Brain research in Whiplash Associated Disorder

After a sudden stretch of cervical soft tissues, pain can be developed in the
neck, head or shoulders, and even eradiate to the arms , with or without
paraesthesia in the fingers. This stretch occurs as a consequence of an
acceleration-deceleration injury to the neck, where rear-end motor vehicle
collision is the most common cause.
In most cases the complaints caused by the injury disappear within several
weeks or months, but in some patients the complaints do not disappear, but
become even worse over time. These complaints include a variety of disturbed
mental functioning, decreased physical capabilities and fatigue. This condition
is known as chronic Whiplash Associated Disorder (WAD). Several patients with
chronic WAD also complain about vision problems, difficulties with reading,
vertigo, dizziness and balance disturbances. A significant portion of these
patients also have memory and concentration problems. The cause of chronic WAD
is still unknown, although females have an increased risk to undergo a rear-end
motor vehicle collision as well a higher risk for developing chronic WAD.
Despite the symptoms in WAD appear as brain-related symptoms, until now no
brain damage has been demonstrated in these patients.
We propose that in this patients the brain function is disturbed, especially in
the midbrain or mesencephalon. The reason for this disturbance may be that
during the sudden unexpected stretch of soft tissues in the neck during the
injury, local receptors might be damaged. These damaged receptors send wrong
information to the mesencephalon, leading to misinterpretation of the
information by higher brain centers, because they don't fit with the other
incoming information from the vestibular organs as well from the visual
system. This inconsistency of information can lead to symptoms as in chronic
WAD patients. Another possibility is that the sudden stretch during the
cranial-cervical acceleration injury caused damage to the mesencephalon itself
leading to functional disfunctioning.
With our experimental set-up, we want to determine the resulting brain
activation and de-activation in patients with chronic WAD and in healthy
volunteers.
The results can give us more insight in the cause of chronic WAD and may lead
to better treatment in the future.

Measuring the brain activity in patients with chronic WAD and compare the
results with those obtained in healthy volunteers. The goal of this research is
to better understand the cause of chronic WAD and how to better treat the
WAD-patients.

Observational study

Subjects have to complete a physical and neurological examination, fill some
questionnaires and undergo a PET scan. For the PET scan, a possible adverse
event can be a small bruise as a result of the catheter, or some discomfort in
the scanner. No adverse effects have been reported in the international
literature, for the use of 15O-water. Patients will not obtain direct benefit
from the study, but if positive results are obtained, it may lead to new
therapies and diagnosis techniques in whiplash injury.