1
|
Summit AG, Chen C, Pettersson E, Boersma K, D’Onofrio BM, Lichtenstein P, Quinn PD. Preliminary Validation of a General Factor Model of Chronic Overlapping Pain Conditions. THE JOURNAL OF PAIN 2024; 25:104502. [PMID: 38417595 PMCID: PMC11283990 DOI: 10.1016/j.jpain.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/25/2024] [Accepted: 02/19/2024] [Indexed: 03/01/2024]
Abstract
Chronic overlapping pain conditions (COPCs) by definition, frequently co-occur, perhaps reflecting their shared etiologies. Their overlapping nature presents a methodological challenge, possibly masking associations between COPCs and health outcomes attributable to either general or specific processes. To address this challenge, we used population-based cohort data to evaluate the predictive validity of a bifactor model of 9 self-reported COPCs by assessing its association with incident pain-related clinical diagnoses; pain-relevant pharmacotherapy; and other health outcomes. We obtained data from a 2005 to 2006 study of Swedish adult twins linked with health data from nationwide registers through 2016 (N = 25,418). We then fit a bifactor model comprising a general COPC factor and 2 independent specific factors measuring pain-related somatic symptoms and neck and shoulder pain. Accounting for age, biological sex, and cancer, the general factor was associated with increased risk of all pain-related outcomes (eg, COPC diagnosis adjusted odds ratio [aOR], 1.71; 95% confidence interval [1.62, 1.81]), most mental health-related outcomes (eg, depression aOR, 1.72 [1.60, 1.85]), and overdose and mortality (eg, all-cause mortality aOR, 1.25 [1.09, 1.43]). The somatic symptoms specific factor was associated with pain-relevant pharmacotherapy (eg, prescribed opioids aOR, 1.25 [1.15, 1.36]), most mental health-related outcomes (eg, depression aOR, 1.95 [1.70, 2.23]), and overdose (eg, nonfatal overdose aOR, 1.66 [1.31, 2.10]). The neck and shoulder pain-specific factor was weakly and inconsistently associated with the outcomes. Findings provide initial support for the validity and utility of a general-factor model of COPCs as a tool to strengthen understanding of co-occurrence, etiology, and consequences of chronic pain. PERSPECTIVE: This article presents associations between a novel measurement model of COPCs and various health outcomes. Findings provide support for measuring pain across multiple domains rather than only measuring pain specific to one physical location in both research and clinical contexts.
Collapse
Affiliation(s)
- Alynna G. Summit
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7 Street, Bloomington, IN, 47405, USA
| | - Cen Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Katja Boersma
- Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, SE-701 82 Örebro, Sweden
| | - Brian M. D’Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10 Street, Bloomington, IN, 47405 USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Patrick D. Quinn
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7 Street, Bloomington, IN, 47405, USA
| |
Collapse
|
2
|
Hui J, Chen Y, Li C, Gou Y, Liu Y, Zhou R, Kang M, Liu C, Wang B, Shi P, Cheng S, Yang X, Pan C, Jia Y, Cheng B, Liu H, Wen Y, Zhang F. Insight into the Causal Relationship between Gut Microbiota and Back Pain: A Two Sample Bidirectional Mendelian Randomization Study. ADVANCED GENETICS (HOBOKEN, N.J.) 2023; 4:2300192. [PMID: 38099244 PMCID: PMC10716053 DOI: 10.1002/ggn2.202300192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/19/2023] [Indexed: 12/17/2023]
Abstract
Observational studies have shown that alterations in gut microbiota composition are associated with low back pain. However, it remains unclear whether the association is causal. To reveal the causal association between gut microbiota and low back pain, a two-sample bidirectional Mendelian randomization (MR) analysis is performed. The inverse variance weighted regression (IVW) is performed as the principal MR analysis. MR-Egger and Weighted Median is further conducted as complementary analysis to validate the robustness of the results. Finally, a reverse MR analysis is performed to evaluate the possibility of reverse causation. The inverse variance weighted (IVW) method suggests that Peptostreptococcaceae (odds ratio [OR] 1.056, 95% confidence interval [CI] [1.015-1.098], P IVW = 0.010), and Lactobacillaceae (OR 1.070, 95% CI [1.026-1.115], P IVW = 0.003) are positively associated with back pain. The Ruminococcaceae (OR 0.923, 95% CI [0.849-0.997], P IVW = 0.033), Butyricicoccus (OR 0.920, 95% CI [0.868 - 0.972], P IVW = 0.002), and Lachnospiraceae (OR 0.948, 95% CI [0.903-0.994], P IVW = 0.022) are negatively associated with back pain. In this study, underlying causal relationships are identified among gut microbiota and low back pain. Notably, further research is needed on the biological mechanisms by which gut microbiota influences low back pain.
Collapse
Affiliation(s)
- Jingni Hui
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Yifan Gou
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Ye Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Ruixue Zhou
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Meijuan Kang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Chen Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Bingyi Wang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Panxing Shi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Huan Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning CommissionSchool of Public HealthHealth Science CenterXi'an Jiaotong UniversityXi'an71006P. R. China
| |
Collapse
|
3
|
Zorkoltseva IV, Elgaeva EE, Belonogova NM, Kirichenko AV, Svishcheva GR, Freidin MB, Williams FMK, Suri P, Tsepilov YA, Axenovich TI. Multi-Trait Exome-Wide Association Study of Back Pain-Related Phenotypes. Genes (Basel) 2023; 14:1962. [PMID: 37895311 PMCID: PMC10606006 DOI: 10.3390/genes14101962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Back pain (BP) is a major contributor to disability worldwide, with heritability estimated at 40-60%. However, less than half of the heritability is explained by common genetic variants identified by genome-wide association studies. More powerful methods and rare and ultra-rare variant analysis may offer additional insight. This study utilized exome sequencing data from the UK Biobank to perform a multi-trait gene-based association analysis of three BP-related phenotypes: chronic back pain, dorsalgia, and intervertebral disc disorder. We identified the SLC13A1 gene as a contributor to chronic back pain via loss-of-function (LoF) and missense variants. This gene has been previously detected in two studies. A multi-trait approach uncovered the novel FSCN3 gene and its impact on back pain through LoF variants. This gene deserves attention because it is only the second gene shown to have an effect on back pain due to LoF variants and represents a promising drug target for back pain therapy.
Collapse
Affiliation(s)
- Irina V. Zorkoltseva
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
| | - Elizaveta E. Elgaeva
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Nadezhda M. Belonogova
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
| | - Anatoliy V. Kirichenko
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
| | - Gulnara R. Svishcheva
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119333 Moscow, Russia
| | - Maxim B. Freidin
- Department of Biology, School of Biological and Behavioural Sciences, Queen Mary University of London, London EC1M 6BQ, UK;
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, UK;
| | - Pradeep Suri
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA 98108, USA
- Division of Rehabilitation Care Services, Seattle, WA 98208, USA
- Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, WA 98195, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
| | - Yakov A. Tsepilov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
| | - Tatiana I. Axenovich
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (I.V.Z.); (E.E.E.); (N.M.B.); (A.V.K.); (G.R.S.); (Y.A.T.)
| |
Collapse
|
4
|
Li S, Brimmers A, van Boekel RL, Vissers KC, Coenen MJ. A systematic review of genome-wide association studies for pain, nociception, neuropathy, and pain treatment responses. Pain 2023; 164:1891-1911. [PMID: 37144689 PMCID: PMC10436363 DOI: 10.1097/j.pain.0000000000002910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 05/06/2023]
Abstract
ABSTRACT Pain is the leading cause of disability worldwide, imposing an enormous burden on personal health and society. Pain is a multifactorial and multidimensional problem. Currently, there is (some) evidence that genetic factors could partially explain individual susceptibility to pain and interpersonal differences in pain treatment response. To better understand the underlying genetic mechanisms of pain, we systematically reviewed and summarized genome-wide association studies (GWASes) investigating the associations between genetic variants and pain/pain-related phenotypes in humans. We reviewed 57 full-text articles and identified 30 loci reported in more than 1 study. To check whether genes described in this review are associated with (other) pain phenotypes, we searched 2 pain genetic databases, Human Pain Genetics Database and Mouse Pain Genetics Database. Six GWAS-identified genes/loci were also reported in those databases, mainly involved in neurological functions and inflammation. These findings demonstrate an important contribution of genetic factors to the risk of pain and pain-related phenotypes. However, replication studies with consistent phenotype definitions and sufficient statistical power are required to validate these pain-associated genes further. Our review also highlights the need for bioinformatic tools to elucidate the function of identified genes/loci. We believe that a better understanding of the genetic background of pain will shed light on the underlying biological mechanisms of pain and benefit patients by improving the clinical management of pain.
Collapse
Affiliation(s)
- Song Li
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Coenen is now with the Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Annika Brimmers
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Coenen is now with the Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Regina L.M. van Boekel
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kris C.P. Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marieke J.H. Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Coenen is now with the Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
5
|
Chen C, Pettersson E, Summit AG, Boersma K, Chang Z, Kuja-Halkola R, Lichtenstein P, Quinn PD. Chronic pain conditions and risk of suicidal behavior: a 10-year longitudinal co-twin control study. BMC Med 2023; 21:9. [PMID: 36600296 PMCID: PMC9814420 DOI: 10.1186/s12916-022-02703-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Understanding the relationship between chronic pain conditions and suicidal behavior-suicide attempt, other intentional self-harm, and death by suicide-is imperative for suicide prevention efforts. Although chronic pain conditions are associated with suicidal behaviors, these associations might be attributed to unmeasured confounding or mediated via pain comorbidity. METHODS We linked a population-based Swedish twin study (N=17,148 twins) with 10 years of longitudinal, nationwide records of suicidal behavior from health and mortality registers through 2016. To investigate whether pain comorbidity versus specific pain conditions were more important for later suicidal behavior, we modeled a general factor of pain and two independent specific pain factors (measuring pain-related somatic symptoms and neck-shoulder pain, respectively) based on 9 self-reported chronic pain conditions. To examine whether the pain-suicidal behavior associations were attributable to familial confounding, we applied a co-twin control model. RESULTS Individuals scoring one standard deviation above the mean on the general pain factor had a 51% higher risk of experiencing suicidal behavior (odds ratio (OR), 1.51; 95% confidence interval (CI), 1.34-1.72). The specific factor of somatic pain was also associated with increased risk for suicidal behavior (OR, 1.80; 95% CI, 1.45-2.22]). However, after adjustment for familial confounding, the associations were greatly attenuated and not statistically significant within monozygotic twin pairs (general pain factor OR, 0.89; 95% CI, 0.59-1.33; somatic pain factor OR, 1.02; 95% CI, 0.49-2.11) CONCLUSION: Clinicians might benefit from measuring not only specific types of pain, but also pain comorbidity; however, treating pain might not necessarily reduce future suicidal behavior, as the associations appeared attributable to familial confounding.
Collapse
Affiliation(s)
- C Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden.
| | - E Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - A G Summit
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - K Boersma
- Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Z Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - R Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden
| | - P D Quinn
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| |
Collapse
|
6
|
Brain-specific genes contribute to chronic but not to acute back pain. Pain Rep 2022; 7:e1018. [PMID: 35975136 PMCID: PMC9371560 DOI: 10.1097/pr9.0000000000001018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/20/2022] [Accepted: 05/20/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Back pain is the leading cause of disability worldwide. Although most back pain cases are acute, 20% of acute pain patients experience chronic back pain symptoms. It is unclear whether acute pain and chronic pain have similar or distinct underlying genetic mechanisms. Objectives To characterize the molecular and cellular pathways contributing to acute and chronic pain states. Methods Cross-sectional observational genome-wide association study. Results A total of 375,158 individuals from the UK Biobank cohort were included in the discovery of genome-wide association study. Of those, 70,633 (19%) and 32,209 (9%) individuals met the definition of chronic and acute back pain, respectively. A total of 355 single nucleotide polymorphism grouped into 13 loci reached the genome-wide significance threshold (5x10-8) for chronic back pain, but none for acute. Of these, 7 loci were replicated in the Nord-Trøndelag Health Study (HUNT) cohort (19,760 chronic low back pain cases and 28,674 pain-free controls). Single nucleotide polymorphism heritability was 4.6% (P=1.4x10-78) for chronic back pain and 0.81% (P=1.4x10-8) for acute back pain. Similar differences in heritability estimates between acute and chronic back pain were found in the HUNT cohort: 3.4% (P=0.0011) and 0.6% (P=0.851), respectively. Pathway analyses, tissue-specific heritability enrichment analyses, and epigenetic characterization suggest a substantial genetic contribution to chronic but not acute back pain from the loci predominantly expressed in the central nervous system. Conclusion Chronic back pain is substantially more heritable than acute back pain. This heritability is mostly attributed to genes expressed in the brain.
Collapse
|
7
|
Madrid-Valero JJ, Andreucci A, Carrillo E, Ferreira PH, Martínez-Selva JM, Ordoñana JR. Nature and nurture. Genetic and environmental factors on the relationship between back pain and sleep quality. Eur J Pain 2022; 26:1460-1468. [PMID: 35536235 PMCID: PMC9541574 DOI: 10.1002/ejp.1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Chronic low back pain (LBP), neck pain (NP), and sleep quality (SQ) are genetically influenced. All three conditions frequently co-occur and shared genetic etiology on a pairwise base has been reported. However, to our knowledge no study has yet investigated if these three conditions are influenced by the same genetic and environmental factors and the extent and pattern of genetic overlap between them, hence the current research. METHODS The sample included 2134 participants. Lifetime prevalence of NP and LBP were assessed through a dichotomous self-reported question derived from the Spanish National Health Survey. SQ was measured using the Pittsburgh Sleep Quality Index Questionnaire. A common pathway model with sleep quality and back pain as latent factors was fitted. RESULTS Our results highlight that a latent back pain factor, including both NP and LBP, is explained by both genetic (41%) and environmental (59%) factors. There are also significant unique environmental factors for NP (33%) and LBP (37%) respectively. Yet, specific genetic factors were scant (9%) for NP and negligible for LBP (0%). Genetic and environmental factors affecting SQ only contribute with 3% and 5% of the variance, respectively, to the common latent back pain variable. CONCLUSIONS NP and LBP share most of their genetic variance, while environmental effects show greater specificity for each of the back pain locations. Associations with SQ were of a limited magnitude.
Collapse
Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain
| | - Alessandro Andreucci
- Center for General Practice at Aalborg University, Department of Clinical Medicine, Aalborg University, Fyrkildevej 7, 9220, Aalborg, Denmark.,Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Eduvigis Carrillo
- Department of Human Anatomy and Psychobiology, University of Murcia, Campus de Espinardo 30100, Murcia, Spain.,Murcia Institute of Biomedical Research, IMIB-Arrixaca, 30120, Murcia, Spain
| | | | - Jose M Martínez-Selva
- Department of Human Anatomy and Psychobiology, University of Murcia, Campus de Espinardo 30100, Murcia, Spain.,Murcia Institute of Biomedical Research, IMIB-Arrixaca, 30120, Murcia, Spain
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Campus de Espinardo 30100, Murcia, Spain.,Murcia Institute of Biomedical Research, IMIB-Arrixaca, 30120, Murcia, Spain
| |
Collapse
|
8
|
Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord 2022; 23:26. [PMID: 34980079 PMCID: PMC8725362 DOI: 10.1186/s12891-021-04957-4] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/12/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Neck pain is one of the most common musculoskeletal disorders, having an age-standardised prevalence rate of 27.0 per 1000 population in 2019. This literature review describes the global epidemiology and trends associated with neck pain, before exploring the psychological and biological risk factors associated with the initiation and progression of neck pain. METHODS The PubMed database and Google Scholar search engine were searched up to May 21, 2021. Studies were included that used human subjects and evaluated the effects of biological or psychological factors on the occurrence or progression of neck pain, or reported its epidemiology. RESULTS Psychological risk factors, such as long-term stress, lack of social support, anxiety, and depression are important risk factors for neck pain. In terms of the biological risks, neck pain might occur as a consequence of certain diseases, such as neuromusculoskeletal disorders or autoimmune diseases. There is also evidence that demographic characteristics, such as age and sex, can influence the prevalence and development of neck pain, although further research is needed. CONCLUSIONS The findings of the present study provide a comprehensive and informative overview that should be useful for the prevention, diagnosis, and management of neck pain.
Collapse
Affiliation(s)
- Somaye Kazeminasab
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Deputy, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parastoo Amiri
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Deputy, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hojjat Pourfathi
- Department of Anesthesiology and Pain Management, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Araj-Khodaei
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Persian Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark J M Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Saeid Safiri
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
9
|
Kumagai G, Wada K, Kudo H, Tanaka S, Asari T, Chiba D, Ota S, Takeda O, Koyama K, Oyama T, Nakaji S, Ishibashi Y. The effect of low back pain and neck-shoulder stiffness on health-related quality of life: a cross-sectional population-based study. BMC Musculoskelet Disord 2021; 22:14. [PMID: 33402157 PMCID: PMC7786956 DOI: 10.1186/s12891-020-03871-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This cross-sectional study sought to determine the neck-shoulder stiffness/low back pain (NSS/LBP) comorbidity rate in a Japanese community population and to compare the quality of life (QOL) in individuals with comorbid NSS/LBP, asymptomatic individuals, and those with symptoms of NSS or LBP alone. METHODS The sample included 1122 subjects (426 men; 696 women) with NSS and LBP symptoms in the previous 3 months, and were grouped according to NSS, LBP, comorbid NSS and LBP symptoms (Comorbid), or no symptoms (NP). They completed the MOS 36-Item Short-Form Health Survey (SF-36). Health QOL was evaluated by the eight domain scores and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores after adjusting for age. The primary outcome was to examine the association between NSS/LBP, NSS, or LBP and bodily pain of the eight domains of SF-36. Secondary outcome was to compare health-related QOL among the four groups. RESULTS Morbidity was 45.6% for NSS and 51.9% for LBP. Comorbidity affected 23% of men and 33% of women. Comorbid NSS/LBP, NSS, and LBP alone were independently associated with bodily pain after adjusting for potential confounders. Men who exhibited comorbidity had significantly lower MCS scores than asymptomatic men. Women who exhibited comorbidity and LBP had significantly lower MCS scores than those with no symptoms or NSS alone. Women who exhibited comorbidity had significantly lower MCS scores than those with no symptoms or LBP alone. CONCLUSIONS Comorbidity of the two diseases is prevalent in 23% of the men and 33% of women in the Japanese sample. Although NSS, LBP, and comorbidity were independently associated with QOL in terms of pain, QOL was worse in individuals who exhibited comorbidity than in those without symptoms or with NSS alone.
Collapse
Affiliation(s)
- Gentaro Kumagai
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
| | - Kanichiro Wada
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Hitoshi Kudo
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Sunao Tanaka
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Toru Asari
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Daisuke Chiba
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Seiya Ota
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - On Takeda
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Kazushige Koyama
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Tetsushi Oyama
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| |
Collapse
|
10
|
Williams FM, Tsepilov YA, Freidin MB, Shashkova TI, Suri P, Aulchenko YS. Sequence variation at 8q24.21 and risk of back pain. F1000Res 2020. [DOI: 10.12688/f1000research.22725.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Back pain (BP) is a common condition of major social importance and poorly understood pathogenesis. Intervertebral lumbar disc degeneration in all its guises is one of the major biological risk factors for BP. Previously, we identified the locus at 8q24.21 associated with chronic BP, which has been found elsewhere associated with sciatica after surgery for lumbar disc herniation. In the current study we used co-localisation methods to identify the gene most likely to harbor the causal variant. We show that the same functional variant at the 8q24.21 locus is responsible for both lumbar disc degeneration and BP, and we also studied the effects of this locus on related phenotypes. Our results link the locus to intervertebral disc and bone mineral density, but not to anthropometric measurements, thus corroborating the epidemiological evidence. Moreover, the same functional variant at the locus is more likely to affect the expression of the nearby FAM49B gene, rather than the GSDMC gene, which was previously proposed as a causative one for BP.
Collapse
|
11
|
Andreucci A, Madrid-Valero JJ, Ferreira PH, Ordoñana JR. Sleep quality and chronic neck pain: a cotwin study. J Clin Sleep Med 2020; 16:679-687. [PMID: 32026805 DOI: 10.5664/jcsm.8316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep quality and chronic neck pain (NP) are associated. However, the genetic influences on this association have not been explored. This study investigated the genetic and environmental influences on the association between sleep quality and chronic NP. METHODS The sample comprised 2,328 individual twins from the Murcia Twin Registry (Spain). A bidirectional cotwin logistic regression analysis was performed (sleep quality assessed as the exposure and chronic NP as the outcome and vice versa). Analysis included 2 sequential stages: total sample analysis and within-pair twin case-control analysis. RESULTS Sleep quality was significantly associated with chronic NP in the total sample analysis (adjusted odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.06, 1.12; P < .001); in the cotwin case-control analysis, including both monozygotic and dizygotic twin pairs (adjusted OR: 1.10; 95% CI: 1.04, 1.17; P = .001); in dizygotic pairs (Adjusted OR: 1.11; 95% CI: 1.03, 1.19; P = .005); but not in monozygotic pairs (adjusted OR: 1.08; 95% CI: 0.98, 1.19; P = .118). Chronic NP was significantly associated with poor sleep quality in the total sample analysis (adjusted OR: 1.80; 95% CI: 1.43, 2.26; P < .001); in the cotwin case-control analysis, including both monozygotic and dizygotic twin pairs (Adjusted OR: 1.63; 95% CI: 1.07, 2.47; P = .023); in dizygotic pairs (Adjusted OR: 1.80; 95% CI: 1.05, 3.09; P = .031), but not in monozygotic pairs (adjusted OR: 1.67; 95% CI: 0.80, 3.48; P = .170). CONCLUSIONS The association between sleep quality and chronic NP is partially confounded by genetic factors.
Collapse
Affiliation(s)
- Alessandro Andreucci
- Center for General Practice at Aalborg University, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - Juan J Madrid-Valero
- Department of Human Anatomy and Psychobiology, University of Murcia, Campus de Espinardo, Murcia, Spain
| | - Paulo H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Campus de Espinardo, Murcia, Spain.,Murcia Institute of Biomedical Research, IMIB-Arrixaca, Murcia, Spain
| |
Collapse
|
12
|
Insight into the genetic architecture of back pain and its risk factors from a study of 509,000 individuals. Pain 2020; 160:1361-1373. [PMID: 30747904 DOI: 10.1097/j.pain.0000000000001514] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Back pain (BP) is a common condition of major social importance and poorly understood pathogenesis. Combining data from the UK Biobank and CHARGE consortium cohorts allowed us to perform a very large genome-wide association study (total N = 509,070) and examine the genetic correlation and pleiotropy between BP and its clinical and psychosocial risk factors. We identified and replicated 3 BP-associated loci, including one novel region implicating SPOCK2/CHST3 genes. We provide evidence for pleiotropic effects of genetic factors underlying BP, height, and intervertebral disk problems. We also identified independent genetic correlations between BP and depression symptoms, neuroticism, sleep disturbance, overweight, and smoking. A significant enrichment for genes involved in the central nervous system and skeletal tissue development was observed. The study of pleiotropy and genetic correlations, supported by the pathway analysis, suggests at least 2 strong molecular axes of BP genesis, one related to structural/anatomical factors such as intervertebral disk problems and anthropometrics, and another related to the psychological component of pain perception and pain processing. These findings corroborate with the current biopsychosocial model as a paradigm for BP. Overall, the results demonstrate BP to have an extremely complex genetic architecture that overlaps with the genetic predisposition to its biopsychosocial risk factors. The work sheds light on pathways of relevance in the prevention and management of low BP.
Collapse
|
13
|
Mather L, Ropponen A, Mittendorfer-Rutz E, Narusyte J, Svedberg P. Health, work and demographic factors associated with a lower risk of work disability and unemployment in employees with lower back, neck and shoulder pain. BMC Musculoskelet Disord 2019; 20:622. [PMID: 31878915 PMCID: PMC6933729 DOI: 10.1186/s12891-019-2999-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background Chronic musculoskeletal pain affects over 20% of the adult population and is one of the most common reasons for sick leave in Sweden. The aim of this study was to investigate which demographic, health and psychosocial work environment factors are of importance for a lower risk of future work disability and unemployment among workers with low back pain (LBP) and/or neck shoulder pain (NSP), and if familial factors influence these associations. Methods All 5556 persons that reported having LBP and/or NSP in a web-based questionnaire study in 2004–2006 were included. They were followed up for work disability (sick leave > 90 days or disability pension), and unemployment (> 180 days in a year) until 31 December 2013. Hazard ratios (HR) with 95% confidence intervals were calculated using cox proportional hazard models of the whole sample, adjusting for covariates. In addition, co-twin analyses of outcome discordant twin pairs were conducted to assess the impact of familial confounding on the associations. Results Being male, 19–28 years old, having higher education, only NSP, no history of depression or anxiety, good self-rated health, low job demands and high job control were associated with a lower risk of work disability (adjusted HR ranging between 0.29–0.85). No history of anxiety and depression and high job control was associated with a lower risk of unemployment (adjusted HR ranging from 0.53 and 0.67). Familial factors were found to affect the association between education and work disability, but none of the other associations investigated. Conclusions Among those with LBP or NSP, good health in terms of mental- and self-rated health, few pain sites, as well as good psychosocial working conditions seem to indicate a lower risk for work disability.
Collapse
Affiliation(s)
- Lisa Mather
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
14
|
Carvalho‐E‐Silva APMC, Harmer AR, Pinheiro MB, Madrid‐Valero JJ, Ferreira M, Ordoñana JR, H.Ferreira P. Does the heritability of chronic low back pain depend on how the condition is assessed? Eur J Pain 2019; 23:1712-1722. [DOI: 10.1002/ejp.1448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 06/24/2019] [Accepted: 06/24/2019] [Indexed: 11/06/2022]
Affiliation(s)
| | - Alison R. Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences The University of Sydney Sydney Australia
| | - Marina B. Pinheiro
- Musculoskeletal Health Research Group, Faculty of Health Sciences The University of Sydney Sydney Australia
| | - Juan J. Madrid‐Valero
- Department of Human Anatomy and Psychobiology, Murcia Institute of BioHealth Research (IMIB‐Arrixaca‐UMU) University of Murcia Murcia Spain
| | - Manuela Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School The University of Sydney Sydney Australia
| | - Juan R. Ordoñana
- Department of Human Anatomy and Psychobiology, Murcia Institute of BioHealth Research (IMIB‐Arrixaca‐UMU) University of Murcia Murcia Spain
| | - Paulo H.Ferreira
- Musculoskeletal Health Research Group, Faculty of Health Sciences The University of Sydney Sydney Australia
| |
Collapse
|
15
|
Jones PC, Salamon KS. Treating Pediatric Chronic Pain in Schools: A Primer for School Psychologists. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2019. [DOI: 10.1080/15377903.2019.1619646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Paul C. Jones
- Pediatric Dentistry and Community Oral Health Sciences, Temple University Kornberg School of Dentistry, Philadelphia, Pennsylvania, USA
| | | |
Collapse
|
16
|
Topalis C, Grauers A, Diarbakerli E, Danielsson A, Gerdhem P. Neck and back problems in adults with idiopathic scoliosis diagnosed in youth: an observational study of prevalence, change over a mean four year time period and comparison with a control group. SCOLIOSIS AND SPINAL DISORDERS 2017; 12:20. [PMID: 28616593 PMCID: PMC5465548 DOI: 10.1186/s13013-017-0125-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 05/16/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The knowledge is sparse concerning neck problems in patients with idiopathic scoliosis. This is an observational study including a control group which aims to describe the prevalence of neck problems and the association with back problems among adult individuals with and without idiopathic scoliosis. METHODS One thousand sixty-nine adults with a mean age of 40 years, diagnosed with idiopathic scoliosis in youth, answered a questionnaire on neck and back problems. Eight hundred seventy of these answered the same questionnaire at a second occasion in a mean of 4 years later. Comparisons were made with a cross-sectional population-based survey of 158 individuals. Statistical analyses were made with logistic regression or analysis of variance, adjusted for age, smoking status, and sex. RESULTS Individuals with scoliosis were previously untreated (n = 374), brace treated (n = 451), or surgically treated (n = 244). Of the individuals with scoliosis, 42% (n = 444) had neck problems compared to 20% (n = 32) of the controls (p = 0.001). The prevalence of neck problems was not affected by the type of treatment (p = 0.67) or onset of scoliosis; juvenile (n = 159) or adolescent (n = 910; p = 0.68). Neck and/or back problems were experienced by 72% of the individuals with scoliosis and 37% of the controls (p < 0.001). Of the individuals with scoliosis having neck problems, 81% also reported back problems, compared to 59% of the individuals in the control group (p < 0.001). The prevalence of neck and back problems was similar at the second survey. CONCLUSIONS Neck problems are more prevalent and more often coexist with back problems in individuals with idiopathic scoliosis than in controls. The majority of individuals have persisting problems over time.
Collapse
Affiliation(s)
- Christos Topalis
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, K54, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Anna Grauers
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Orthopaedics, Sundsvall and Härnösand County Hospital, Sundsvall, Sweden
| | - Elias Diarbakerli
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
| | - Aina Danielsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
17
|
Angst F, Angst J, Ajdacic-Gross V, Aeschlimann A, Rössler W. Epidemiology of Back Pain in Young and Middle-Aged Adults: A Longitudinal Population Cohort Survey From Age 27-50 Years. PSYCHOSOMATICS 2017; 58:604-613. [PMID: 28867433 DOI: 10.1016/j.psym.2017.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 05/30/2017] [Accepted: 05/30/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Back pain is extremely common and a huge burden for both individuals and health care services. OBJECTIVE The aim was to determine the prevalence and incidence of lumbar and cervical back pain over 23 years and to quantify associations with concomitant disorders. METHODS Data on lumbar and cervical back pain, and mental disorders from the Zurich study, collected between 1986 (age men: 27/women: 28 years) and 2008 (age 49/50) were analyzed. Epidemiological parameters were representative rates for the general population. Associations were quantified by odds ratios (ORs). RESULTS Of 499 subjects, 68.9% ever experienced lumbar pain and 60.7% ever experienced cervical back pain; the 23-year prevalences were 66.9% and 54.9% and the 23-year incidences 52.3% and 48.9% for lumbar and cervical back pain, respectively. Annual prevalences varied between 28.4% and 47.2% for lumbar and 18.3% and 54.7% for cervical back pain; the corresponding annual incidences varied by 5.8-13.3% (lumbar) and 7.8-12.6% (cervical). Lumbar back pain was significantly associated with cardiovascular disease (OR = 4.58), obesity (OR = 3.99), asthma spectrum (OR = 5.76), tranquillizer dependence (OR = 5.84), and other comorbidities (ORs = 1.47-3.27). Significant associations with cervical back pain were observed for specific phobia (OR = 5.10), panic attacks (OR = 4.79), and other comorbidities (ORs = 1.61-2.62). CONCLUSIONS This study contributes to the refinement of epidemiological data on lumbar and cervical back pain. Some associations with treatable disorders were high, which may offer hope for the indirect management of lumbar and cervical back pain.
Collapse
Affiliation(s)
- Felix Angst
- Research Department, Rehabilitation Clinic ("Reh aClinic"), Bad Zurzach, Switzerland.
| | - Jules Angst
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital Burghölzli, University of Zurich, Zurich, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital Burghölzli, University of Zurich, Zurich, Switzerland
| | - André Aeschlimann
- Research Department, Rehabilitation Clinic ("Reh aClinic"), Bad Zurzach, Switzerland
| | - Wulf Rössler
- Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil; Collegium Helveticum, Joint Research Institute of the University of Zurich & ETH Zurich, Zurich, Switzerland
| |
Collapse
|
18
|
Godfrey KM, Strachan E, Mostoufi S, Poeschla B, Succop A, Afari N. Familial Contributions to Self-Reported Sleep and Pain in Female Twins. PAIN MEDICINE 2016; 17:33-9. [PMID: 26271474 DOI: 10.1111/pme.12894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The relationship between sleep quality and pain has been studied in populations with chronic pain and in nonclinical populations using experimental paradigms. Little is known about the familial contributions to this relationship. This study examines self-reported sleep quality and pain in a nonclinical sample and to explore familial (i.e., shared genetic and common family environment) confounding in those relationships. DESIGN Cross-sectional. SUBJECTS Ninety nine community-based female twin pairs (N = 198) with a mean age of 29 years; 72% monozygotic. METHODS The short form McGill Pain Questionnaire (McGill), a visual analog scale (VAS), a body map, and the Pittsburgh Sleep Quality Index (PSQI) measured self-reported pain and sleep quality. Mixed model regression adjusted for age was used to examine relationships between the pain indices and PSQI in overall and within-pair models. RESULTS Higher PSQI total scores were significantly associated with higher scores across the McGill sensory (B = 0.37, p < 0.001), affective (B = 0.16, p < 0.001), total scores (B = 0.54, p < 0.001), the VAS (B = 2.41, p < 0.001), and number of sites with any pain on the body map (B = 0.42, p = 0.001). All of these associations were diminished and rendered nonsignificant in within-pair analyses that accounted for genetic and familial factors (all p's ≥ 0.01; Bonferroni α = 0.01). CONCLUSIONS These findings support an association between poor sleep quality and pain and suggest that this relationship may be confounded by shared genetic and environmental factors, which could elucidate biological mechanisms that underlie the development and maintenance of pain and sleep problems.
Collapse
|
19
|
|
20
|
Lirk P, Fiegl H, Weber NC, Hollmann MW. Epigenetics in the perioperative period. Br J Pharmacol 2015; 172:2748-55. [PMID: 25073649 DOI: 10.1111/bph.12865] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/13/2014] [Accepted: 07/18/2014] [Indexed: 01/29/2023] Open
Abstract
The perioperative period is characterized by profound changes in the body's homoeostatic processes. This review seeks to address whether epigenetic mechanisms may influence an individual's reaction to surgery and anaesthesia. Evidence from animal and human studies suggests that epigenetic mechanisms can explain many facets of susceptibility to acute and chronic pain, making them potential therapeutic targets. Modern pain management is still based upon opiates, and both the developmental expression of opioid receptors and opioid-induced hyperalgesia have been linked to epigenetic mechanisms. In general, opiates seem to increase global DNA methylation levels. This is in contrast to local anaesthetics, which have been ascribed a global demethylating effect. Even though no direct investigations have been carried out, the potential influence of epigenetics on the inflammatory response that follows surgery seems a promising area for research. There is a considerable body of evidence that supports the involvement of epigenetics in the complex process of wound healing. Epigenetics is an important emerging research topic in perioperative medicine, with a huge potential to positively influence patient outcome.
Collapse
Affiliation(s)
- P Lirk
- Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - H Fiegl
- Department of Gynaecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - N C Weber
- Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M W Hollmann
- Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
21
|
Visscher CM, Lobbezoo F. TMD pain is partly heritable. A systematic review of family studies and genetic association studies. J Oral Rehabil 2014; 42:386-99. [PMID: 25523980 DOI: 10.1111/joor.12263] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 01/24/2023]
Abstract
The aim of this study was to describe the current knowledge on the role of heritability in TMD pain through a systematic review of the literature, including familiar aggregation studies and genetic association studies. For the systematic search of the literature, the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines were followed. In total, 21 studies were included in the review, including five familiar aggregation studies and 16 genetic association studies. From both familiar aggregation studies and genetic association studies, modest evidence for the role of heritability in TMD pain was found. The literature mainly suggests genetic contributions from candidate genes that encode proteins involved in the processing of painful stimuli from the serotonergic and catecholaminergic system. This systematic review shows that the evidence for the role of heritability in the development of TMD pain is cumulating.
Collapse
Affiliation(s)
- C M Visscher
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | | |
Collapse
|
22
|
Lier R, Nilsen TIL, Vasseljen O, Mork PJ. Neck/upper back and low back pain in parents and their adult offspring: Family linkage data from the Norwegian HUNT Study. Eur J Pain 2014; 19:762-71. [PMID: 25263611 DOI: 10.1002/ejp.599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic pain in the neck and low back is highly prevalent. Although heritable components have been identified, knowledge about generational transmission of spinal pain between parents and their adult offspring is sparse. METHODS This study examined the intergenerational association of spinal pain using data from 11,081 parent-offspring trios participating in the population-based HUNT Study in Norway. Logistic regression was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for offspring spinal pain associated with parental spinal pain. RESULTS In total, 3654 (33%) offspring reported spinal pain at participation. Maternal and paternal spinal pain was consistently associated with higher ORs for offspring spinal pain. The results suggest a slightly stronger association for parental multilevel spinal pain (i.e., both neck/upper back pain and low back pain) than for pain localized to the neck/upper back or low back. Multilevel spinal pain in both parents was associated with ORs of 2.6 (95% CI, 2.1-3.3), 2.4 (95% CI, 1.9-3.1) and 3.1 (95% CI, 2.2-4.4) for offspring neck/upper back, low back and multilevel spinal pain, respectively. CONCLUSION Parental chronic spinal pain was consistently associated with increased occurrence of chronic spinal pain in their adult offspring, and this association was particularly strong for multilevel spinal pain.
Collapse
Affiliation(s)
- R Lier
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Liaison Committee between the Central Norway Regional Health Authority, Stjørdal, Norway; the Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | |
Collapse
|
23
|
Lessans S, Dorsey SG. The role for epigenetic modifications in pain and analgesia response. Nurs Res Pract 2013; 2013:961493. [PMID: 24228176 PMCID: PMC3817675 DOI: 10.1155/2013/961493] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 09/12/2013] [Indexed: 12/12/2022] Open
Abstract
Pain remains a poorly understood and managed symptom. A limited mechanistic understanding of interindividual differences in pain and analgesia response shapes current approaches to assessment and treatment. Opportunities exist to improve pain care through increased understanding of how dynamic epigenomic remodeling shapes injury, illness, pain, and treatment response. Tightly regulated alterations of the DNA-histone chromatin complex enable cells to control transcription, replication, gene expression, and protein production. Pathological alterations to chromatin shape the ability of the cell to respond to physiologic and environmental cues leading to disease and reduced treatment effectiveness. This review provides an overview of critical epigenetic processes shaping pathology and pain, highlights current research support for the role of epigenomic modification in the development of chronic pain, and summarizes the therapeutic potential to alter epigenetic processes to improve health outcomes.
Collapse
Affiliation(s)
- Sherrie Lessans
- School of Nursing, University of Maryland, Baltimore, USA
- Program in Neuroscience, University of Maryland, Baltimore, USA
| | - Susan G. Dorsey
- School of Nursing, University of Maryland, Baltimore, USA
- Program in Neuroscience, University of Maryland, Baltimore, USA
| |
Collapse
|
24
|
Abstract
Back pain episodes are traditionally regarded as individual events, but this model is currently being challenged in favour of treating back pain as a long-term or lifelong condition. Back pain can be present throughout life, from childhood to older age, and evidence is mounting that pain experience is maintained over long periods: for example, people with pain continue to have it on and off for years, and people without pain do not suddenly develop long-term pain. A number of factors predict back pain presence in epidemiological studies, and these are often present, and predictive, at different life stages. There are also factors present at particular life stages, such as childhood or adolescence, which predict back pain in adulthood. However, there are little published data on long-term pain patterns or predictors over the life course. Such studies could improve our understanding of the development and fluctuations in back pain, and therefore influence treatment approaches.
Collapse
Affiliation(s)
- Kate M Dunn
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire ST5 5BG, UK.
| | | | | |
Collapse
|
25
|
Dunn KM, Hestbaek L, Cassidy JD. WITHDRAWN: Low back pain across the lifecourse. Best Pract Res Clin Rheumatol 2013. [DOI: 10.1016/j.berh.2013.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
26
|
|
27
|
Nielsen CS, Knudsen GP, Steingrímsdóttir ÓA. Twin studies of pain. Clin Genet 2012; 82:331-40. [PMID: 22823509 DOI: 10.1111/j.1399-0004.2012.01938.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 07/12/2012] [Accepted: 07/12/2012] [Indexed: 12/14/2022]
Abstract
Twin studies provide a method for estimating the heritability of phenotypes and for examining genetic and environmental relationships between phenotypes. We conducted a systematic review of twin studies of pain, including both clinical and experimental pain phenotypes. Fifty-six papers were included, whereof 52 addressed clinical phenotypes. Of the most comprehensively studied phenotypes, available data indicates heritability around 50% for migraine, tension-type headache and chronic widespread pain, around 35% for back and neck pain, and around 25% for irritable bowel syndrome. However, differences in phenotype definitions make these results somewhat uncertain. All clinical studies relied on dichotomous outcomes and none used pain intensity as continuous phenotype. This is a major weakness of the reviewed studies and gives reason to question their validity with respect to pain mechanisms. Experimental pain studies indicate large differences in heritability across pain modalities. Whereas there is evidence for substantial common genetic risk across many clinical pain conditions, different experimental pain phenotypes appear to be associated with different genetic factors. Recommendations for future research include inclusion of pain intensity scaling and number of pain sites in phenotyping. Furthermore, studies examining the genetic relationships between pain phenotypes, in particular between clinical and experimental phenotypes, should be prioritized.
Collapse
Affiliation(s)
- C S Nielsen
- Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway.
| | | | | |
Collapse
|
28
|
Holliday KL, McBeth J. Recent advances in the understanding of genetic susceptibility to chronic pain and somatic symptoms. Curr Rheumatol Rep 2012; 13:521-7. [PMID: 21877183 DOI: 10.1007/s11926-011-0208-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Regional (e.g., low back) and widespread chronic pain disorders are common in the general population and are known to be heritable. Recent research suggests that genetic factors increase the risk of developing chronic pain independent of the site of pain. Candidate gene studies have been conducted on key pathways to elucidate susceptibility genes that are likely to be involved in both the sensory and affective components of pain. Findings have been largely equivocal, predominantly due to small sample size, but larger studies of pain in general population samples are being conducted. Interesting candidate genes from animal models and monogenic pain disorders are beginning to emerge. Recent advances in genetics research have yet to make an impact in the pain field but provide considerable scope for future research efforts.
Collapse
Affiliation(s)
- Kate L Holliday
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester Academic Health Science Centre, England, UK.
| | | |
Collapse
|
29
|
Tajerian M, Alvarado S, Millecamps M, Dashwood T, Anderson KM, Haglund L, Ouellet J, Szyf M, Stone LS. DNA methylation of SPARC and chronic low back pain. Mol Pain 2011; 7:65. [PMID: 21867537 PMCID: PMC3182907 DOI: 10.1186/1744-8069-7-65] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 08/25/2011] [Indexed: 12/21/2022] Open
Abstract
Background The extracellular matrix protein SPARC (Secreted Protein, Acidic, Rich in Cysteine) has been linked to degeneration of the intervertebral discs and chronic low back pain (LBP). In humans, SPARC protein expression is decreased as a function of age and disc degeneration. In mice, inactivation of the SPARC gene results in the development of accelerated age-dependent disc degeneration concurrent with age-dependent behavioral signs of chronic LBP. DNA methylation is the covalent modification of DNA by addition of methyl moieties to cytosines in DNA. DNA methylation plays an important role in programming of gene expression, including in the dynamic regulation of changes in gene expression in response to aging and environmental signals. We tested the hypothesis that DNA methylation down-regulates SPARC expression in chronic LBP in pre-clinical models and in patients with chronic LBP. Results Our data shows that aging mice develop anatomical and behavioral signs of disc degeneration and back pain, decreased SPARC expression and increased methylation of the SPARC promoter. In parallel, we show that human subjects with back pain exhibit signs of disc degeneration and increased methylation of the SPARC promoter. Methylation of either the human or mouse SPARC promoter silences its activity in transient transfection assays. Conclusions This study provides the first evidence that DNA methylation of a single gene plays a role in chronic pain in humans and animal models. This has important implications for understanding the mechanisms involved in chronic pain and for pain therapy.
Collapse
Affiliation(s)
- Maral Tajerian
- Alan Edwards Centre for Research on Pain, McGill University, 740 Dr, Penfield Avenue, Montreal, Quebec, H3A 1A4, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|