TY - JOUR
T1 - Concordance of Phantom and Residual Limb Pain Phenotypes in Double Amputees
T2 - Evidence for the Contribution of Distinct and Common Individual Factors
AU - Streit, Fabian
AU - Bekrater-Bodmann, Robin
AU - Diers, Martin
AU - Reinhard, Iris
AU - Frank, Josef
AU - Wüst, Stefan
AU - Seltzer, Ze'Ev
AU - Flor, Herta
AU - Rietschel, Marcella
N1 - Publisher Copyright:
© 2015 American Pain Society.
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
KW - concordance
KW - heritability of pain
KW - multiple amputations
KW - Phantom limb pain
KW - residual limb pain
UR - http://www.scopus.com/inward/record.url?scp=84962235258&partnerID=8YFLogxK
U2 - 10.1016/j.jpain.2015.08.013
DO - 10.1016/j.jpain.2015.08.013
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C2 - 26431882
AN - SCOPUS:84962235258
SN - 1526-5900
VL - 16
SP - 1377
EP - 1385
JO - Journal of Pain
JF - Journal of Pain
IS - 12
ER -