Scientists have made a significant breakthrough in understanding chronic pain development following whiplash injuries. A recent study by Northwestern Medicine reveals that within one to three days of such an injury, it is possible to predict which patients are likely to develop chronic pain. This prediction is based on the interaction between two brain regions and the patient's anxiety levels post-injury.
The study indicates that increased communication between the hippocampus, responsible for memory consolidation, and the cortex, involved in long-term memory storage, raises the likelihood of chronic pain development. "The hippocampus is responsible for consolidating new memories into long-lasting ones," explained Paulo Branco, assistant professor at Northwestern University Feinberg School of Medicine.
Moreover, higher anxiety levels immediately after a car accident improve predictions about chronic pain one year later. The research underscores the importance of addressing anxiety soon after injury to potentially prevent these changes through medications or other interventions.
Corresponding author Apkar V. Apkarian highlighted the shift in focus towards prevention: “Now that we know there is this critical time period when this happens, we can focus our treatment efforts at this early stage to prevent chronic pain rather than try to cure it.”
This large-scale longitudinal study was conducted with collaboration from Technion-Israel Institute of Technology and McGill University. It included over 200 whiplash patients who underwent brain imaging within three days of their injuries. They were monitored over 12 months to track their pain progression.
In future research, scientists aim to explore additional physiological and psychological factors influencing these brain mechanisms and test whether findings apply across other chronic pain conditions. The ultimate goal is to target maladaptive responses early after injury using various treatments.
The paper titled “Maladaptive hippocampal plasticity within days of whiplash and mild traumatic brain” will be published in Nature Mental Health on October 24. Other contributors include Andrew D. Vigotsky from Northwestern University.
This research received support from several grants including those from the Department of Defense and National Institutes of Health.