Spinal cord metabolism and muscle water diffusion in whiplash

Study design: Case series. Objectives: To quantify spinal cord metabolites and neck muscle fast and slow water diffusion in a small sample of patients with chronic whiplash and healthy controls. Setting: Brisbane, Queensland, Australia. Methods: In five subjects with chronic whiplash and seven controls, we performed magnetic resonance spectroscopy (MRS) of the cervical spinal cord and diffusion-weighted imaging (DWI) of the cervical multifidus muscle. Results: Significant reductions in N-acetylaspartate/creatine ratios were found in subjects with chronic whiplash when compared with healthy controls (P=0.02). Significantly higher fast apparent diffusion coefficients (ADCs) were found in chronic whiplash when compared with the healthy controls (P=0.01). There was no difference in slow ADCs between the two groups (P=0.3). Conclusion: The potential value of MRS and DWI to quantify the presence of neuromuscular degeneration as a potential mechanism underlying chronic whiplash is recognized. Larger-scaled prospective studies are warranted and required.