Association of catechol-O-methyltransferase genetic variants with outcome in patients undergoing surgical treatment for lumbar degenerative disc disease

Dai, Feng; Belfer, Inna; Schwartz, Carolyn E.; Banco, Robert; Martha, Julia; Tighioughart, Hocine; Tromanhauser, Scott; Jenis, Louis G.; Kim, David H.

doi:10.1016/j.spinee.2010.07.387

Cited by 67 publications

(39 citation statements)

References 34 publications

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“…However, COMT SNP rs4633 may modulate postsurgical improvement of the disability index score [43]. In addition, COMT pain sensitivity haplotypes affect pain ratings together with pain catastrophizing ratings, again suggesting a modulatory role for COMT in chronic pain [42].…”

Section: Meta-analysesmentioning

confidence: 98%

Catechol-O-methyltransferase gene polymorphism and chronic human pain

Tammimäki

Männistö

2012

Pharmacogenetics and Genomics

147

109

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In human studies, low COMT (catechol-O-methyltransferase) activity has been associated with increased sensitivity to acute clinical preoperative or postoperative pain. We explored the association between the COMT genotype and three chronic pain conditions: migrainous headache, fibromyalgia, or chronic widespread pain and chronic musculoskeletal pain. Furthermore, we evaluated whether COMT genotype affects the efficacy of opioids in chronic pain. After a systematic literature review, we carried out meta-analyses on the three chronic pain conditions. The efficacy of opioids was evaluated using a systematic review only. The meta-analyses showed that fibromyalgia or chronic widespread pain is the only type of chronic pain that could be associated with the COMT single nucleotide polymorphism rs4680 (Val158Met). Met158, which results in the low-activity variant of COMT, is the risk allele. In chronic clinical pain, the effect of the COMT polymorphism depends on the pain condition. Low COMT activity is not associated with migrainous headache or chronic musculoskeletal pain conditions, but it may increase the risk for fibromyalgia or chronic widespread pain. Low COMT activity increases opioid receptors and enhances opioid analgesia and adverse effects in some cancer pains. Findings from animal studies that have utilized COMT inhibitors elucidate the mechanism behind these findings. In rodent pain models, COMT inhibitors are pronociceptive, except for neuropathic pain models, where nitecapone was found to be antiallodynic. The complex interplay between enhanced adrenergic and dopaminergic activity in different parts of the nociceptive system probably explains the complicated actions of low COMT activity.

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Section: Meta-analysesmentioning

confidence: 98%

Catechol-O-methyltransferase gene polymorphism and chronic human pain

Tammimäki

Männistö

2012

Pharmacogenetics and Genomics

147

109

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“…COMT variants are associated with various forms of pain including neuropathic pain, musculoskeletal pain, fibromyalgia, temporomandibular disorder (TMD), headache, and postsurgical pain. [88][89][90][91][92][93] Importantly, COMT alleles also predict pain severity. 94 Furthermore, individuals homozygous for the COMT Val158Met variant consistently demonstrate psychological dysfunction associated with their chronic pain.…”

Section: Central Sensitization and Chronic Dry Eye Symptomsmentioning

confidence: 99%

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

Galor

Levitt

Felix

et al. 2014

Eye

184

187

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Dry eye has gained recognition as a public health problem given its prevalence, morbidity, and cost implications. Dry eye can have a variety of symptoms including blurred vision, irritation, and ocular pain. Within dry eyeassociated ocular pain, some patients report transient pain whereas others complain of chronic pain. In this review, we will summarize the evidence that chronicity is more likely to occur in patients with dysfunction in their ocular sensory apparatus (ie, neuropathic ocular pain). Clinical evidence of dysfunction includes the presence of spontaneous dysesthesias, allodynia, hyperalgesia, and corneal nerve morphologic and functional abnormalities. Both peripheral and central sensitizations likely play a role in generating the noted clinical characteristics. We will further discuss how evaluating for neuropathic ocular pain may affect the treatment of dry eye-associated chronic pain.

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“…60 If we can identify specifi c genetic factors that may infl uence sensitivity, perception, tolerance, and memory of pain, the realm of targeted therapy for CLPB may be near. Large patient cohorts available for subanalyses will be incredibly valuable for future directions of research and the formulation of a new era of "results-based medicine," going beyond the principles formulated for the current era of "evidence-based medicine.…”

Section: Conclusion: From "Evidence-based Medicine" To "Results-basementioning

confidence: 99%

Chronic Low Back Pain

Fourney

Andersson

Arnold

et al. 2011

Spine

100

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"Chronic" low back pain (LBP), defined as present for 3 or more months, has become a major socioeconomic problem insufficiently addressed by five major entities largely working in isolation from one another - procedural based specialties, strength based rehabilitation, cognitive behavioral therapy, pain management and manipulative care. As direct and indirect costs continue to rise, many authors have systematically evaluated the body of evidence in an effort to demonstrate the effectiveness (or lack thereof) for various diagnostic and therapeutic interventions. The objective of this Spine Focus issue is not to replicate previous work in this area. Rather, our expert panel has chosen a set of potentially controversial topics for more in-depth study and discussion. A recurring theme is that chronic LBP is a heterogeneous condition, and this affects the way it is diagnosed, classified, treated, and studied. The efficacy of some treatments may be appreciated only through a better understanding of heterogeneity of treatment effects (i.e., identification of clinically relevant subgroups with differing responses to the same treatment). Current clinical guidelines and payer policies for LBP are systematically compared for consistency and quality. Novel approaches for data gathering, such as national spine registries, may offer a preferable approach to gain meaningful data and direct us towards a "results-based medicine." This approach would require more high-quality studies, more consistent recording for various phenotypes and exploration of studies on genetic epidemiologic undertones to guide us in the emerging era of "results based medicine."

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Association of catechol-O-methyltransferase genetic variants with outcome in patients undergoing surgical treatment for lumbar degenerative disc disease

Cited by 67 publications

References 34 publications

Catechol-O-methyltransferase gene polymorphism and chronic human pain

Catechol-O-methyltransferase gene polymorphism and chronic human pain

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

Chronic Low Back Pain

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