Open AccessIs Traumatic and Non-Traumatic Neck Pain Associated with Brain Alterations? – A Systematic Review
Author(s) -
Robby De Pauw,
Iris Coppieters,
Mira Meeus,
Karen Caeyenberghs,
Lieven Danneels,
Barbara Cagnie
Publication year - 2017
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2017.260
Subject(s) - medicine , whiplash , chronic pain , neck pain , systematic review , physical therapy , medline , pathology , poison control , alternative medicine , emergency medicine , political science , law
Background: Chronic neck pain affects 50% – 85% of people who have experienced an acuteepisode. This transition and the persistence of chronic complaints are believed to be mediated bybrain alterations among different central mechanisms.Objectives: This study aimed to systematically review and critically appraise the currentexisting evidence regarding structural and functional brain alterations in patients with whiplashassociated disorders (WAD) and idiopathic neck pain (INP). Additionally, associations betweenbrain alterations and clinical symptoms reported in neck pain patients were evaluated.Study Design: Systematic review.Methods: The present systematic review was performed according to the PRISMA guidelines.PubMed, Web of Science, and Cochrane databases were searched. First, the obtained articleswere screened based on title and abstract. Secondly, the screening was based on the full text.Risk of bias in included studies was investigated.Results: Twelve studies met the inclusion criteria. Alterations in brain morphology and function,including perfusion, neurotransmission, and blood oxygenation level dependent-signal, weredemonstrated in chronic neck pain patients. There is some to moderate evidence for bothstructural and functional brain alterations in patients with chronic neck pain. In contrast, noevidence for structural brain alterations in acute neck pain patients was found.Limitations: Only 12 articles were included, which allows only cautious conclusions to bedrawn.Conclusion: Brain alterations were observed in both patients with chronic WAD and chronicINP. Furthermore, more evidence exists for brain alterations in chronic WAD, and differentunderlying mechanisms might be present in both pathologies. In addition, pain and disabilitywere correlated with the observed brain alterations. Accordingly, morphological and functionalbrain alterations should be further investigated in patients with chronic WAD and chronicINP with newer and more sensitive techniques, and associative clinical measurements seemindispensable in future research.Key words: Traumatic neck pain, idiopathic non-traumatic neck pain, brain alterations,magnetic resonance imaging, single photon emission computed tomography, photon emissiontomography, chronic neck pain