination and MRI including morphologic, diffusion weighted and phase-contrast images were recorded. The apparent diffusion coefficient and fractional anisotropy were calculated, and measurement and analysis of CSF flow was conducted. Statistical analyses included Fisher's exact test, Mann Whitney U test and analysis of variance between groups. The studied population was described in detail using readily available clinical tools. No statistically significant differences were found between the groups on MRI. This study did not show that MRI-based measures of morphology, spinal cord and nerve root diffusion or cerebrospinal fluid flow are sensitive biomarkers to distinguish between chronic whiplash patients and healthy controls. The detailed description of the chronic whiplash patients using readily available clinical tools may be of great relevance to the clinician. In the context of feasibility, clinical practice-based advanced imaging studies with a technical setup similar to the presented can be expected to have a high likelihood of successful completion.
Sections du résumé
BACKGROUND
Whiplash injury is common following road traffic crashes affecting millions worldwide, with up to 50% of the injured developing chronic symptoms and 15% having a reduced working capability due to ongoing disability. Many of these patients receive treatment in primary care settings based upon clinical and diagnostic imaging findings. Despite the identification of different types of injuries in the whiplash patients, clinically significant relationships between injuries and chronic symptoms remains to be fully established. This study investigated the feasibility of magnetic resonance imaging (MRI) techniques including quantitative diffusion weighted imaging and measurements of cerebrospinal fluid (CSF) flow as novel non-invasive biomarkers in a population of healthy volunteers and chronic whiplash patients recruited from a chiropractic clinic for the purpose of improving our understanding of whiplash injury.
METHODS
Twenty chronic whiplash patients and 18 healthy age- and gender matched control subjects were included [mean age ± SD (sex ratio; females/males), case group: 37.8 years ± 9.1 (1.22), control group: 35.1 years ± 9.2 (1.25)]. Data was collected from May 2019 to July 2020. Data from questionnaires pertaining to the car crash, acute and current symptoms were retrieved and findings from clinical examination and MRI including morphologic, diffusion weighted and phase-contrast images were recorded. The apparent diffusion coefficient and fractional anisotropy were calculated, and measurement and analysis of CSF flow was conducted. Statistical analyses included Fisher's exact test, Mann Whitney U test and analysis of variance between groups.
RESULTS
The studied population was described in detail using readily available clinical tools. No statistically significant differences were found between the groups on MRI.
CONCLUSIONS
This study did not show that MRI-based measures of morphology, spinal cord and nerve root diffusion or cerebrospinal fluid flow are sensitive biomarkers to distinguish between chronic whiplash patients and healthy controls. The detailed description of the chronic whiplash patients using readily available clinical tools may be of great relevance to the clinician. In the context of feasibility, clinical practice-based advanced imaging studies with a technical setup similar to the presented can be expected to have a high likelihood of successful completion.
Identifiants
pubmed: 34996490
doi: 10.1186/s12998-022-00410-y
pii: 10.1186/s12998-022-00410-y
pmc: PMC8742358
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2Subventions
Organisme : fonden til lægevidenskabens fremme
ID : 17-L-0224
Informations de copyright
© 2022. The Author(s).
Références
Spine (Phila Pa 1976). 2008 Aug 15;33(18):2012-6
pubmed: 18708935
J Manipulative Physiol Ther. 1998 Oct;21(8):520-7
pubmed: 9798180
Sci Data. 2021 Aug 16;8(1):219
pubmed: 34400655
Health Qual Life Outcomes. 2014 Mar 13;12:38
pubmed: 24625124
Eur Spine J. 2017 Jan;26(1):40-48
pubmed: 27858239
AJNR Am J Neuroradiol. 2014 Oct;35(10):1864-9
pubmed: 25012674
Clin J Pain. 2020 Dec;36(12):923-931
pubmed: 32826406
Sci Rep. 2020 Jul 10;10(1):11471
pubmed: 32651447
Spine (Phila Pa 1976). 2006 Nov 15;31(24):2820-6
pubmed: 17108836
Musculoskelet Sci Pract. 2018 Feb;33:46-52
pubmed: 29153925
Brain Inj. 2010;24(7-8):988-94
pubmed: 20545453
Acta Radiol. 2010 Mar;51(2):207-12
pubmed: 19912072
BMJ Open. 2013 Jan 30;3(1):
pubmed: 23370009
Spine (Phila Pa 1976). 2011 Dec 1;36(25 Suppl):S309-15
pubmed: 22020601
PLoS One. 2021 Apr 8;16(4):e0249659
pubmed: 33831060
Eur J Pain. 2019 Mar;23(3):515-525
pubmed: 30318773
PM R. 2019 Nov;11(11):1228-1239
pubmed: 31020768
Int J Environ Res Public Health. 2020 Mar 05;17(5):
pubmed: 32150926
Spine (Phila Pa 1976). 2011 Dec 1;36(25 Suppl):S194-9
pubmed: 22020612
Eur J Pain. 2013 Mar;17(3):299-312
pubmed: 23008191
J Neurosurg. 2013 May;118(5):1135-40
pubmed: 23495878
Arthritis Rheum. 1990 Feb;33(2):160-72
pubmed: 2306288
Nat Protoc. 2021 Oct;16(10):4611-4632
pubmed: 34400839
J Magn Reson Imaging. 2019 Jun;49(6):1638-1654
pubmed: 30614121
Pain Med. 2018 Jan 1;19(1):124-129
pubmed: 28419379
Spine (Phila Pa 1976). 1995 Apr 15;20(8 Suppl):1S-73S
pubmed: 7604354
J Manipulative Physiol Ther. 1991 Sep;14(7):409-15
pubmed: 1834753
Front Aging Neurosci. 2019 Aug 02;11:199
pubmed: 31427956
Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S83-92
pubmed: 18204405
Clin J Pain. 2018 Feb;34(2):95-103
pubmed: 28678060
Neuroimage. 2017 Jan 15;145(Pt A):24-43
pubmed: 27720818
Front Neurol. 2016 Oct 20;7:177
pubmed: 27812348
AJNR Am J Neuroradiol. 2011 Nov-Dec;32(10):1836-41
pubmed: 21920865
J Orthop Traumatol. 2017 Mar;18(1):9-16
pubmed: 27738773
J Forensic Leg Med. 2009 Jul;16(5):253-60
pubmed: 19481706
Injury. 2018 Feb;49(2):165-176
pubmed: 29269107
PLoS One. 2015 Jun 22;10(6):e0130298
pubmed: 26098860