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Changes in Pain Modulation Occur Soon After Whiplash Trauma but are not Related to Altered Perception of Distorted Visual Feedback
Author(s) -
Daenen Liesbeth,
Nijs Jo,
Cras Patrick,
Wouters Kristien,
Roussel Nathalie
Publication year - 2014
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12113
Subject(s) - medicine , whiplash , sensory system , perception , chronic pain , visual feedback , visual perception , physical medicine and rehabilitation , neuroscience , audiology , poison control , physical therapy , psychology , medical emergency , computer science , computer vision
Objectives Widespread sensory hypersensitivity has been observed in acute whiplash associated disorders ( WAD ). Changes in descending pain modulation take part in central sensitization. However, endogenous pain modulation has never been investigated in acute WAD . Altered perception of distorted visual feedback has been observed in WAD . Both mechanisms (ie, pain modulation and perception of distorted visual feedback) may be different components of one integrated system orchestrated by the brain. This study evaluated conditioned pain modulation ( CPM ) in acute WAD . Secondly, we investigated whether changes in CPM are associated with altered perception of distorted visual feedback. Methods Thirty patients with acute WAD , 35 patients with chronic WAD and 31 controls were subjected to an experiment evaluating CPM and a coordination task inducing visual mediated changes between sensory feedback and motor output. Results A significant CPM effect was observed in acute WAD ( P  = 0.012 and P  = 0.006), which was significantly lower compared to controls ( P  = 0.004 and P  = 0.020). No obvious differences in CPM were found between acute and chronic WAD ( P  = 0.098 and P  = 0.041). Changes in CPM were unrelated to altered perception of distorted visual feedback ( P  > 0.01). Conclusion Changes in CPM were observed in acute WAD , suggesting less efficient pain modulation. The results suggest that central pain and sensorimotor processing underlie distinctive mechanisms.

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