Neuropathic pain as part of chronic widespread pain: environmental and genetic influences.
Neuropathic pain as part of chronic widespread pain: environmental and genetic influences.
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DOI：
10.1097/j.pain.0000000000000277
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发表时间：
2015-10
期刊：
影响因子：
7.4
通讯作者：
Williams FMK
中科院分区：
文献类型：
--
作者：
Momi SK;Fabiane SM;Lachance G;Livshits G;Williams FMK
补充数字内容在文本中可用。慢性广泛性疼痛中神经性疼痛的患病率为16%。神经性疼痛有37%是遗传的，并且与慢性广泛性疼痛共享潜在的遗传因素。慢性广泛性疼痛（CWP）具有复杂的病因学，并形成纤维肌痛综合征的一部分。最近的证据表明，CWP患者的神经性疼痛特征的频率高于以前的想法。本研究的目的是确定神经病理性疼痛的特点在个体与煤工尘肺的患病率，并估计遗传和环境因素对神经病理性疼痛的影响。使用经验证的问卷（伦敦纤维肌痛筛查研究问卷和PainDETECT问卷）分别将双胞胎分为CWP和神经性疼痛。CWP的患病率为14.7%（n = 4324），1357对双胞胎邀请完成神经性疼痛筛查，15.9%的CWP表现出神经性疼痛的特点。发现神经性疼痛是可遗传的（A = 37%; 95%置信区间[CI]：23%-50%），其中独特的环境因素占方差的63%（95% CI：49%-79%）。神经病理性疼痛的遗传度与CWP相关，为0.54（95%CI：0.42-0.65）。年龄增加、体重指数增加、女性、吸烟是神经病理性疼痛和CWP的危险因素（P <0.05）。高社会经济地位与神经病理性疼痛（P = 0.003）和CWP（P = 0.001）呈负相关。两种疼痛特征的双变量分析显示，神经性疼痛的遗传易感性与CWP的遗传易感性相同。这是第一个研究提供正式的遗传估计神经性疼痛的煤工尘肺。研究结果表明，至少有一些遗传因素的发展神经性疼痛和CWP是相同的。
Supplemental Digital Content is Available in the Text. The prevalence of neuropathic pain within chronic widespread pain is 16%. Neuropathic pain is 37% heritable and shares underlying genetic factors with chronic widespread pain. Chronic widespread pain (CWP) has complex aetiology and forms part of the fibromyalgia syndrome. Recent evidence suggests a higher frequency of neuropathic pain features in those with CWP than previously thought. The aim of this study was to determine the prevalence of neuropathic pain features in individuals with CWP and to estimate the influence of genetic and environmental factors on neuropathic pain in CWP. Validated questionnaires (the London Fibromyalgia Screening Study questionnaire and PainDETECT questionnaire) were used to classify twins as having CWP and neuropathic pain, respectively. The prevalence of CWP was 14.7% (n = 4324), and of the 1357 twins invited to complete neuropathic pain screening, 15.9% of those having CWP demonstrated features of neuropathic pain. Neuropathic pain was found to be heritable (A = 37%; 95% confidence interval [CI]: 23%-50%) with unique environmental factors accounting for 63% (95% CI: 49%-79%) of the variance. Heritability of neuropathic pain and CWP were found to be correlated, 0.54 (95% CI: 0.42-0.65). Increasing age, raised body mass index, female gender, and smoking were all risk factors for neuropathic pain (P < 0.05), and CWP (P < 0.05). High socioeconomic status showed negative correlation with neuropathic pain (P = 0.003) and CWP (P = 0.001). Bivariate analysis of the 2 pain traits revealed that genetic predisposition to neuropathic pain is shared with that for CWP. This is the first study to provide formal heritability estimates for neuropathic pain in CWP. The findings suggest that at least some of the genetic factors underlying the development of neuropathic pain and CWP are the same.