MRI-based brain volumetry in chronic whiplash patients: no evidence for traumatic brain injury.
BACKGROUND
Cognitive complaints, such as poor concentration and memory deficits, are frequent after whiplash injury and play an important role in disability. The origin of these complaints is discussed controversially. Some authors postulate brain lesions as a consequence of whiplash injuries. Potential diffuse axonal injury (DAI) with subsequent atrophy of the brain and ventricular expansion is of particular interest as focal brain lesions have not been documented so far in whiplash injury.


OBJECTIVE
To investigate whether traumatic brain injury can be identified using a magnetic resonance (MR)-based quantitative analysis of normalized ventricle-brain ratios (VBR) in chronic whiplash patients with subjective cognitive impairment that cannot be objectively confirmed by neuropsychological testing.


METHODS
MR examination was performed in 21 patients with whiplash injury and symptom persistence for 9 months on average and in 18 matched healthy controls. Conventional MR imaging (MRI) was used to assess the volumes of grey and white matter and of ventricles. The normalized VBR was calculated.


RESULTS
The values of normalized VBR did not differ in whiplash patients when compared with that in healthy controls (F = 0.216, P = 0.645).


CONCLUSIONS
This study does not support loss of brain tissue following whiplash injury as measured by VBR. On this basis, traumatic brain injury with subsequent DAI does not seem to be the underlying mechanism for persistent concentration and memory deficits that are subjectively reported but not objectively verifiable as neuropsychological deficits.
Sturzenegger
M
M
Department of Neurology, University Hospital of Berne, Berne, Switzerland.
Radanov
B P
BP
Winter
P
P
Simko
M
M
Farra
A D
AD
Di Stefano
G
G
D000328:Adult; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001930:Brain Injuries / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D002908:Chronic Disease; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014911:Whiplash Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology