Is Chronic Whiplash-Associated Disorder Associated with Central Nervous System Impairments? A Controlled...

Background/Objectives: The aim of this study was to investigate the natural course of a whiplash-associated disorder (WAD) in a Lithuanian population with low awareness of the condition. Methods: In this controlled observational study, 45 participants, enrolled during the acute period after motor vehicle accident, and 50 matched controls were followed up at 8 months. Clinical evaluation of WAD grades was combined with self-scored questionnaires for pain, WAD symptoms, disability, emotional state, and cognitive impairment. The Quebec Task Force Questionnaire was used to assess persistence or development of new symptoms at follow-up. Demographic and sick leave data were collected. Results: The WAD group showed a significant improvement in clinical signs and self-rated scores for pain and disability after 8 months and became largely comparable to the control group. However, only 13 out of 45 WAD participants were symptom-free at follow-up. Persistent neck pain and dizziness/unsteadiness as well as newly developed cognitive complaints were more frequent in the WAD group compared to controls, each reported by around a third of individuals. Logistic regression showed that new cognitive symptoms could be predicted by nausea/vomiting in the acute period and persisting neck pain at follow-up. None of the participants remained on sick leave at follow-up. Conclusions: In a country with low awareness of WAD, a larger proportion of individuals remain symptomatic months after acute whiplash injury but maintain their ability to work. The emergence of new cognitive complaints may suggest concomitant central nervous system involvement.