Currently, there are no biomarkers to determine if patients have severe whiplash from a motor vehicle collision. Mark Hoggarth, a DPT/PhD student, is investigating this issue in the Neuromuscular Imaging Research Laboratory, which is led by James Elliott, PT, PhD, assistant professor in Physical Therapy and Human Movement Sciences.
“There are a significant portion of people with whiplash who end up having chronic pain in the long-term,” Hoggarth said. “It is crazy to think that we don’t know why or who these people are going to be. So what we do in our lab is investigate biomarkers, or clinical evidence, for spinal cord damage in the neck.”
Hoggarth created a new screening measure that could be the first biomarker to determine if a patient is going to have chronic pain from whiplash. Hoggarth began by comparing MRI neck scans of healthy patients and whiplash patients using measurements called magnetization transfer ratio (MTR) to observe damage to nerves.
The team did not observe significant differences in the images, so Hoggarth created a new measure called dMTR, which analyzes the white matter, or myelinated nerve cells, in different regions of the spinal cord. Using this measure, Hoggarth found that patients with severe whiplash had some sections of white matter with lower signaling activity than others. Healthy patients had the same range of signaling activity in all regions.
Given this new measure, a radiologist could potentially analyze the spinal cord and determine if specific regions have been injured. Ultimately, these measurements could be done within hours to days after an accident.
Hoggarth’s research has broad applications, opening the possibilities to better show injury to the spinal cord caused by everything from collisions to sports and combat. Next steps include looking into therapies for whiplash and the relationship between whiplash and post-traumatic stress disorder.
“There is an interesting tie between whiplash and post-traumatic stress and that is something that can be looked at down the line. Patients who don’t have symptoms of spinal cord injury but have post-traumatic stress might have some underlying spinal cord injury,” he said. “Once you realize a patient has a spinal cord injury, it opens a realm of treatment options and I would like to explore that in the future.”
