Event-Related Potentials Following Cutaneous Electrical Stimulation in Patients With Chronic Whiplash-Associated Disorders

Dorine Lenoir, Ward Willaert, Kelly Ickmans, Jo Nijs, Barbara Cagnie, Mira Meeus, Kristl Vonck, Jean Delbeke, Robby De Pauw, Iris Coppieters

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Whiplash injuries typically occur from a motor vehicle collision and lead to chronic whiplash-associated disorders (CWAD) in 20% to 50% of cases. Changes in neurotransmission, metabolism, and networks seem to play a role in the pathogenic mechanism of CWAD.

OBJECTIVES: To further elucidate the functional brain alterations, a neurophysiological study was performed to investigate the somatosensory processing of CWAD patients by comparing the event-related potentials (ERPs) resulting from electrical nociceptive stimulation between patients suffering from CWAD and healthy controls (HC).

STUDY DESIGN: Case-control study.

SETTING: University Hospital in Ghent.

METHODS: In this case-control study (CWAD patients/HC: 50/50), ankle and wrist electrical pain thresholds (EPT), and amplitude and latency of the event-related potentials (ERPs) resulting from 20 electrical stimuli were investigated. Correlations between the ERP characteristics, EPT, self-reported pain, disability, pain catastrophizing, and self-reported symptoms of central sensitization were investigated.

RESULTS: Only the latency of the P3 component after left wrist stimulation (t = -2.283; P = 0.023) differed between both groups. In CWAD patients, the ankle EPT correlated with the amplitude of the corresponding P1 (rho s = 0.293; P = 0.044) and P3 (rho s = 0.306; P = 0.033), as well as with the amplitude of the P3 to left wrist stimulation (rho s = 0.343; P = 0.017). Self-reported symptoms of CS correlated with right wrist P3 amplitude (rho s = 0.308; P = 0.030) and latency (rho s = -0.341; P = 0.015), and the worst pain reported during the past week was correlated with left wrist P1 latency (rho s = 0.319; P = 0.029).

LIMITATIONS: Although the inclusion criteria stated that CWAD patients had to report a moderate-to-severe pain-related disability, 8 of the included CWAD patients (that scored above this threshold in the inclusion questionnaire), scored below the required cutoff at baseline.

CONCLUSIONS: The CWAD patients did not show signs of hypersensitivity, but their ERP characteristics were related to the intensity of the applied stimulus, self-reported symptoms of CS, and the worst pain reported during the past week.

Original languageEnglish
Pages (from-to)E435-E438
Number of pages14
JournalPain Physician
Issue number3
Publication statusPublished - 2022

Bibliographical note

Funding Information:
Research Foundation – Flanders (FWO, grant number: 12Q0119N).

Funding Information:
Address Correspondence: Dorine Lenoir, MSc C. Heymanslaan 10 9000 Gent , Belgium E-mail: Dorine.lenoir@ugent.be Disclaimer: Robby De Pauw and Iris Coppieters contributed equally to this manuscript. The researcher D. Lenoir was funded by “Bijzonder onderzoeksfonds Gent” (grant number BOF19/DOC/170). The researchers W. Willaert and I. Coppieters were funded by the Flemish Research Foundation (FWO, grant number: G007217N). K. Ickmans is a postdoctoral research fellow employed by the

Publisher Copyright:
© 2022, American Society of Interventional Pain Physicians. All rights reserved.

Copyright 2022 Elsevier B.V., All rights reserved.


  • Case-Control Studies
  • Chronic Disease
  • Electric Stimulation
  • Evoked Potentials
  • Humans
  • Pain
  • Whiplash Injuries/complications


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