The relationship between sensory and sympathetic nervous system changes and posttraumatic stress reaction following whiplash injury - a prospective study

Objective: To investigate differences in sensory and sympathetic nervous system (SNS) function between whiplash-injured persons with and without a posttraumatic stress reaction (PTSR). To explore associations between sensory, SNS function, and persistent PTSR at 6 months postinjury. Methods: Seventy-six acutely (< 1 month) whiplash-injured persons (10 with PTSR persisting to 6 months postinjury, 14 with early PTSR that resolved, and 52 with no PTSR) were prospectively investigated. Results: Those with persistent PTSR showed sensory hypersensitivity and impaired peripheral vasoconstriction compared to those whose PTSR resolved and those without PTSR (P <.05). The early presence of sensory hypersensitivity was associated with PTSR at 6 months, but this relationship was mediated by pain and disability levels. Impaired vasoconstriction and higher pain and disability levels were associated with PTSR at 6 months. Conclusion: Sensory disturbances following whiplash injury are associated with persistent PTSR but may be mediated by levels of pain and disability. (c) 2006 Elsevier Inc. All rights reserved.