Concordance of Phantom and Residual Limb Pain Phenotypes in Double Amputees: Evidence for the Contribution of Distinct and Common Individual Factors - 28/11/15
, Robin Bekrater-Bodmann ‡, Martin Diers ‡, §, Iris Reinhard ¶, Josef Frank ∗, Stefan Wüst ∗, ‖, Ze'ev Seltzer ∗∗, ††, Herta Flor ‡, Marcella Rietschel ∗Abstract |
Most, but not all, limb amputees develop phantom limb pain (PLP) or residual limb pain (RLP), and large interindividual differences in pain intensity and course are apparent. The present cross-sectional study of 122 double amputees investigated the possible role of genetic factors in PLP and RLP, assuming that strong individual predisposition results in high intraindividual concordance in pain phenotype. Intraindividual concordance was observed in 116 (95%) patients for development of PLP and in 110 patients (90%) for development of RLP. For both pain types, high intraindividual concordance was also observed for remission and current intensity. Moderate association for lifetime history and current intensity of PLP and RLP was observed both within and between limbs. The high intraindividual concordance in pain phenotypes suggests strong individual predisposition for PLP and RLP development. However, the finding of only moderate association between PLP and RLP suggests that susceptibility to these pain phenomena involves distinct, as well as common, risk factors. Genome-wide studies in large samples of single amputees may facilitate the dissection of these phenotypes and their underlying mechanisms.
Perspective |
The observation of high intraindividual concordance for PLP and RLP in 122 double amputees suggests that individual factors contribute to post-amputation pain. The relatively low intraindividual association between PLP and RLP suggests that these factors are at least partially specific for each pain type.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Phantom and residual limb pain were assessed in 122 double limb amputees. |
• | High intraindividual concordance between limbs was observed for each type of pain. |
• | Phantom and residual pain were only moderately associated. |
• | Intraindividual concordance suggested a predisposition for both types of pain. |
• | Medium association between both types of pain suggested some distinct risk factors. |
Key words : Phantom limb pain, residual limb pain, concordance, heritability of pain, multiple amputations
Plan
| F.S., R.B.-B., Z.S., H.F., and M.R. contributed equally to this work. |
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| This research was supported by a European Research Council Advanced Grant for the project “Phantom Phenomena: A Window To The Mind And The Brain (PHANTOMIND),” which received research funding from the European Community's Seventh Framework Programme (FP7/2007–2013/ERC Grant Agreement No. 230249 [erc.europa.eu/]) awarded to H.F. and by funding from the German Research Foundation to the project “Genetische Grundlagen des Phantomschmerzes: Aufbau einer nationalen Forschungsressource (PHANTOMGENE)” (DFG; WU392/7-1: 2010–2014) awarded to S.W., H.F., and M.R. Z.S. is founding CEO and owner of Algogene Pain Genetics Inc, a board member of Newron Pharmaceuticals S.p.A., and received consultant fees from deCODE genetics. All other authors declare that they have no conflicts of interest regarding the material discussed in the article. |
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| Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com. |
Vol 16 - N° 12
P. 1377-1385 - décembre 2015 Retour au numéro
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