Relation between neuropsychological and neuroimaging findings in patients with late whiplash syndrome
- Bogdan P Radanova,
- Ivette Bicikb,
- Jiri Dvorakc,
- James Antinnesd,
- Gustav K von Schulthessb,
- Alfred Buckb
- aDepartment of Psychiatry, University of Berne, Inselspital, CH—3010 Berne, Switzerland, bDivision of Nuclear Medicine, University Hospital Zuerich, CH—8091 Zuerich, Switzerland, cDepartment of Neurology, Wilhelm Schulthess Hospital, Lengghalde 2, CH—8008 Zuerich, Switzerland, dDepartment of Orthopedic Surgery, Ochsner Foundation Hospital, 1516 Jefferson Highway, New Orleans, Louisiana 70121, USA
- Dr BP Radanov, Department of Psychiatry, University of Berne, Inselspital, CH—3010 Berne, Switzerland. Telehone: 0041 31 632 88 11; fax 0041 31 632 89 50; emailradanov{at}pupk.unibe.ch
- Received 13 March 1998
- Revised 24 August 1998
- Accepted 23 September 1998
Abstract
OBJECTIVES The interpretation of long term cognitive impairment after whiplash injury is still a problem for many physicians. On the grounds of nuclear medicine findings previous research speculated that brain damage is responsible for cognitive problems of patients with whiplash. To test this hypothesis the relation between neuroimaging and neuropsychological findings was analysed.
METHODS Twenty one patients (11 women, 10 men, mean age 42.2 (SD 8.6) years) with the late whiplash syndrome (average interval of trauma 26.1 (SD 20.7) months) referred for diagnostic action to the Department of Neurology were investigated. Assessment included computer assisted assessment of working memory and divided attention, neuroimaging (by the means of [99mTc]-HMPAO-SPECT, [15O]-H2O-PET and [18F]-FDG-PET), testing of emotional functioning (depression and anxiety ratings), and pain intensity at the time of testing.
RESULTS On average, scoring on tests of cognitive functioning was very low. However, no significant correlations were found between regional perfusion or metabolism in any brain area and the scores of divided attention or working memory. By contrast, significant relations were found between indices of impaired emotional functioning (state anxiety) and divided attention. In addition, low scoring in divided attention was significantly correlated with pain intensity at the time of testing.
CONCLUSIONS The present data do not provide evidence of a significant relation between detectable morphological or functional brain damage and impaired cognitive performance in the late whiplash syndrome. Results indicate triggering of emotional and cognitive symptoms on the basis of initial injury of the cervical spine.
