Sundström Torbjörn, Guez Michel, Hildingsson Christer, Toolanen Göran, Nyberg Lars, Riklund Katrine
Department of Radiation Sciences, Diagnostic Radiology, Norrlands University Hospital, Umeå University, 901 85, Umea, Sweden.
Eur Spine J. 2006 Aug;15(8):1189-95. doi: 10.1007/s00586-005-0040-5. Epub 2006 Apr 14.
A cross-sectional study to investigate regional cerebral blood flow (rCBF) in patients with chronic whiplash syndrome and chronic neck pain patients without previous history of trauma along with a healthy control group. Chronic neck pain is a common disorder and a history of cervical spine injury including whiplash trauma constitute a risk factor for persistent neck pain. The aetiology of the late whiplash syndrome is unknown with no specific diagnostic criteria based on imaging, physiological, or psychological examination. Earlier studies indicate a parieto-occipital hypoperfusion but it is unclear if the hypoperfusion represents a response to chronic pain. The rCBF was monitored in 45 patients with chronic neck pain: 27 cases with chronic whiplash syndrome and 18 age and gender matched cases with non-traumatic chronic neck pain. The rCBF was estimated with single-photon emission computed tomography (SPECT) using technetium-99m hexamethylpropylene amine oxime (HMPAO). The non-traumatic patients displayed rCBF changes in comparison with the whiplash group and the healthy control group. These changes included rCBF decreases in a right temporal region close to hippocampus, and increased rCBF in left insula. The whiplash group displayed no significant differences in rCBF in comparison with the healthy controls. The present study suggests different pain mechanisms in patients with chronic neck pain of non-traumatic origin compared to those with chronic neck pain due to a whiplash trauma.
一项横断面研究，旨在调查慢性挥鞭样损伤综合征患者、无既往创伤史的慢性颈部疼痛患者以及健康对照组的局部脑血流量（rCBF）。慢性颈部疼痛是一种常见疾病，包括挥鞭样损伤在内的颈椎损伤史是持续性颈部疼痛的一个危险因素。晚期挥鞭样损伤综合征的病因尚不清楚，尚无基于影像学、生理学或心理学检查的具体诊断标准。早期研究表明顶枕部灌注不足，但尚不清楚这种灌注不足是否代表对慢性疼痛的一种反应。对45例慢性颈部疼痛患者的rCBF进行了监测：27例慢性挥鞭样损伤综合征患者以及18例年龄和性别匹配的非创伤性慢性颈部疼痛患者。使用锝-99m六甲基丙烯胺肟（HMPAO）通过单光子发射计算机断层扫描（SPECT）估计rCBF。与挥鞭样损伤组和健康对照组相比，非创伤性患者的rCBF出现了变化。这些变化包括靠近海马体的右侧颞区rCBF降低，以及左侧岛叶rCBF增加。与健康对照组相比，挥鞭样损伤组的rCBF无显著差异。本研究表明，非创伤性起源的慢性颈部疼痛患者与因挥鞭样损伤导致慢性颈部疼痛的患者具有不同的疼痛机制。
