Abstract
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.
Perspective
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.
Key words
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Article info
Publication history
Accepted:
September 24,
2013
Received in revised form:
September 13,
2013
Received:
July 18,
2013
Footnotes
This study was completed with funding from the National Institutes of Health, NIAMS (AR055899) and NINDS (NS045551).
The authors have no financial or other conflict of interest to report for the data reported in this manuscript.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
