• Dorine Lenoir, Ward Willaert, Kelly Ickmans, Jo Nijs, Barbara Cagnie, Mira Meeus, Kristl Vonck, Jean Delbeke, Robby De Pauw, and Iris Coppieters.
• Pain in Motion International Research Group; Department of Rehabilitation sciences, Ghent University, Campus Heymans, Ghent, Belgium; Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Brussels, Belgium; Bijzonder onderzoeksfonds Gent (BOF), Belgium.
• Pain Physician. 2022 May 1; 25 (3): E435-E448.

BackgroundWhiplash injuries typically occur from a motor vehicle collision and lead to chronic whiplash-associated disorders (CWAD) in 20% to 50% of cases. Changes in neurotransmission, metabolism, and networks seem to play a role in the pathogenic mechanism of CWAD.ObjectivesTo further elucidate the functional brain alterations, a neurophysiological study was performed to investigate the somatosensory processing of CWAD patients by comparing the event-related potentials (ERPs) resulting from electrical nociceptive stimulation between patients suffering from CWAD and healthy controls (HC).Study DesignCase-control study.SettingUniversity Hospital in Ghent.MethodsIn this case-control study (CWAD patients/HC: 50/50), ankle and wrist electrical pain thresholds (EPT), and amplitude and latency of the event-related potentials (ERPs) resulting from 20 electrical stimuli were investigated. Correlations between the ERP characteristics, EPT, self-reported pain, disability, pain catastrophizing, and self-reported symptoms of central sensitization were investigated.ResultsOnly the latency of the P3 component after left wrist stimulation (t = -2.283; P = 0.023) differed between both groups. In CWAD patients, the ankle EPT correlated with the amplitude of the corresponding P1 (rho s = 0.293; P = 0.044) and P3 (rho s = 0.306; P = 0.033), as well as with the amplitude of the P3 to left wrist stimulation (rho s = 0.343; P = 0.017). Self-reported symptoms of CS correlated with right wrist P3 amplitude (rho s = 0.308; P = 0.030) and latency (rho s = -0.341; P = 0.015), and the worst pain reported during the past week was correlated with left wrist P1 latency (rho s = 0.319; P = 0.029).LimitationsAlthough the inclusion criteria stated that CWAD patients had to report a moderate-to-severe pain-related disability, 8 of the included CWAD patients (that scored above this threshold in the inclusion questionnaire), scored below the required cutoff at baseline.ConclusionsThe CWAD patients did not show signs of hypersensitivity, but their ERP characteristics were related to the intensity of the applied stimulus, self-reported symptoms of CS, and the worst pain reported during the past week.

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