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

David Champion,Tiina Jaaniste,Daniel Lemberg,Minh Bui,Shuxiang Goh,Cindy Chapman,Theresa Donnelly,Aneeka Bott,John Hopper

doi:10.3390/children8020089

David Champion, Tiina Jaaniste + Show 7 more

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https://doi.org/10.3390/children8020089

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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.

Highlights

Subsequent to the analysis presented in the current study, a substudy drawing on the same data has shown that onethird of the cases fulfilling the stated criteria for growing pains have the painful phenotype of the restless legs syndrome [44]
Our study provides additional twin family evidence for genetic influence in the pediatric population over a wide age range
There have been no twin studies published on pediatric RAP, and the present study further suggests a potential role for genetic influence

Summary

Introduction

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. The common recurrent and chronic pain disorders of childhood and adolescence without injury or definable disease, increasingly categorized as primary pain disorders, share several common features These include spontaneous or provoked onset, female preponderance, no biomarkers or pathology identifiable by routine clinical or imaging investigations, disordered somatosensory processing in the central nervous system, multiple comorbidities or associations with each other and with additional disorders including anxiety and depression.

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