title: Whiplash and concussion: similar acute changes in middle-latency SEPs.
abstract: OBJECTIVE
  Middle-latency somatosensory evoked potentials (SEPs) following median nerve stimulation can provide a sensitive measure of cortical function. We sought to determine whether the mechanical forces of whiplash injury or concussion alter normal processing of middle-latency SEPs.
  
  
  METHODS
  In a cross-sectional pilot study 20 subjects with whiplash were investigated (50% between 0.5-2 months and 50% between 6-41 months post injury) and compared to 83 healthy subjects using a standard middle-latency SEP procedure. In a subsequent prospective study subjects with either acute whiplash (n=13) or Grade 3 concussion (n=16) were investigated within 48 hours and again three months post injury.
  
  
  RESULTS
  In the pilot study the middle-latency SEP component N60 was significantly increased in the ten subjects investigated within two months after whiplash. In contrast, the ten subjects examined more than six months after injury showed normal latencies. In the prospective study N60 latencies were increased after whiplash and concussion when tested within 48 hours of injury. At three months, latencies were improved though still significantly different from controls post whiplash and concussion.
  
  
  CONCLUSIONS
  Both whiplash injury and concussion alter processing of the middle-latency SEP component N60 in the acute post traumatic period. The acute changes appear to normalize between three-six months post injury. The SEP similarities suggest that the overlapping clinical symptomatology post whiplash and concussion may reflect a similar underlying mechanism of rotational mild traumatic brain injury.
authors.affiliation: Krembil Neuroscience Centre, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Dominik
authors.initials: D
authors.lastname: Zumsteg
authors.forename: Richard
authors.initials: R
authors.lastname: Wennberg
authors.forename: Eva
authors.initials: E
authors.lastname: Gütling
authors.forename: Klaus
authors.initials: K
authors.lastname: Hess
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001924:Brain Concussion / Q000503:physiopathology*; D018592:Cross-Over Studies; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014911:Whiplash Injuries / Q000503:physiopathology*