TWIN STUDY OF CHRONIC WIDESPREAD PAIN

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic widespread pain (CWP) occurs in 4-13% of people and is one of the defining characteristics of Fibromyalgia (FM). The complexity of FM and the continuum of CWP have led us to develop a multidimensional theoretical model of CWP. Predisposing factors are of particular interest in this model since these represent premorbid risk or protective factors that relate to the development of CWP. Further, predisposing factors can be differentiated from illness-associated features that occur as a consequence of the condition. A co-twin control study is a powerful means for examining specific hypotheses about the etiology and consequences of CWP derived from our model. Forty MZ and 40 DZ twin pairs discordant for CWP, along with 40 MZ and DZ pain-free control twin pairs will be recruited from the population-based University of Washington Twin Registry. Twins will undergo an intensive evaluation of autonomic nervous system (ANS) function, hypothalamic-pituitary-adrenal (HPA) axis function, exercise capacity, sleep and activity levels, evoked pain processing, and psychiatric and psychosocial factors involved in CWP. There are 2 Specific Aims: 1) To assess within-pair differences in ANS function, HPA axis function, exercise capacity, sleep and activity levels, evoked pain sensitivity, and psychiatric and psychosocial factors. 2) To assess between-pair effects to determine if the association between CWP and the above illness characteristics is due to genetics or common environmental factors. Investigating the pattern of differences between twin groups can help to distinguish factors that are predisposing to CWP and those that occur after the onset of the illness.