Whiplash is a neck injury that usually occurs from rear-end car crashes and less commonly occurs from sport injuries, physical violence, and other trauma.
Over 3.3 million adults in the United States currently experience chronic pain as a result of whiplash injuries, making it a significant public health concern.
Key Brain Regions Show Early Warning Signs
The research, published on Oct. 31 in Nature Mental Health, focuses on communication between two critical brain regions: the hippocampus, which serves as the brain’s memory center, and the cerebral cortex, responsible for long-term memory consolidation.Increased communication between these regions in the days following injury significantly correlates with chronic pain development, according to the study.
“While the underlying mechanisms of chronic pain are not yet fully understood, the brain’s emotional-learning circuits have been hypothesized to play an important role in the development and persistence of chronic pain,” the researchers wrote.
Anxiety Levels Play Crucial Role
The research also identified anxiety as a critical factor.In the study, patients who experienced higher anxiety levels immediately after their accident showed a greater likelihood of developing chronic pain. “If the memory has high emotional significance, then it makes these patients associate this movement with pain,” Branco said.
This link between heightened brain connectivity and anxiety highlights the complex process involved in how we perceive pain.
“While we commonly think of pain as relating only to an injury, it is the brain that actually makes up the pain experience,” Branco said. “The brain makes the decision about whether a movement should be painful or not.”
Shifting Focus from Treatment to Prevention
The researchers argue that understanding the timing of chronic pain could shift the treatment landscape from a focus on cure to one on prevention.“Now that we know there is this critical time period when this happens, we can focus our treatment efforts at this early stage to prevent chronic pain rather than try to cure it, which is much more difficult,” Apkar Apkarian, director of the Center for Translational Pain Research and corresponding author, said in a statement.
“Since anxiety plays an important role for the brain changes, targeting the anxiety immediately after the injury may be able to halt these changes, possibly through anti-anxiety drugs or other medications.”
Pain Onset Was Traced Back to Moment of Injury
The large-scale longitudinal study, conducted in collaboration with the Technion-Israel Institute of Technology and McGill University, followed more than 200 whiplash patients from March 2016 to December 2021. Of these participants, 177 underwent magnetic resonance imaging (MRI) within three days of injury.This patient population provided researchers with an opportunity to study early brain changes, as they could precisely trace the onset of pain to the time of accident. Researchers monitored participants’ pain levels over 12 months to determine who developed chronic pain and who did not.
The research team plans to further investigate the mechanisms driving hippocampal response to injury, examining various physiological and psychological factors that could influence these changes. Their goal is to develop early interventions that can effectively target dysfunctional responses.
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