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<meta name="DC.Title" content="Brain Network Disruption in Whiplash" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6569" />
<meta name="DC.Date" content="2020-06-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Whiplash-associated disorders frequently develop following motor vehicle collisions and often involve a range of cognitive and affective symptoms, though the neural correlates of the disorder are largely unknown. In this study, a sample of participants with chronic whiplash injuries were scanned by using resting-state fMRI to assess brain network changes associated with long-term outcome metrics.

MATERIALS AND METHODS: Resting-state fMRI was collected for 23 participants and used to calculate network modularity, a quantitative measure of the functional segregation of brain region communities. This was analyzed for associations with whiplash-associated disorder outcome metrics, including scales of neck disability, traumatic distress, depression, and pain. In addition to these clinical scales, cervical muscle fat infiltration was quantified by using Dixon fat-water imaging, which has shown promise as a biomarker for assessing disorder severity and predicting recovery in chronic whiplash.

RESULTS: An association was found between brain network structure and muscle fat infiltration, wherein lower network modularity was associated with larger amounts of cervical muscle fat infiltration after controlling for age, sex, body mass index, and scan motion ( t  =   −4.02, partial R 2   =   0.49, P  &lt; .001).

CONCLUSIONS: This work contributes to the existing whiplash literature by examining a sample of participants with whiplash-associated disorder by using resting-state fMRI. Less modular brain networks were found to be associated with greater amounts of cervical muscle fat infiltration suggesting a connection between disorder severity and neurologic changes, and a potential role for neuroimaging in understanding the pathophysiology of chronic whiplash-associated disorders.

rs-fMRI
:   resting-state fMRI
MFI
:   muscle fat infiltration
WAD
:   whiplash-associated disorder(s)
MVC
:   motor vehicle collision" />
<meta name="DC.Contributor" content="J.P. Higgins" />
<meta name="DC.Contributor" content="J.M. Elliott" />
<meta name="DC.Contributor" content="T.B. Parrish" />
<meta name="article:published_time" content="2020-06-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Brain Network Disruption in Whiplash" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Whiplash-associated disorders frequently develop following motor vehicle collisions and often involve a range of cognitive and affective symptoms, though the neural correlates of the disorder are largely unknown. In this study, a sample of participants with chronic whiplash injuries were scanned by using resting-state fMRI to assess brain network changes associated with long-term outcome metrics.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Resting-state fMRI was collected for 23 participants and used to calculate network modularity, a quantitative measure of the functional segregation of brain region communities. This was analyzed for associations with whiplash-associated disorder outcome metrics, including scales of neck disability, traumatic distress, depression, and pain. In addition to these clinical scales, cervical muscle fat infiltration was quantified by using Dixon fat-water imaging, which has shown promise as a biomarker for assessing disorder severity and predicting recovery in chronic whiplash.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;An association was found between brain network structure and muscle fat infiltration, wherein lower network modularity was associated with larger amounts of cervical muscle fat infiltration after controlling for age, sex, body mass index, and scan motion (&lt;i&gt;t&lt;/i&gt; =&lt;i&gt; &lt;/i&gt;−4.02, partial &lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;i&gt; &lt;/i&gt;=&lt;i&gt; &lt;/i&gt;0.49, &lt;i&gt;P &lt;/i&gt;&amp;lt; .001).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;This work contributes to the existing whiplash literature by examining a sample of participants with whiplash-associated disorder by using resting-state fMRI. Less modular brain networks were found to be associated with greater amounts of cervical muscle fat infiltration suggesting a connection between disorder severity and neurologic changes, and a potential role for neuroimaging in understanding the pathophysiology of chronic whiplash-associated disorders.&lt;/p&gt;" />
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<meta name="twitter:title" content="Brain Network Disruption in Whiplash" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Whiplash-associated disorders frequently develop following motor vehicle collisions and often involve a range of cognitive and affective symptoms, though the neural correlates of the disorder are largely unknown. In this study, a sample of participants with chronic whiplash injuries were scanned by using resting-state fMRI to assess brain network changes associated with long-term outcome metrics.

MATERIALS AND METHODS: Resting-state fMRI was collected for 23 participants and used to calculate network modularity, a quantitative measure of the functional segregation of brain region communities. This was analyzed for associations with whiplash-associated disorder outcome metrics, including scales of neck disability, traumatic distress, depression, and pain. In addition to these clinical scales, cervical muscle fat infiltration was quantified by using Dixon fat-water imaging, which has shown promise as a biomarker for assessing disorder severity and predicting recovery in chronic whiplash.

RESULTS: An association was found between brain network structure and muscle fat infiltration, wherein lower network modularity was associated with larger amounts of cervical muscle fat infiltration after controlling for age, sex, body mass index, and scan motion ( t  =   −4.02, partial R 2   =   0.49, P  &lt; .001).

CONCLUSIONS: This work contributes to the existing whiplash literature by examining a sample of participants with whiplash-associated disorder by using resting-state fMRI. Less modular brain networks were found to be associated with greater amounts of cervical muscle fat infiltration suggesting a connection between disorder severity and neurologic changes, and a potential role for neuroimaging in understanding the pathophysiology of chronic whiplash-associated disorders.

rs-fMRI
:   resting-state fMRI
MFI
:   muscle fat infiltration
WAD
:   whiplash-associated disorder(s)
MVC
:   motor vehicle collision" />
<meta name="og-title" property="og:title" content="Brain Network Disruption in Whiplash" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/41/6/994" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Whiplash-associated disorders frequently develop following motor vehicle collisions and often involve a range of cognitive and affective symptoms, though the neural correlates of the disorder are largely unknown. In this study, a sample of participants with chronic whiplash injuries were scanned by using resting-state fMRI to assess brain network changes associated with long-term outcome metrics.

MATERIALS AND METHODS: Resting-state fMRI was collected for 23 participants and used to calculate network modularity, a quantitative measure of the functional segregation of brain region communities. This was analyzed for associations with whiplash-associated disorder outcome metrics, including scales of neck disability, traumatic distress, depression, and pain. In addition to these clinical scales, cervical muscle fat infiltration was quantified by using Dixon fat-water imaging, which has shown promise as a biomarker for assessing disorder severity and predicting recovery in chronic whiplash.

RESULTS: An association was found between brain network structure and muscle fat infiltration, wherein lower network modularity was associated with larger amounts of cervical muscle fat infiltration after controlling for age, sex, body mass index, and scan motion ( t  =   −4.02, partial R 2   =   0.49, P  &lt; .001).

CONCLUSIONS: This work contributes to the existing whiplash literature by examining a sample of participants with whiplash-associated disorder by using resting-state fMRI. Less modular brain networks were found to be associated with greater amounts of cervical muscle fat infiltration suggesting a connection between disorder severity and neurologic changes, and a potential role for neuroimaging in understanding the pathophysiology of chronic whiplash-associated disorders.

rs-fMRI
:   resting-state fMRI
MFI
:   muscle fat infiltration
WAD
:   whiplash-associated disorder(s)
MVC
:   motor vehicle collision" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node75817--5" data-node-nid="75817" id="top-node-75817--61622390020" data-pisa="ajnr;41/6/994" data-pisa-master="ajnr;ajnr.A6569" data-apath="/ajnr/41/6/994.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Adult Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Brain Network Disruption in Whiplash</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J.P. Higgins</span>, <span class="highwire-citation-author" data-delta="1">J.M. Elliott</span> and <span class="highwire-citation-author" data-delta="2">T.B. Parrish</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2020,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">994-1000; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6569 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-75817--61622390020" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J.P. Higgins </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.P.H., T.B.P.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.P.%2BHiggins%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Higgins%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.P.%2BHiggins%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7916-8468" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.P. Higgins</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.M. Elliott </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Physical Therapy and Human Movement Sciences (J.M.E.), Feinberg School of Medicine, Northwestern University, Chicago, Illinois</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Discipline of Physiotherapy, Faculty of Health Sciences (J.M.E.), The University of Sydney and the Northern Sydney Local Health District; and The Kolling Research Institute, St. Leonards, NSW, Australia.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.M.%2BElliott%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Elliott%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.M.%2BElliott%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8890-6012" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.M. Elliott</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">T.B. Parrish </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.P.H., T.B.P.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.B.%2BParrish%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Parrish%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.B.%2BParrish%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1184-1572" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T.B. Parrish</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-41.6.994.1"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Spitzer</span>  <span class="cit-name-given-names">WO</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Skovron</span>  <span class="cit-name-given-names">ML</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Salmi</span>  <span class="cit-name-given-names">LR</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Scientific monograph of the Quebec Task Force on 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class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Beeckmans</span>  <span class="cit-name-given-names">K</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Crunelle</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Van Ingelgom</span>  <span class="cit-name-given-names">S</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Persistent cognitive deficits after whiplash injury: a comparative study with mild traumatic brain injury patients and healthy volunteers</span>. <abbr class="cit-jnl-abbrev">Acta Neurol Belg</abbr> <span class="cit-pub-date">2017</span>;<span class="cit-vol">117</span>:<span class="cit-fpage">493</span>–<span class="cit-lpage">500</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1007/s13760-017-0745-3</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>28102492</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1007/s13760-017-0745-3&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=28102492&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F6%2F994.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-journal" id="cit-41.6.994.3" data-doi="10.1136/jnnp.55.10.943"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Ettlin</span>  <span class="cit-name-given-names">TM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kischka</span>  <span class="cit-name-given-names">U</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Reichmann</span>  <span class="cit-name-given-names">S</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Cerebral symptoms after whiplash injury of the neck: a prospective clinical and neuropsychological study of whiplash injury</span>. <abbr class="cit-jnl-abbrev">J Neurol Neurosurg Psychiatry</abbr> <span class="cit-pub-date">1992</span>;<span class="cit-vol">55</span>:<span class="cit-fpage">943</span>–<span class="cit-lpage">48</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1136/jnnp.55.10.943</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> 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class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Matsumoto</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Ichihara</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Okada</span>  <span class="cit-name-given-names">E</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Cross-sectional area of the posterior extensor muscles of the cervical spine in whiplash injury patients versus healthy volunteers–10 year follow-up MR study</span>. <abbr class="cit-jnl-abbrev">Injury</abbr> <span class="cit-pub-date">2012</span>;<span class="cit-vol">43</span>:<span class="cit-fpage">912</span>–<span class="cit-lpage">16</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span 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class="cit-name-surname">Ronnen</span>  <span class="cit-name-given-names">HR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">de Korte</span>  <span class="cit-name-given-names">PJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Brink</span>  <span class="cit-name-given-names">PR</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Acute whiplash injury: is there a role for MR imaging?–a prospective study of 100 patients</span>. <abbr class="cit-jnl-abbrev">Radiology</abbr> <span class="cit-pub-date">1996</span>;<span class="cit-vol">201</span>:<span class="cit-fpage">93</span>–<span class="cit-lpage">96</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1148/radiology.201.1.8816527</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 41</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 6 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jun 2020 </div></div>
      
      
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      <div class="highwire-cite-title">Brain Network Disruption in Whiplash</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.P.</span> <span class="nlm-surname">Higgins</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.M.</span> <span class="nlm-surname">Elliott</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">T.B.</span> <span class="nlm-surname">Parrish</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">994-1000; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6569 </span></div>
  
  
  
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