Neuromuscular Mechanisms Underlying Poor Recovery From Whiplash Injuries

This study is investigating whether changes in the shape and size of bodily muscles and spinal cord anatomy can influence recovery rates following a motor vehicle collision (MVC). The objective is to demonstrate that the presence of muscle and spinal cord degeneration and associated muscle weakness is the consequence of a mild MVC-related injury involving the cervical spinal cord.

Whiplash is a condition that consists of patients that display varying degrees of pain and disability. Most patients should expect full-recovery within the first 2-3 months post injury. At the other end of the spectrum is a group of patients (~ 25%) who continue to have moderate-severe pain-related disability in the long-term. Reasons for this transition to chronicity are largely unknown. The situation would benefit if there were radiological findings of the disorder. However, clear and consistent findings of injured tissues on standard radiological exams remain elusive. As part of this study, the investigators will innovatively investigate measures to 1) quantify the temporal development of widespread muscle degeneration, 2) identify quantifiable markers of altered cervical spinal cord physiology, 3) quantify reductions in central activation and fatigue 4) evaluate potential genetic variants that may be associated with chronic pain after a MVC and 5) determine the mediational influence of psychosocial factors on recovery rates following whiplash injury, as a potential mechanism underlying the transition to chronic pain.

RNA/DNA blood sample will be collected. Participant will complete questionnaires, MRI and strength and reflex testing.

MRI to assess the changes in markers of altered cervical spinal cord physiology and muscle degeneration.

This questionnaire will access the influence of psychosocial factors on recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence and psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

This questionnaire will access the influence of psychosocial factors and recovery rates over a period of time.

The samples will evaluate potential genetic variants that may be associated with chronic pain after a MVC.

Inclusion Criteria: Males and Females (18 - 65 years of age) Individuals less than one week post MVA with a primary complaint of neck pain. Able to give written informed consent and complete interviews in English Exclusion Criteria: Individuals with a spinal fracture from the MVA, or spinal surgeries History of one or more MVAs or previous diagnosis of cervical or lumbar radiculopathy History of neurological disorders (e.g. Multiple Sclerosis, previous stroke, myelopathy), inflammatory diseases (e.g. Hepatitis, Systemic Lupus Erythematosus, Rheumatoid Arthritis or Osteoarthritis, Alzheimers, Ankylosing Spondylitis, Crohn's disease, Fibromyalgia) or metabolic disorders (e.g. Diabetes, hyper- and hypo-thyroidism) Standard contraindications to MRI: claustrophobia, metallic implants, pacemaker and pregnancy.

Modarresi S, MacDermid JC, Suh N, Elliott JM, Walton DM. How Is the Probability of Reporting Various Levels of Pain 12 Months After Noncatastrophic Injuries Associated with the Level of Peritraumatic Distress? Clin Orthop Relat Res. 2022 Feb 1;480(2):226-234. doi: 10.1097/CORR.0000000000002024.