title: Shared genetic factors underlie chronic pain syndromes.
abstract: Chronic pain syndromes (CPS) are highly prevalent in the general population, and increasingly the evidence points to a common etiological pathway. Using a large cohort of twins (n=8564) characterized for chronic widespread musculoskeletal pain (CWP), chronic pelvic pain (PP), migraine (MIG), dry eye disease, and irritable bowel syndrome (IBS), we explored the underlying genetic and environmental factors contributing to CPS and the correlation between them. The sample was predominantly female (87.3%), with a mean age of 54.7 (±14.7) years. Prevalence of the different CPS ranged from 7.4% (PP) to 15.7% (MIG). For all CPS the within-twin correlation in monozygotic twin pairs was higher than in dizygotic pairs, suggesting a heritable component. Estimated heritability ranged from 19% (IBS) to 46% (PP). Except for MIG, we found significant pairwise phenotypic correlations between the CPS. The phenotypic correlation was highest between CWP and IBS (0.40; 95% confidence interval: 0.27 to 0.46). Excluding MIG from further analyses, cross-twin cross-trait correlations were higher in monozygotic compared with dizygotic twin pairs, suggestive of shared genetic factors between CWP, PP, IBS, and dry eye disease. Twin modeling analysis revealed the common pathway model as the model best explaining the observed pattern of correlation between the traits, with an estimated heritability of 66% of the underlying latent variable. These results are evidence of shared genetic factors in conditions manifesting chronic pain and justify the search for underlying genetic variants.
authors.affiliation: Department of Twin Research and Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, UK Department of Ophthalmology and Epidemiology, University Medical Center Groningen, Groningen, The Netherlands Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, UK Department of Ophthalmology, King's College London, St. Thomas' Hospital, London, UK Department of Rheumatology, King's College London, St. Thomas' Hospital, London, UK.
authors.forename: Jelle
authors.initials: J
authors.lastname: Vehof
authors.forename: Helena M S
authors.initials: HMS
authors.lastname: Zavos
authors.forename: Genevieve
authors.initials: G
authors.lastname: Lachance
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hammond
authors.forename: Frances M K
authors.initials: FMK
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000453:epidemiology / Q000235:genetics*; D004200:Diseases in Twins / Q000453:epidemiology / Q000235:genetics*; D015352:Dry Eye Syndromes / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology / Q000235:genetics*; D059352:Musculoskeletal Pain / Q000453:epidemiology / Q000235:genetics*; D017699:Pelvic Pain / Q000453:epidemiology / Q000235:genetics*; D010641:Phenotype; D015995:Prevalence; D012307:Risk Factors; D014427:Twins / Q000235:genetics
keywords: Chronic pain syndrome; Chronic widespread pain; Dry eye disease; Environment; Functional somatic syndrome; Gene; Heritability; Irritable bowel syndrome; Migraine; Pain; Pelvic pain