Central Sensitization in Chronic Whiplash Patients

• Conditions: Chronic Pain
• Interventions: Radiation: Spectroscopy; Other: Questionnaires; Procedure: Conditioned Pain Modulation

• Registration Number: NCT03005691
• Lead Sponsor: University of Castilla-La Mancha

Brief Summary

The purpose of this study is to determine whether the metabolite concentrations within the anterior cingulate cortex and periaqueductal gray matter predict the intensity and interference of neuropathic pain after the development of chronic whiplash syndrome.

Detailed Description

Persistent chronic pain is a common symptom of whiplash leading to reduced quality of life. Little information is available regarding changes in brain processing areas and change in central sensitization to noxious input during the chronic phase of whiplash. Metabolite concentrations in the anterior cingulate cortex and periaqueductal gray matter may be predictors of neuropathic pain and these changes may explain the development of central sensitization in people with chronic whiplash.

Until now, there is not any study that show this approach.

Study Timeline

• Status Verified: 2016-12
• Study First Submitted: 2016-12-15
• Study First Submitted QC: 2016-12-28
• Last Update Submitted: 2016-12-28
• Study First Posted: 2016-12-29
• Last Update Posted: 2016-12-29
• Study Start: 2017-01
• Primary Completion: 2017-03
• Study Completion: 2017-05

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• Whiplash syndrome
• Chronic pain
• Age between 18 to 65 years
• 4 months to 2 years after the whiplash syndrome

Exclusion Criteria

• Neurological disease
• Claustrophobia

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Non-injured	Conditioned Pain Modulation	Subjects without whiplash syndrome. The inclusion criteria are defined as a absence of previous or actual symptoms or signs of neck pain.
Whiplash-no Pain	Questionnaires	Subjects with chronic whiplash syndrome and pain. The inclusion criteria for pain include the ausence of daily pain during the previous 8 weeks. Specifically, pain will be diagnosed based on the pain intensity measured on the 0 to 10 numerical rating scale. The maximun will be 2 points. Subjects will be recruited between the 4 months until 2 years after the whiplash.
Non-injured	Spectroscopy	Subjects without whiplash syndrome. The inclusion criteria are defined as a absence of previous or actual symptoms or signs of neck pain.
Whiplash-Pain	Conditioned Pain Modulation	Subjects with chronic whiplash syndrome and pain. The inclusion criteria for pain include the presence of daily pain during the previous 8 weeks. Specifically, pain will be diagnosed based on the pain intensity measured on the 0 to 10 numerical rating scale. The minimum will be 2 points. Subjects will be recruited between the 4 months until 2 years after the whiplash.
Whiplash-Pain	Spectroscopy	Subjects with chronic whiplash syndrome and pain. The inclusion criteria for pain include the presence of daily pain during the previous 8 weeks. Specifically, pain will be diagnosed based on the pain intensity measured on the 0 to 10 numerical rating scale. The minimum will be 2 points. Subjects will be recruited between the 4 months until 2 years after the whiplash.
Whiplash-Pain	Questionnaires	Subjects with chronic whiplash syndrome and pain. The inclusion criteria for pain include the presence of daily pain during the previous 8 weeks. Specifically, pain will be diagnosed based on the pain intensity measured on the 0 to 10 numerical rating scale. The minimum will be 2 points. Subjects will be recruited between the 4 months until 2 years after the whiplash.
Whiplash-no Pain	Spectroscopy	Subjects with chronic whiplash syndrome and pain. The inclusion criteria for pain include the ausence of daily pain during the previous 8 weeks. Specifically, pain will be diagnosed based on the pain intensity measured on the 0 to 10 numerical rating scale. The maximun will be 2 points. Subjects will be recruited between the 4 months until 2 years after the whiplash.
Whiplash-no Pain	Conditioned Pain Modulation	Subjects with chronic whiplash syndrome and pain. The inclusion criteria for pain include the ausence of daily pain during the previous 8 weeks. Specifically, pain will be diagnosed based on the pain intensity measured on the 0 to 10 numerical rating scale. The maximun will be 2 points. Subjects will be recruited between the 4 months until 2 years after the whiplash.
Non-injured	Questionnaires	Subjects without whiplash syndrome. The inclusion criteria are defined as a absence of previous or actual symptoms or signs of neck pain.

Primary Outcome Measures

Name	Time	Method
Conditioned Pain Modulation	Baseline at 0 min	Conditioned Pain Modulation will be measured by a Pathway system (Medoc Ltd)
Metabolite concentrations	Baseline at 0 min	The metabolite concentrations will be measured by magnetic resonance (spectroscopy)
Brief Pain Inventory	Baseline at 0 min	Brief Pain Inventory (BPI), it is used to evaluate the subject's perception of pain severity and its interference.
Neurophatic Pain Symptoms Inventory	Baseline at 0 min	Neurophatic Pain Symptoms Inventory (NPSI), it is used to detect paresthesia/dysaesthesia, evoked pain and paroxysmal pain.
Pain Catastrophizing Helplessness Subscale	Baseline at 0 min	Pain Catastrophizing Helplessness Subscale it is used to assess the catastrophizing score
Neck Disability Index	Baseline at 0 min	Neck Disability Index (NDI), it is used to assess the disability after whiplash syndrome