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

Abstract

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.