急性颈部扭伤后周围神经炎症的证据。

IF 5.5 1区 医学 Q1 ANESTHESIOLOGY
PAIN® Pub Date : 2025-10-01 Epub Date: 2025-03-04 DOI:10.1097/j.pain.0000000000003560
Colette Ridehalgh, Joel Fundaun, Stephen Bremner, Mara Cercignani, Soraya Koushesh, Rupert Young, Alex Novak, Jane Greening, Annina B Schmid, Andrew Dilley
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引用次数: 0

摘要

摘要:鞭臼损伤具有较高的社会经济成本和较差的预后。大多数人被归类为II级鞭打相关疾病(wodi),伴有颈部不适和肌肉骨骼症状,没有明显的神经症状。然而,有证据表明,在WADII中有一个亚群与潜在的神经受累,如周围神经炎症。本研究旨在通过对臂丛、背根神经节和正中神经的t2加权磁共振成像,以及神经炎症的临床替代症状:神经机械敏感性升高(HNM)、血清炎症介质升高和体感痛觉过敏,探讨急性wdii中神经炎症的存在。在4周内招募了122名wadi参与者和43名健康对照(hc)。与hc相比,wdii参与者臂丛C5根和C5- c8背根神经节的磁共振成像T2信号比增加,但远端正中神经干没有。55%的wdii参与者有HNM的迹象。与hc相比,炎症介质也增加,47%的wdii参与者在定量感觉测试中出现体感觉变化。在那些患有HNM的wdii个体中,存在对寒冷和压力的痛觉过敏以及神经性疼痛的比例增加。许多wdii患者有多种神经炎症指标。总的来说,我们的研究结果呈现出急性WADII的复杂表型特征,并提供证据表明在个体亚组中存在周围神经炎症。结果提示有必要重新考虑wdii患者的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Evidence for peripheral neuroinflammation after acute whiplash.

Evidence for peripheral neuroinflammation after acute whiplash.

Evidence for peripheral neuroinflammation after acute whiplash.

Evidence for peripheral neuroinflammation after acute whiplash.

Abstract: Whiplash injury is associated with high socioeconomic costs and poor prognosis. Most people are classified as having whiplash-associated disorder grade II (WADII), with neck complaints and musculoskeletal signs, in the absence of frank neurological signs. However, evidence suggests that there is a subgroup with underlying nerve involvement in WADII, such as peripheral neuroinflammation. This study aimed to investigate the presence of neuroinflammation in acute WADII using T2-weighted magnetic resonance imaging of the brachial plexus, dorsal root ganglia and median nerve, and clinical surrogates of neuroinflammation: heightened nerve mechanosensitivity (HNM), raised serum inflammatory mediators, and somatosensory hyperalgesia. One hundred twenty-two WADII participants within 4 weeks of whiplash and 43 healthy controls (HCs) were recruited. Magnetic resonance imaging T2 signal ratio was increased in the C5 root of the brachial plexus and the C5-C8 dorsal root ganglia in WADII participants compared with HCs but not in the distal median nerve trunk. Fifty-five percent of WADII participants had signs of HNM. Inflammatory mediators were also raised compared with HCs, and 47% of WADII participants had somatosensory changes on quantitative sensory testing. In those WADII individuals with HNM, there was hyperalgesia to cold and pressure and an increased proportion of neuropathic pain. Many people with WADII had multiple indicators of neuroinflammation. Overall, our results present a complex phenotypic profile for acute WADII and provide evidence suggestive of peripheral neuroinflammation in a subgroup of individuals. The results suggest that there is a need to reconsider the management of people with WADII.

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来源期刊
PAIN®
PAIN® 医学-临床神经学
CiteScore
12.50
自引率
8.10%
发文量
242
审稿时长
9 months
期刊介绍: PAIN® is the official publication of the International Association for the Study of Pain and publishes original research on the nature,mechanisms and treatment of pain.PAIN® provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest.
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