Abstract
Previous research has shown a consistent association among genetic factors, psychological symptoms and pain associated with fibromyalgia. However, how these symptoms interact to moderate genetic factors in fibromyalgia has rarely been studied to date. The present research investigates whether psychological symptoms can moderate the effects of catechol-O-methyltransferase on pain and fatigue. A total of 108 women diagnosed with fibromyalgia and 77 healthy control participants took part in the study. Pain, fatigue, and psychological symptoms (anxiety, depression, pain catastrophizing, fear of pain and fear of movement) were measured by self-report questionnaires. Two types of statistical analyses were performed; the first was undertaken to explore the influences of COMT genotypes on clinical symptoms by comparing patients with fibromyalgia and healthy controls. In the second analysis, moderation analyses to explore the role of psychological symptoms as potential factors that moderate the relationship between pain/fatigue and COMT genotypes were performed. The main results indicated that patients carrying the Met/Met genotype reported significantly higher levels of fatigue than heterozygote carriers (i.e., Met/Val genotype) and higher levels of fatigue, but not significantly different, than Val homozygote carriers. Among patients with fibromyalgia carrying methionine alleles (i.e., Met/Met + Met/Val carriers), only those who scored high on medical fear of pain, experienced an intensified feeling of fatigue. Thus, the present research suggests that fear of pain, as a psychological symptom frequently described in fibromyalgia may act as a moderating factor in the relationship between the Met allele of the COMT gene and the increase or decrease in self-reported fatigue. Although further research with wider patient samples is needed to confirm the present findings, these results point out that the use of psychological interventions focused on affective symptomatology might be a useful tool to reduce the severity of fibromyalgia.
Highlights
Fibromyalgia is a multifactorial, but not yet fully understood, disease that is mainly characterized by chronic and diffuse musculoskeletal pain [1]
The chi-square (χ2) test was used to assess the distribution of the genotypes between patients and healthy control (HC) participants to check for Hardy-Weinberg equilibrium (HWE)
Our results indicated that patients carrying the Met/Met genotype of the COMT gene showed significantly more self-reported fatigue than those carrying the Met/Val genotype, but not significant higher, than the valine homozygote carriers
Summary
Fibromyalgia is a multifactorial, but not yet fully understood, disease that is mainly characterized by chronic and diffuse musculoskeletal pain [1]. Multiple factors, such as sensory disturbances of pain perception [2, 3], dysfunctions of the central nervous system [4], stress [5] and environmental conditions [6] are very often involved in the development of fibromyalgia. The COMT gene contains a single nucleotide polymorphism (SNP) resulting in a substitution of guanine for adenine at codon 158 (the Val158Met polymorphism). This change results in the amino acid-encoding gene being methionine (Met) instead of valine (Val) [11]
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