Familial and Genetic Influences on the Common Pediatric Primary Pain Disorders: A Twin Family Study

Abstract

The primary pain disorders of childhood are highly prevalent but have infrequently been studied collectively. Genetic influences have been suggested to be causally implicated. Surveys were sent to 3909 Australian twin families, assessing the lifetime prevalence of growing pains, migraine, headache, recurrent abdominal pain, low back pain, and persistent pain (not otherwise specified) in pediatric twins and their immediate family members. Comparisons between monozygous (MZ) and dizygous (DZ) twin pair correlations, concordances and odds ratios were performed to assess the contribution of additive genetic influences. Random-effects logistic regression modelling was used to evaluate relationships between twin individuals and their co-twins, mothers, fathers and oldest siblings with the subject conditions. Twin analyses of responses from 1016 families revealed significant influence of additive genetic effects on the presence of growing pains, migraine, and recurrent abdominal pain. The analyses for headache, low back pain, and persistent pain overall did not conclusively demonstrate that genetic influences were implicated more than shared environmental factors. Regression analyses demonstrated varying levels of significance in relationships between family members and twin individuals for the tested conditions, with strongest support for genetic influences in growing pains and migraine. These data, together with previously published association analyses, suggest common causal influences including genes.

Primary dysmenorrhoea in adolescents and young women: A twin family study of maternal transmission, genetic influence and associations

“…Twin individuals registered with Twins Research Australia (TRA) who had completed other childhood pain disorders twin family case–control studies were recruited for the current study. 3 , 15 Female twin pairs were aged between 10 and 22 years. Mothers and non‐twin eldest sisters of twin pairs were also invited to participate.…”

“…The following pain disorders were assessed via questionnaires in earlier phases of this research: growing pains (GP), non‐migraine headache, migraine, recurrent abdominal pain (RAP), persistent pain (including fibromyalgia) and RLS. 3 , 15 , 16 Respondents were classified as meeting criteria for iron deficiency if they endorsed both screening questions: ‘have you ever had iron deficiency?’ and ‘did a doctor diagnose it?’ The empirically derived anxious/depressed syndrome subscale of the Achenbach System was used to assess the presence of anxiety and depression within the previous six months. 15 …”

“…The International Association for the Study of Pain identifies dysmenorrhoea as an important recurring pain disorder with features of dysregulated somatosensory processing 2 . Paediatric primary dysmenorrhea shares characteristics with common recurrent and chronic pain disorders of childhood and adolescence without injury or definable disease 3 . Some characteristics include spontaneous onset; no clinically indicative biomarkers or pathology; disordered somatosensory processing in the central nervous system; multiple comorbidities or associations with additional disorders, including anxiety and depression; and multiple risk markers (with possible causal associations) 4 …”

“…Maternal transmission of paediatric pain has been extensively studied in recent years, with particular interest in psychosocial influences but relative neglect of genetic influences, 3,6 perhaps because the latter are not usually considered amenable to change. In primary dysmenorrhea in adolescents and young women, maternal, and to a lesser extent sister, associations have been reported in multiple studies in many countries but with limited further development of risk status 7,8 .…”

“…2 Paediatric primary dysmenorrhea shares characteristics with common recurrent and chronic pain disorders of childhood and adolescence without injury or definable disease. 3 Some characteristics include spontaneous onset; no clinically indicative biomarkers or pathology; disordered somatosensory processing in the central nervous system; multiple comorbidities or associations with additional disorders, including anxiety and depression; and multiple risk markers (with possible causal associations). 4 Primary dysmenorrhoea typically presents within the first 6-12 months of menstruation, coinciding with the commencement of ovulatory cycles.…”