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fMRI Response During Visual Motion Stimulation in Patients with Late Whiplash Syndrome

Department of Neuroradiology, University Hospital Basel, Basel, Switzerland

M.W. Greenlee

Department of Neurology, University of Freiburg, and Institute for Cognitive Science, University oF Oldenburg, Germany

K. Wachter

Rehabilitation Clinic Rheinfelden, Rheinfelden, Switzerland

Th.M. Ettlin

Rehabilitation Clinic Rheinfelden, Rheinfelden, Switzerland

E.W. Radue

Department of Neuroradiology, University Hospital Basel, Basel, Switzerland

After whiplash trauma, up to one fourth of patients develop chronic symptoms including head and neck pain and cognitive disturbances. Resting perfusion single-pho ton-emission computed tomography (SPECT) found decreased temporoparietooccipi tal tracer uptake among these long-term symptomatic patients with late whiplash syn drome. As MT/MST (V5/V5a) are located in that area, this study addressed the question whether these patients show impairments in visual motion perception. We examined five symptomatic patients with late whiplash syndrome, five asymptomatic patients after whiplash trauma, and a control group of seven volunteers without the history of trauma. Tests for visual motion perception and functional magnetic resonance imaging (fMRI) measurements during visual motion stimulation were performed. Symptomatic patients showed a significant reduction in their ability to perceive coherent visual motion com pared with controls, whereas the asymptomatic patients did not show this effect. fMRI activation was similar during random dot motion in all three groups, but was signifi cantly decreased during coherent dot motion in the symptomatic patients compared with the other two groups. Reduced psychophysical motion performance and reduced fMRI responses in symptomatic patients with late whiplash syndrome both point to a functional impairment in cortical areas sensitive to coherent motion. Larger studies are needed to confirm these clinical and functional imaging results to provide a possi ble additional diagnostic criterion for the evaluation of patients with late whiplash syn drome. Key Words: Whiplash—fMRI—Visual motion perception.

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