Department of Physical Therapy, Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida.
Comprehensive Center for Pain Research, University of Florida, Gainesville, Florida.
J Pain. 2014 Jan;15(1):68-80. doi: 10.1016/j.jpain.2013.09.012. Epub 2013 Oct 5.
Chronic pain is influenced by biological, psychological, social, and cultural factors. The current study investigated potential roles for combinations of genetic and psychological factors in the development and/or maintenance of chronic musculoskeletal pain. An exercise-induced shoulder injury model was used, and a priori selected genetic (ADRB2, COMT, OPRM1, AVPR1 A, GCH1, and KCNS1) and psychological (anxiety, depressive symptoms, pain catastrophizing, fear of pain, and kinesiophobia) factors were included as predictors. Pain phenotypes were shoulder pain intensity (5-day average and peak reported on numerical rating scale), upper extremity disability (5-day average and peak reported on the QuickDASH), and shoulder pain duration (in days). After controlling for age, sex, and race, the genetic and psychological predictors were entered as main effects and interaction terms in separate regression models for the different pain phenotypes. Results from the recruited cohort (N = 190) indicated strong statistical evidence for interactions between the COMT diplotype and 1) pain catastrophizing for 5-day average upper extremity disability and 2) depressive symptoms for pain duration. There was moderate statistical evidence for interactions for other shoulder pain phenotypes between additional genes (ADRB2, AVPR1 A, and KCNS1) and depressive symptoms, pain catastrophizing, or kinesiophobia. These findings confirm the importance of the combined predictive ability of COMT with psychological distress and reveal other novel combinations of genetic and psychological factors that may merit additional investigation in other pain cohorts.
Interactions between genetic and psychological factors were investigated as predictors of different exercise-induced shoulder pain phenotypes. The strongest statistical evidence was for interactions between the COMT diplotype and pain catastrophizing (for upper extremity disability) or depressive symptoms (for pain duration). Other novel genetic and psychological combinations were identified that may merit further investigation.
慢性疼痛受生物、心理、社会和文化因素的影响。本研究调查了遗传和心理因素组合在慢性肌肉骨骼疼痛的发展和/或维持中的潜在作用。使用了一种运动引起的肩部损伤模型，并预先选择了遗传（ADRB2、COMT、OPRM1、AVPR1A、GCH1 和 KCNS1）和心理（焦虑、抑郁症状、疼痛灾难化、对疼痛的恐惧和运动恐惧）因素作为预测因子。疼痛表型为肩部疼痛强度（数值评定量表报告的 5 天平均值和峰值）、上肢残疾（QuickDASH 报告的 5 天平均值和峰值）和肩部疼痛持续时间（以天为单位）。在控制年龄、性别和种族后，将遗传和心理预测因子作为主要效应和交互项分别纳入不同疼痛表型的回归模型中。来自招募队列（N=190）的结果表明，COMT 二型与 1）疼痛灾难化与 5 天平均上肢残疾和 2）抑郁症状与疼痛持续时间之间存在强烈的统计学证据的相互作用。其他肩部疼痛表型之间存在其他基因（ADRB2、AVPR1A 和 KCNS1）与抑郁症状、疼痛灾难化或运动恐惧之间存在中度统计学证据的相互作用。这些发现证实了 COMT 与心理困扰的综合预测能力的重要性，并揭示了其他遗传和心理因素的新组合，这些组合可能值得在其他疼痛队列中进一步研究。
研究了遗传和心理因素之间的相互作用作为不同运动引起的肩部疼痛表型的预测因子。最强的统计学证据是 COMT 二型与疼痛灾难化（上肢残疾）或抑郁症状（疼痛持续时间）之间的相互作用。还确定了其他可能值得进一步研究的新的遗传和心理组合。
