Department of Clinical Neuropsychology, VU University, 1081 BT Amsterdam, The Netherlands
Department of Clinical Child and Family Studies, VU University, 1081 BT Amsterdam, The Netherlands.
Arch Clin Neuropsychol. 2016 Aug;31(5):389-400. doi: 10.1093/arclin/acw022. Epub 2016 May 8.
The presence of apolipoprotein E (ApoE) ɛ4 allele might be related to higher pain experience due to increased risk for potentially painful physical conditions and cognitive impairment (less efficient coping with pain). This hypothesis is clinically relevant to examine in adults with Down syndrome (DS) because they are at risk for painful physical conditions, their presence of ApoE ε4 is related to cognitive impairment, and their pain experience is unclear. The present pilot study addressed the associations between ApoE genotype, cognition, and pain in DS.
DNA analysis of saliva, neuropsychological tests (assessing memory and executive functioning), and self-reporting pain scales (in rest and after movement) were used with a cross-sectional design in 146 adults with DS (mean age 39.1 years, mild to moderate intellectual disabilities, 46% men, 30% ApoE ɛ4 carrier).
The difference between ApoE ɛ4 carriers and noncarriers was not statistically significant for cognitive function, pain experience, and prevalence of potentially painful conditions. Among ɛ4 carriers, the presence of potentially painful conditions was associated with worse executive functioning (p = .022, r = .39).
The clinical implication of the results is that ApoE ɛ4 in DS may play a role in pain, although the theoretical explanation via associations with pain experience and cognition remains unclear. Further research should include a large sample of adults with DS selected on diagnosed painful conditions to obtain more insight into the possible role of ApoE genotype (and its association with cognition) in the pain experience of this target group.
载脂蛋白 E（ApoE）ɛ4 等位基因的存在可能与更高的疼痛体验有关，因为其增加了发生潜在疼痛性躯体疾病和认知障碍（疼痛应对能力下降）的风险。该假说与唐氏综合征（Down syndrome，DS）成人的相关性具有临床意义，因为他们有发生疼痛性躯体疾病的风险，其 ApoE ε4 的存在与认知障碍有关，且他们的疼痛体验尚不清楚。本初步研究旨在探讨 DS 中 ApoE 基因型、认知与疼痛之间的关联。
使用横断面设计，对 146 名 DS 成人（平均年龄 39.1 岁，轻度至中度智力障碍，46%为男性，30%为 ApoE ɛ4 携带者）进行唾液 DNA 分析、神经心理学测试（评估记忆和执行功能）和自我报告疼痛量表（休息时和运动后）。
在认知功能、疼痛体验和潜在疼痛性疾病的患病率方面，ApoE ɛ4 携带者与非携带者之间的差异无统计学意义。在 ɛ4 携带者中，潜在疼痛性疾病的存在与执行功能更差相关（p =.022，r =.39）。
尽管通过与疼痛体验和认知的关联来解释理论上的解释尚不清楚，但这些结果的临床意义是，DS 中的 ApoE ɛ4 可能在疼痛中起作用。进一步的研究应包括一个选择患有诊断性疼痛性疾病的大型 DS 成人样本，以更深入地了解 ApoE 基因型（及其与认知的关联）在该目标人群疼痛体验中的可能作用。
