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Biopsychosocial influence on shoulder pain: risk subgroups translated across preclinical and clinical prospective cohorts.

Abstract：

:Tailored treatment based on individual risk factors is an area with promise to improve options for pain relief. Musculoskeletal pain has a biopsychosocial nature, and multiple factors should be considered when determining risk for chronic pain. This study investigated whether subgroups comprised genetic and psychological factors predicted outcomes in preclinical and clinical models of shoulder pain. Classification and regression tree analysis was performed for an exercise-induced shoulder injury cohort (n = 190) to identify high-risk subgroups, and a surgical pain cohort (n = 150) was used for risk validation. Questionnaires for fear of pain and pain catastrophizing were administered before injury and preoperatively. DNA collected from saliva was genotyped for a priori selected genes involved with pain modulation (COMT and AVPR1A) and inflammation (IL1B and TNF/LTA). Recovery was operationalized as a brief pain inventory rating of 0/10 for current pain intensity and <2/10 for worst pain intensity. Follow-up for the preclinical cohort was in daily increments, whereas follow-up for the clinical cohort was at 3, 6, and 12 months postoperatively. Risk subgroups comprised the COMT high pain sensitivity variant and either pain catastrophizing or fear of pain were predictive of heightened shoulder pain responses in the preclinical model. Further analysis in the clinical model identified the COMT high pain sensitivity variant and pain catastrophizing subgroup as the better predictor. Future studies will determine whether these findings can be replicated in other anatomical regions and whether personalized medicine strategies can be developed for this risk subgroup.

journal_name

Pain

journal_title

Pain

authors

George SZ,Wallace MR,Wu SS,Moser MW,Wright TW,Farmer KW,Borsa PA,Parr JJ,Greenfield WH 3rd,Dai Y,Li H,Fillingim RB

doi

10.1016/j.pain.0000000000000012

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

148-156

issue

1

eissn

0304-3959

issn

1872-6623

pii

00006396-201501000-00019

journal_volume

156

pub_type

杂志文章

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