The association between neuropathic pain features and central sensitization with acute headache associated to a whiplash injury

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2024-11-01 DOI:10.1016/j.msksp.2024.103212

Ernesto Anarte-Lazo , Marco Barbero , Carlos Bernal-Utrera , Cleofas Rodriguez-Blanco , Deborah Falla

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Abstract

Background

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.

Methods

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.

Results

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 (R² = 0.68) the presence of WAH according to a logistic regression model.

Conclusion

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.

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神经病理性疼痛特征和中枢敏感性与鞭打伤引起的急性头痛之间的关联。

背景：头痛是鞭打伤后最常见的症状之一，但其病理生理学仍在讨论之中。本研究旨在评估在鞭打伤后不久出现鞭打相关性头痛（WAH）的患者与未出现鞭打相关性头痛的患者在神经病理性疼痛和中枢敏化特征方面的差异：这项病例对照研究评估了在鞭打伤后急性期出现 WAH 的患者（46 人）与未出现 WAH 的患者（36 人）在自编利兹神经病理性症状和体征评估（S-LANSS）、疼痛检测问卷（PDQ）和中枢敏感性量表（CSI）上的差异。此外，还通过逻辑回归分析了这些变量与颈部疼痛强度和颈部残疾指数（NDI）得分之间的关系：虽然在神经病理性和中枢敏感性特征方面发现了组间差异，但只有神经病理性疼痛特征与头痛存在相关，46 名头痛患者中有 27 人在 S-LANSS 中得分，23 人在 PDQ 中得分（分别占 58.6% 和 50.0%）。根据逻辑回归模型，NDI和S-LANSS可以部分解释（R2 = 0.68）是否存在WAH：结论：在对 S-LANSS、PDQ 和 CSI 进行评估时，发现有 WAH 和无 WAH 的鞭打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。这些研究结果表明，神经性疼痛特征可能与急性 WAH 的存在有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.