Whiplash,​ Anxiety linked to Chronic Pain⁣ Development

Updated June 9, 2025
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A⁤ new Northwestern Medicine study ​indicates ⁢that scientists can predict which whiplash patients will ‍develop chronic pain ⁣by observing brain activity and anxiety levels within days of the injury. ‌The research, focused on understanding⁣ the development‌ of ‌chronic pain, reveals a connection between the brain’s memory center (hippocampus) and long-term memory storage (cortex).

The study, which will be published in Nature Mental⁢ Health on Oct. 24,found that ⁢increased communication between‌ these brain regions,combined with high anxiety immediately⁣ following a car accident,strongly predicted ​chronic⁢ pain one‌ year ⁢later. ⁣This suggests the brain adapts ⁤rapidly ⁢after injury, creating a risk ⁢for long-term pain.

Paulo Branco, assistant professor of ⁣anesthesiology and pain medicine at Northwestern ‌University Feinberg School of Medicine and ⁢lead author of the study, said the communication between ‌the hippocampus and cortex appears to be related to forming new memories of⁢ the accident and pain. “The hippocampus is responsible ​for‍ consolidating new memories⁢ into long-lasting ones,” ​Branco ⁤said.

Researchers hypothesize that heightened​ connectivity encodes a strong memory associating head and⁢ neck movement⁢ with ⁢pain. “This creates expectations and associations,” Branco said. “If the memory has high emotional importance, then it makes ‍these patients associate this movement with pain.”

Apkar V. Apkarian, director of the⁢ Center for Translational Pain Research and professor of neuroscience at‌ Northwestern University Feinberg School of Medicine, emphasized the importance of early⁤ intervention. “Now ‍that we certainly know there is this critical time period when this happens,we‍ can focus our treatment​ efforts at this early stage to prevent chronic pain rather than try​ to cure it,which is much ⁣more difficult,” Apkarian said.

Apkarian suggested that targeting anxiety immediately after injury,possibly ⁤with medication,could halt these brain changes.Future treatments ‍might also target hippocampal activity through pharmacology or neuromodulation.

The study involved ‍a collaboration‌ between the Technion-Israel Institute of Technology, Northwestern ⁢University, and McGill University. Researchers collected brain imaging data from over 200 whiplash patients between March 2016 and December 2021,⁣ using functional magnetic resonance imaging (fMRI) within three days of the ‍injury. Patients where followed⁤ for 12 months to assess pain levels and track⁢ the development ​of chronic pain.

What’s next

Researchers plan to investigate the underlying‌ mechanisms ‍of the ⁤hippocampal response to injury, assessing physiological and psychological factors that drive these brain mechanisms. They also aim to⁤ determine if these findings apply to other chronic pain conditions. The ‍long-term goal is⁢ to target maladaptive⁤ responses early after injury to test their role in the development of chronic pain, perhaps using pharmacological treatments, ‌cognitive-behavioral therapy, or ‌transcranial magnetic stimulation.