Relation between neuropsychological and neuroimaging findings in patients with late whiplash syndrome
Relation between neuropsychological and neuroimaging findings in patients with late whiplash syndrome
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晚期颈椎扭伤综合征患者的神经心理学和神经影像学结果之间的关系
DOI：
10.1136/jnnp.66.4.485
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
A. Buck
中科院分区：
文献类型：
--
作者：
B. Radanov;I. Bicik;J. Dvořák;J. Antinnes;G. V. von Schulthess;A. Buck
对于许多医生来说，对挥鞭样损伤后长期认知障碍的解释仍然是一个问题。根据核医学的发现，以前的研究推测，脑损伤是造成挥鞭样损伤患者认知问题的原因。为了验证这一假设，神经影像学和神经心理学结果之间的关系进行了分析。方法21例（女性11例，男性10例，平均年龄42.2（SD 8.6）岁）迟发性挥鞭样损伤综合征患者（平均创伤间隔26.1（SD 20.7）个月）被转诊至神经内科进行诊断。评估包括工作记忆和分散注意力的计算机辅助评估、神经成像（通过[99 mTc]-HMPAO-SPECT、[15 O]-H2O-PET和[18 F]-FDG-PET）、情绪功能测试（抑郁和焦虑评级）和测试时的疼痛强度。结果：平均而言，认知功能测试得分很低。然而，没有发现任何脑区的局部灌注或代谢与分配注意或工作记忆得分之间存在显著相关性。相比之下，显着的关系被发现之间的指标受损的情绪功能（状态焦虑）和分散注意力。此外，注意力分散的低得分与测试时的疼痛强度显著相关。结论：目前的数据并没有提供证据表明，在晚期挥鞭样损伤综合征中，可检测到的形态或功能性脑损伤与认知能力受损之间存在显著关系。结果表明，触发的情绪和认知症状的基础上的颈椎的初始损伤。
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.