Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Queensland, Australia.
School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia.
Pain Pract. 2023 Sep;23(7):759-775. doi: 10.1111/papr.13240. Epub 2023 May 9.
Exercise for people with whiplash associated disorder (WAD) induces hypoalgesic effects in some, but hyperalgesic effects in others. We investigated the exercise-induced neurobiological effects of aerobic and strengthening exercise in individuals with chronic WAD.
Sixteen participants (8 WAD, 8 pain-free [CON]) were randomised to either aerobic or strengthening exercise. MRI for brain morphometry, functional MRI for brain connectivity, and magnetic resonance spectroscopy for brain biochemistry, were used at baseline and after the 8-week intervention.
There were no differences in brain changes between exercise groups in either the WAD or CON group, therefore aerobic and strengthening data were combined to optimise sample size. After the exercise intervention, the CON group demonstrated increased cortical thickness (left parahippocampus: mean difference = 0.04, 95% CI = 0.07-0.00, p = 0.032; and left lateral orbital frontal cortex: mean difference = 0.03, 95% CI = 0.00-0.06, p = 0.048). The WAD group demonstrated an increase in prefrontal cortex (right medial orbital frontal) volume (mean difference = 95.57, 95% CI = 2.30-192.84, p = 0.046). Functional changes from baseline to follow-up between the default mode network and the insula, cingulate cortex, temporal lobe, and somatosensory and motor cortices, were found in the CON group, but not in the WAD group. There were no changes post-exercise in brain biochemistry.
Aerobic and strengthening exercises did not exert differential effects on brain characteristics, however differences in structural and functional changes were found between WAD and CON groups. This suggests that an altered central pain modulatory response may be responsible for differential effects of exercise in individuals with chronic WAD.
运动疗法对某些颈痛伴活动障碍（WAD）患者具有镇痛作用，但对另一些患者则具有痛觉过敏作用。我们研究了慢性 WAD 患者有氧运动和力量训练的运动诱导的神经生物学效应。
将 16 名参与者（8 名 WAD，8 名无痛[CON]）随机分为有氧运动组或力量训练组。在基线和 8 周干预后，使用 MRI 进行脑形态计量学、功能 MRI 进行脑连接以及磁共振波谱进行脑生物化学研究。
在 WAD 或 CON 组中，两种运动方式均未引起脑变化的差异，因此将有氧运动和力量训练数据合并以优化样本量。运动干预后，CON 组表现出皮质厚度增加（左侧海马旁回：平均差异=0.04，95%CI=0.07-0.00，p=0.032；和左侧外侧眶额皮层：平均差异=0.03，95%CI=0.00-0.06，p=0.048）。WAD 组表现出前额叶皮质（右侧内侧眶额皮质）体积增加（平均差异=95.57，95%CI=2.30-192.84，p=0.046）。CON 组在默认模式网络与岛叶、扣带回皮质、颞叶以及躯体感觉和运动皮质之间的功能变化，而 WAD 组则没有。运动后大脑生物化学没有变化。
有氧运动和力量训练对大脑特征没有产生不同的影响，但在 WAD 和 CON 组之间发现了结构和功能变化的差异。这表明中央疼痛调节反应的改变可能是慢性 WAD 患者运动治疗效果不同的原因。
