title: Gray matter changes related to chronic posttraumatic headache.
abstract: BACKGROUND
  Although up to 15% of patients with whiplash injury develop chronic headache, the basis and mechanisms of this posttraumatic headache are not well understood.
  
  
  METHODS
  Thirty-two patients with posttraumatic headache following whiplash injury were investigated within 14 days after the accident and again after 3 months using magnetic resonance-based voxel-based morphometry. Twelve patients developed chronic headache lasting longer than 3 months and were studied a third time after 1 year.
  
  
  RESULTS
  Patients who developed chronic headache revealed decreases in gray matter in the anterior cingulate and dorsolateral prefrontal cortex after 3 months. These changes resolved after 1 year, in parallel to the cessation of headache. The same patients who developed chronic headache showed an increase of gray matter in antinociceptive brainstem centers, thalamus, and cerebellum 1 year after the accident.
  
  
  CONCLUSIONS
  We demonstrate adaptive gray matter changes of pain processing structures in patients with chronic posttraumatic headache in regard to neuronal plasticity, thus providing a biologically plausible basis for this common, disabling problem.
authors.affiliation: Department of Neurology, University of Duisburg-Essen, 45122 Essen, Germany. mark.obermann@uni-due.de
authors.forename: Mark
authors.initials: M
authors.lastname: Obermann
authors.forename: K
authors.initials: K
authors.lastname: Nebel
authors.forename: C
authors.initials: C
authors.lastname: Schumann
authors.forename: D
authors.initials: D
authors.lastname: Holle
authors.forename: E R
authors.initials: ER
authors.lastname: Gizewski
authors.forename: M
authors.initials: M
authors.lastname: Maschke
authors.forename: P J
authors.initials: PJ
authors.lastname: Goadsby
authors.forename: H-C
authors.initials: HC
authors.lastname: Diener
authors.forename: Z
authors.initials: Z
authors.lastname: Katsarava
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001933:Brain Stem / Q000473:pathology / Q000503:physiopathology; D002531:Cerebellum / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology / Q000503:physiopathology; D020773:Headache Disorders / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D009473:Neuronal Plasticity / Q000502:physiology; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology; D013995:Time; D014911:Whiplash Injuries / Q000150:complications*; D055815:Young Adult