Cognitive functioning after whiplash injury: A meta-analysis

Complaints on cognitive functioning are often reported in patients sufferin g from whiplash syndrome, although objective neuropsychological test result s do not always support these. In addition, radiological abnormalities and anatomical lesions are found only in a minority of these patients. This has led to a controversy about its existence in the literature. In this system atic review, the results of 22 neuropsychological studies on whiplash were quantitatively analyzed, focusing on working memory, attention, immediate a nd delayed recall, visuomotor tracking, and cognitive flexibility. Our find ings suggest that a consistent overall, pattern of cognitive dysfunction ca n be demonstrated after whiplash injury through neuropsychological testing, both compared to healthy and to asymptomatic controls. Six months after th e accident, improvement is found in working memory, attention, immediate re call, and visuomotor tracking. The results are discussed in the light of re cent findings on the effect of cerebral dysfunction, malingering, pain-rela ted factors, and the role of coping strategies and posttraumatic stress on neuropsychological test performance.