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Central Pain Sensitization, COMT Val158Met Polymorphism, and Emotional Factors in Fibromyalgia

Published in Journal of Pain. 2014, vol. 15, no. 2, p. 129-135
Abstract Neurobiological evidence points to altered central nervous system processing of nociceptive stimuli in fibromyalgia. Enzymes like catechol-O-methyl-transferase (COMT) are involved in the elimination of catecholamines playing a possible role in central sensitization and pain. We used quantitative sensory testing to evidence central sensitization in fibromyalgia patients and test whether COMTVal158Met polymorphism, associated with a reduction in enzyme activity, plays a role in sensitized patients. Pain evaluation and quantitative sensory testing were performed including the spinal nociceptive flexion reflex, a physiologic correlate for the evaluation of central nociceptive pathways. Quality of life and distress questionnaires were used. A total of 137 fibromyalgia patients were assessed and compared to 99 matched controls. Central sensitization (nociceptive flexion reflex <27 mA) was present in 95/134 (71%) patients. Among them, COMT p.Val158Met polymorphism displayed a significant linear "genotype effect" (P = .033), with the Met/Met (mean = 17.8 ± 4.8 mA) and Val/Val (mean = 21.4 ± 4.6 mA) subgroups at the opposite ends of the nociceptive flexion reflex threshold (Met/Met vs Val/Val P = .015) and the Val/Met subgroup (mean = 19 ± 4.9 mA) in between (Val/Met vs Val/Val P = .041). Spontaneous moderate to severe pain was more likely to be associated with COMT Met/Met genotype. Patients showed important emotional distress compared to controls. In sensitized patients, the COMT Met/Met subgroup showed systematically-though not significantly-worse scores for all psychological variables.
PMID: 24342707
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Research groups Groupe Desmeules Jules (pharmacologie/toxicologie) (567)
Groupe Bouchardy Magnin Christine (Registre genevois des tumeurs) (532)
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DESMEULES, Jules Alexandre et al. Central Pain Sensitization, COMT Val158Met Polymorphism, and Emotional Factors in Fibromyalgia. In: Journal of Pain, 2014, vol. 15, n° 2, p. 129-135. doi: 10.1016/j.jpain.2013.10.004 https://archive-ouverte.unige.ch/unige:33237

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Deposited on : 2014-01-14

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