Volume 16, Issue 7 pp. 1064-1069
Epidemiology

The COMT rs4680 Met allele contributes to long-lasting low back pain, sciatica and disability after lumbar disc herniation

L.M. Jacobsen

Corresponding Author

L.M. Jacobsen

National Institute of Occupational Health, Oslo, Norway

Correspondence

Line Melå Jacobsen

E-mail: [email protected]

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E.I. Schistad

E.I. Schistad

Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål, Norway

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A. Storesund

A. Storesund

Department of Anesthesiology and Intensive Care, Haukeland University Hospital, Bergen, Norway

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L.M. Pedersen

L.M. Pedersen

National Institute of Occupational Health, Oslo, Norway

Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål, Norway

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L.J. Rygh

L.J. Rygh

Department of Anesthesiology and Intensive Care, Haukeland University Hospital, Bergen, Norway

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C. Røe

C. Røe

Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevål, Norway

Faculty of Medicine, University of Oslo, Oslo, Norway

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J. Gjerstad

J. Gjerstad

National Institute of Occupational Health, Oslo, Norway

Department of Molecular Biosciences, University of Oslo, Oslo, Norway

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First published: 19 January 2012
Citations: 48

Funding sources:

The present work was supported by EXTRA funds from the Norwegian Foundation for Health and Rehabilitation and the Norwegian Research Council.

Conflicts of interest:

The authors state that there are no conflicts of interest.

Abstract

Background

The COMT enzyme metabolizes catecholamines and thus modulates adrenergic, noradrenergic and dopaminergic signaling. A functional polymorphism in the gene encoding this enzyme, i.e. the COMT Val158Met SNP that reduces enzyme activity, has previously been linked to pain sensitivity.

Methods

We examined if the COMT Val158Met SNP could contribute to discogenic subacute low back pain and sciatica by comparing the frequency of the Val158Met genotypes of degenerative disc disease patients with healthy controls. Moreover, we examined if this SNP could predict the clinical outcome, i.e. the progression of pain and disability.

Results

The present data demonstrated that there were no differences in COMT genotype frequencies between the newly diagnosed patients and controls. Analysis of pain and disability in the patients over time revealed, however, a significant or border-line significant increase in McGill sensory score and Oswestry Disability Index (ODI) score for individuals with COMT Met/Met genotype. Furthermore, significant associations between the COMT Met-allele and VAS activity score, McGill sensory score and ODI score were observed in the patients 6 months after inclusion.

Discussion

Although the Val158Met SNP was not a risk factor for disc herniation, patients with Met/Met had more pain and slower recovery than those with Val/Met, which in turn also had more pain and slower recovery than those with Val/Val suggesting the SNP contributes to the progression of the symptoms of disc herniation.

Conclusion

We conclude that the functional COMT Val158Met SNP contributes to long lasting low back pain, sciatica and disability after lumbar disc herniation.

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