Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Review Article Volume 6 Issue 12

How Acute Whiplash Injuries Become Chronic: The Neuro-Biological Triad of Neuronal-Glial-Immune Cells as Culprit

Bilal F Shanti*, Ihsan F Shanti, Daniel Spillmann and Zaynab IF Shanti

Omina Pain Consultants, USA

*Corresponding Author: Bilal F Shanti, Omina Pain Consultants, USA.

Received: September 27, 2023; Published: November 23, 2023

Abstract

Whiplash-associated disorder (WAD) occur when there is shifting and movement of energy, during a crash or collision, from acceleration-deceleration mechanism transferred mainly to the neck region. WAD is characterized by excessive extension-flexion movements, and/or excessive side bending of the head and neck, beyond the normal and regular range of motion.

Motor vehicle collisions account for the majority of trauma related to WAD, but there are other causes such as contact sports injuries, falls, physical and domestic abuse, and other types of traumas.

Clinically, encountering cases of chronic neck pain stemming from untreated, poorly treated, or mis-managed whiplash injuries after motor vehicle collisions has become a more common and challenging encounter. The necessity to address acute whiplash injury pain-related symptoms very aggressively, early on, and in a systematic and interdisciplinary matter is essential to avoid unnecessary and avoidable long-term sequelae.

This manuscript seeks to explain the latest neurobiological theories, interplay, and interaction of a triad of neuron-glia-immune cells in the genesis of chronic pain that potentially can also apply for chronic whiplash pain. We will exclusively deal with the chronic pain aspects of WAD. The chronicity is associated with functionality limitations and restrictions, psychological and psychosocial ramifications, financial crisis, unemployment, and in cases, prolonged disability. This causes a significant economic burden on country.

 Keywords: Whiplash; Whiplash-Associated Disorder; Neck Pain; Chronic Neck Pain; Motor Vehicle Collision; Chronic Pain Syndrome; Chronic Pain; Neck Trauma; Triad of Chronic Pain

References

  1. Blincoe LJ., et al. “The economic and societal impact of motor vehicle crashes. (Revised) (Report No. DOT HS 812013). Washington, DC: National Highway Traffic Safety Administration (2010).
  2. Shanti BF., et al. “Whiplash Injuries: A Systemic Review". Acta Scientific Neurology4 (2023): 51-67.
  3. Cairns BE., et al. “Perspectives in Pain Research 2014: Neuroinflammation and glial cell activation: The cause of transition from acute to chronic pain?” Scandinavian Journal of Pain 1 (2015): 3-6.
  4. Murray I., et al. “Neuron-Glia-Immune Triad, and Cortico-Limbic System in Pathology of Pain”. Cells6 (2021): 1553.
  5. Halievski K., et al. “Microglia-P2X4R Sex Differences in Pain”. Journal of Pharmacology and Experimental Therapeutics 1 (2020): 202-209.
  6. Shanti BF., et al. “BDNF: The Old-New Pain Mediator and Modulator of Neuropathic Pain and Neuroinflammation". Acta Scientific Neurology12 (2022): 33-42.
  7. Boakye PA., et al. “Mediators of Neuropathic Pain; Focus on Spinal Microglia, CSF-1, BDNF, CCL21, TNF-α, Wnt Ligands, and Interleukin 1β”. Frontiers in Pain Research (Lausanne) 2 (2021): 698157.
  8. Yam MF., et al. “General Pathways of Pain Sensation, and the Major Neurotransmitters Involved in Pain Regulation”. International Journal of Molecular Sciences 8 (2018): 2164.
  9. Ji RR and Suter. “p38 MAPK, microglial signaling, and neuropathic pain”. Molecular Pain 3 (2007): 33.
  10. Yang S and Chang MC. “Chronic Pain: Structural and Functional Changes in Brain Structures and Associated Negative Affective States”. International Journal of Molecular Sciences 13 (2019): 3130.
  11. Reddi D., et al. “An introduction to pain pathways and mechanisms”. British Journal of Hospital Medicine 74 (2013): C188-C191.
  12. Cata JP., et al. “Altered discharges of spinal wide dynamic range neurons and down-regulation of glutamate transporter expression in rats with paclitaxel-induced hyperalgesia”. Neuroscience 138 (2023): 329-338.
  13. Bourne S., et al. “Basic anatomy, and physiology of pain pathways”. Neurosurgery Clinics of North America 25 (2014): 629-638.
  14. Apkarian AV., et al. “Human brain mechanisms of pain perception and regulation in health and disease”. European Journal of Pain 9 (2009): 463-484.
  15. Chen Q and Heinricher MM. “Descending Control Mechanisms and Chronic Pain”. Current Rheumatology Reports 21 (2019): 13.
  16. Kuner R. “Central mechanisms of pathological pain”. Nature Medicine 16 (2010): 1258-1266.
  17. Latremoliere A and Woolf CJ. “Central sensitization: A generator of pain hypersensitivity by central neural plasticity”. The Journal of Pain 10 (2009): 895-926.
  18. Vachon-Presseau E., et al. “The Emotional Brain as a Predictor and Amplifier of Chronic Pain”. Journal of Dental Research 95 (2016): 605-612.
  19. Mansour AR., et al. “Chronic pain: the role of learning and brain plasticity”. Restorative Neurology and Neuroscience 1 (2014): 129-139.
  20. Thompson JM and Neugebauer V. “Cortico-limbic pain mechanisms”. Neuroscience Letters (2019).
  21. Duvarci S and Pare D. “Amygdala microcircuits controlling learned fear”. Neuron 82 (2014): 966-980.
  22. Neugebauer V. “Amygdala pain mechanisms”. Handbook of Experimental Pharmacology 227 (2015): 261-284.
  23. Vachon-Presseau E., et al. “Corticolimbic anatomical characteristics predetermine risk for chronic pain”. Brain 139 (2016) 1958-1970.
  24. Bushnell MC., et al. “Cognitive and emotional control of pain and its disruption in chronic pain”. Nature Reviews Neuroscience 7 (2013): 502-511.
  25. Navratilova E., et al. “Brain Circuits Encoding Reward from Pain Relief”. Trends in Neurosciences 38 (2015): 741-750.
  26. Journée SH., et al. “Janus effect of the anterior cingulate cortex: Pain and emotion”. Neuroscience and Biobehavioral Reviews 153 (2023):
  27. Yu W., et al. “Periaqueductal gray/dorsal raphe dopamine neurons contribute to sex differences in pain-related behaviors”. Neuron8 (2021): 1365-1380.e5.
  28. Carrive P. “The periaqueductal gray and defensive behavior: functional representation and neuronal organization”. Behavioural Brain Research 1-2 (1993): 27-47.
  29. Wang S., et al. “Distinct networks of periaqueductal gray columns in pain and threat processing”. Neuroimage 250 (2022):
  30. Apkarian AV., et al. “Role of adult hippocampal neurogenesis in persistent pain”. Pain2 (2016): 418-428.
  31. Reckziegel D., et al. “Hippocampus shape deformation: a potential diagnostic biomarker for chronic back pain in women”. Pain5 (2021): 1457-1467.
  32. Mokhtari T., et al. “Involvement of the hippocampus in chronic pain and depression”. Brain Science Advances4 (2019): 288-298.
  33. Apkarian AV., et al. “Predicting transition to chronic pain”. Current Opinion in Neurology 4 (2013): 360-367.
  34. Vachon-Presseau E., et al. “Corticolimbic anatomical characteristics predetermine risk for chronic pain”. Brain 139 (2016): 1958-1970.
  35. Harris HN and Peng YB. “Evidence and explanation for the involvement of the nucleus accumbens in pain processing”. Neural Regeneration Research 4 (2020): 597-605.
  36. Mallory GW., et al. “The nucleus accumbens as a potential target for central poststroke pain”. Mayo Clinic Proceedings 10 (2012): 1025-1031.
  37. Ahimsadasan N., et al. “Neuroanatomy, Dorsal Root Ganglion”.Stat Pearls; Treasure Island, FL, USA (2021).
  38. Ohara PT., et al. “Gliopathic Pain: When Satellite Glial Cells Go Bad”. Neuroscientist 15 (2009): 450-463.
  39. Chancellor-Freeland C., et al. “Substance P and Stress-Induced Changes in Macrophages”. Annals of the New York Academy of Sciences 771 (1995): 472-484.
  40. Krames ES. “The Role of the Dorsal Root Ganglion in the Development of Neuropathic Pain”. Pain management 15 (2014): 1669-1685.
  41. Shanti BF., et al. “The Ambivalent Role of Glial Cells in Neuroinflammation and Neuropathic Pain". Acta Scientific Neurology6 (2020): 51-58.
  42. Moalem G and Tracey DJ. “Immune and inflammatory mechanisms in neuropathic pain”. Brain Research Reviews 51 (2006): 240-264.
  43. Ji RR., et al. “Glia and pain; is chronic pain a gliopathy?” The Journal of Pain1 (2013): S10-S28.
  44. DeLeo JA., et al. “Immune and glial regulation of pain”. Seattle: IASP Press (2007).
  45. Hanani M. “Satellite glial cells in sensory ganglia: from form to function”. Brain Research Reviews3 (2005): 457-476.
  46. Pertin M., et al. “Delayed sympathetic dependence in the spared nerve injury (SNI) model of neuropathic pain”. Molecular Pain 3 (2007): 21.
  47. Zhou XF., et al. “Satellite-cell-derived nerve growth factor and neurotrophin-3 are involved in noradrenergic sprouting in the dorsal root ganglia following peripheral nerve injury in the rat”. European Journal of Neuroscience5 (1999): 1711-1722.
  48. Liddelow SA., et al. “Neurotoxic reactive astrocytes are induced by activated microglia”. Nature 541 (2017): 481-487.
  49. Hara M., et al. “Interaction of reactive astrocytes with type I collagen induces astrocytic scar formation through the integrin-N-cadherin pathway after spinal cord injury”. Nature Medicine 23 (2017): 818-828.
  50. Li T., et al. “An update on reactive astrocytes in chronic pain”. Journal of Neuroinflammation 16 (2019): 140.
  51. Wei Y., et al. “Emerging Role of Schwann Cells in Neuropathic Pain: Receptors, Glial Mediators and Myelination”. Frontiers in Cellular Neuroscience 13 (2019): 116.
  52. Gosselin RD., et al. “Glial cells and chronic pain”. Neuroscientist5 (2010): 519-531.
  53. Zheng Q., et al. “Peripheral mechanisms of chronic pain”. Medical Review3 (2022): 251-270.
  54. Galli SJ., et al. “Cytokine production by mast cells and basophils”. Current Opinion in Immunology 3 (1991): 865-872.
  55. Kanashiro A., et al. “The role of neutrophils in neuro-immune modulation”. Pharmacological Research 151 (2020):
  56. Farquhar-Smith., et al. “A novel neuroimmune mechanism in cannabinoid-mediated attenuation of nerve growth factor-induced hyperalgesia”. Anesthesiology 99 (2003): 1391-1401.
  57. Chen O., et al. “Regulation of pain by neuro-immune interactions between macrophages and nociceptor sensory neurons”. Current Opinion in Neurobiology 62 (2020): 17-25.
  58. Laumet G., et al. “T Cells as an Emerging Target for Chronic Pain Therapy”. Frontiers in Molecular Neuroscience 12 (2019):
  59. Brennan PC., et al. “Lymphocyte profiles in patients with chronic low back pain enrolled in a clinical trial”. Journal of Manipulative and Physiological Therapeutics 17 (1994): 219-227.
  60. Melemedjian OK., et al. “BDNF regulates atypical PKC at spinal synapses to initiate and maintain a centralized chronic pain state”. Molecular Pain 9 (2013):

Citation

Citation: Bilal F Shanti., et al. “How Acute Whiplash Injuries Become Chronic: The Neuro-Biological Triad of Neuronal-Glial-Immune Cells as Culprit”. Acta Scientific Neurology 6.12 (2023): 18-27.

Copyright

Copyright: © 2023 Bilal F Shanti., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US