Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorc-n, Madrid, Spain; Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorc-n, Spain;Department of Neurology, Hospital Uni.
Pain Physician. 2013 Sep-Oct;16(5):E591-600.
The genetic influence of Val158Met polymorphisms, one of the potential genetic determinants for nociceptive processing, has not been previously investigated in women with carpal tunnel syndrome (CTS).
To investigate the association between the Val158Met polymorphism with CTS and to assess the relationship between the Val158Met polymorphism and the clinical outcomes and widespread pressure pain hypersensitivity in women with CTS.
Case control study.
Neurology department at an urban hospital.
One hundred nine (n = 109) women (mean age: 47 ± 9 years) with a clinical and electrodiagnostic diagnosis of CTS and 109 matched healthy women participated. After amplifying the Val158Met polymorphism by polymerase chain reactions, rs4680 genotype frequencies and allele distributions were calculated. We classified individuals according to their Val158Met polymorphism: Val/Val, Val/Met, Met/Met. The intensity of the pain was assessed with a numeric rating scale (0-10) and disability was determined with the Boston Carpal Tunnel Questionnaire. Pressure pain thresholds were bilaterally assessed over median, radial, and ulnar nerve trunks; C5-C6 facet joints; and carpal tunnel and tibialis anterior muscles.Institutional Review Board: The study project was approved by the local human research committee (HUFA-12/14). All participants signed an informed consent prior to their inclusion in the study.
The distribution of the 3 Val158Met genotypes (Val/Val, Val/Met, Met/Met) and alleles was not significantly different between women with CTS and healthy women (Chi-Square = 0.498; P = 0.780). Women with CTS carrying the Met/Met genotype showed higher levels of pain and disability than those with the Val/Met genotype (P < 0.01) and with the Val/Val genotype (P < 0.001). No differences in the years with pain (P = 0.954), age (P = 0.740), depression (P = 0.530), severity of CTS (P = 0.744) or presence of unilateral-bilateral symptoms (P = 0.279) existed depending on the rs4680 Val158Met genotype. No significant differences in widespread pressure pain sensitivity were observed in any of the points depending on the rs4680 Val158Met genotype (P > 0.315).
We only recruited women from a specialized department.
Current results indicated that the Val158Met polymorphism seems not to be a risk factor for the development of CTS; however, it was associated with increased perception of pain and higher disability scores.
Val158Met 多态性是痛觉处理的潜在遗传决定因素之一，但其在腕管综合征（CTS）女性中的遗传影响尚未得到研究。
研究 Val158Met 多态性与 CTS 的关系，并评估 Val158Met 多态性与 CTS 女性的临床结局和广泛压痛敏化的关系。
病例对照研究。
城市医院神经内科。
109 名（n=109）女性（平均年龄：47±9 岁）患有临床和电诊断为 CTS 的患者和 109 名匹配的健康女性参与了研究。通过聚合酶链反应扩增 Val158Met 多态性后，计算 rs4680 基因型频率和等位基因分布。我们根据 Val158Met 多态性对个体进行分类：Val/Val、Val/Met、Met/Met。使用数字评分量表（0-10）评估疼痛强度，使用波士顿腕管问卷评估残疾程度。双侧评估正中神经、桡神经和尺神经干；C5-C6 小关节；腕管和胫骨前肌的压痛阈值。机构审查委员会：本研究项目得到了当地人类研究委员会（HUFA-12/14）的批准。所有参与者在参与研究之前都签署了知情同意书。
CTS 女性与健康女性的 3 种 Val158Met 基因型（Val/Val、Val/Met、Met/Met）和等位基因分布无显著差异（卡方=0.498；P=0.780）。携带 Met/Met 基因型的 CTS 女性的疼痛和残疾程度高于携带 Val/Met 基因型的女性（P<0.01）和携带 Val/Val 基因型的女性（P<0.001）。rs4680 Val158Met 基因型与疼痛持续时间（P=0.954）、年龄（P=0.740）、抑郁（P=0.530）、CTS 严重程度（P=0.744）或单侧双侧症状的存在（P=0.279）无关。根据 rs4680 Val158Met 基因型，在任何一点都没有观察到广泛压痛敏化的显著差异（P>0.315）。
我们只招募了来自专门部门的女性。
目前的结果表明，Val158Met 多态性似乎不是 CTS 发展的危险因素；然而，它与疼痛感知增加和更高的残疾评分有关。
