Doctoral Program in Health Sciences, University of Seville, Seville, Spain; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; University UNIE, 28015, Madrid, Spain.
Rehabilitation Research Laboratory 2rLab, Department of Business, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.
Musculoskelet Sci Pract. 2024 Nov;74:103212. doi: 10.1016/j.msksp.2024.103212. Epub 2024 Nov 7.
Headache is one of the most common symptoms after a whiplash injury, although the pathophysiology remains under discussion. This study aimed to evaluate differences in neuropathic pain and central sensitization features between those who present with whiplash-associated headache (WAH) soon after a whiplash injury and those who do not.
This case-control study evaluated differences on the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Pain Detect Questionnaire (PDQ) and the Central Sensitization Inventory (CSI) between those who present with WAH in the acute phase after a whiplash injury (n = 46) and those who do not (n = 36). Moreover, the association of these variables in addition to neck pain intensity and the Neck Disability Index (NDI) score, with the presence of WAH was examined through logistic regression.
While differences between groups were found for both neuropathic and central sensitization features, only the presence of neuropathic pain features was associated with the presence of headache, with 27 scores for the S-LANSS and 23 for the PDQ from 46 people with headache (58.6% and 50.0%, respectively). The NDI and the S-LANSS partially explained (R = 0.68) the presence of WAH according to a logistic regression model.
Significant differences were found between people with whiplash with and without WAH when the S-LANSS, the PDQ and the CSI were assessed. S-LANSS and NDI were the variables most associated with the presence of WAH. These findings suggest that neuropathic pain features may be associated with the presence of acute WAH.
头痛是挥鞭样损伤后最常见的症状之一，尽管其病理生理学仍存在争议。本研究旨在评估在挥鞭样损伤后急性期出现与挥鞭样损伤相关的头痛（WAH）和不出现头痛的患者之间，神经病理性疼痛和中枢敏化特征的差异。
本病例对照研究通过自我评估的 Leeds 感觉神经病变症状和体征问卷（S-LANSS）、疼痛察觉问卷（PDQ）和中枢敏化量表（CSI），评估了急性挥鞭样损伤后出现和不出现 WAH 的患者之间的差异（n=46）和那些没有的（n=36）。此外，通过逻辑回归检查这些变量以及颈痛强度和颈部残疾指数（NDI）评分与 WAH 存在的关系。
尽管两组之间在神经病理性和中枢敏化特征方面存在差异，但只有神经病理性疼痛特征与头痛的存在相关，46 例头痛患者中 S-LANSS 有 27 分，PDQ 有 23 分（分别为 58.6%和 50.0%）。NDI 和 S-LANSS 根据逻辑回归模型部分解释（R=0.68）了 WAH 的存在。
当评估 S-LANSS、PDQ 和 CSI 时，发现有和没有 WAH 的挥鞭样损伤患者之间存在显著差异。S-LANSS 和 NDI 是与 WAH 存在最相关的变量。这些发现表明神经病理性疼痛特征可能与急性 WAH 的存在有关。
