Blood Sample Donations to Study the Role of Genes in Pain
| Status: | Completed |
|---|---|
| Conditions: | Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/21/2016 |
| Start Date: | December 2002 |
| End Date: | March 2010 |
Genetic Risk of Chronic Pain After Acute Sciatica
This study attempts to identify genes that may increase or decrease the likelihood of
sciatic pain (shooting pain down the leg) persisting 1 year after treatment of a herniated
spinal disc. Many proteins in the nerves, spinal cord, and brain are involved in processing
pain. These proteins vary slightly in different people. Animal studies have shown that rats
and mice with certain types of proteins experience chronic pain after sciatic injury while
those with other types do not. Better information about the role of genes in pain processing
may lead to a test for the risk of chronic pain for specific individuals and more effective
treatment approaches.
This study will include people who participated in the Maine Lumbar Pain Study of the
natural history of spinal pain. The Maine study included patients treated for sciatic pain
caused by a herniated disc. In this study, patients who did not improve with medical
treatment were referred for surgery to remove the disc. Of those referred for surgery, 275
elected to have the operation, and 232 did not. One year after surgical consultation, leg
pain was reduced in 81 percent of patients who underwent surgery. Of those who declined
surgery, 56 percent improved after 1 year. This study will look for genetic differences in
the non-surgical group that might reveal differences among those who improved and those who
did not.
Participants will provide a blood sample (approximately 2 tablespoons) for genetic testing.
They will also provide information on the ethnic background of their parents and
grandparents. Different gene variants occur in different ethnic groups, so information on
ethnic background will help researchers know what gene variants to look for. Participants
will complete a questionnaire about their smoking history, because the same protein in the
brain that responds to nicotine may also play a part in decreasing or increasing pain. Also,
some surgeons believe that smoking can interfere with spinal bone healing. Information from
this study will help resolve this question.
sciatic pain (shooting pain down the leg) persisting 1 year after treatment of a herniated
spinal disc. Many proteins in the nerves, spinal cord, and brain are involved in processing
pain. These proteins vary slightly in different people. Animal studies have shown that rats
and mice with certain types of proteins experience chronic pain after sciatic injury while
those with other types do not. Better information about the role of genes in pain processing
may lead to a test for the risk of chronic pain for specific individuals and more effective
treatment approaches.
This study will include people who participated in the Maine Lumbar Pain Study of the
natural history of spinal pain. The Maine study included patients treated for sciatic pain
caused by a herniated disc. In this study, patients who did not improve with medical
treatment were referred for surgery to remove the disc. Of those referred for surgery, 275
elected to have the operation, and 232 did not. One year after surgical consultation, leg
pain was reduced in 81 percent of patients who underwent surgery. Of those who declined
surgery, 56 percent improved after 1 year. This study will look for genetic differences in
the non-surgical group that might reveal differences among those who improved and those who
did not.
Participants will provide a blood sample (approximately 2 tablespoons) for genetic testing.
They will also provide information on the ethnic background of their parents and
grandparents. Different gene variants occur in different ethnic groups, so information on
ethnic background will help researchers know what gene variants to look for. Participants
will complete a questionnaire about their smoking history, because the same protein in the
brain that responds to nicotine may also play a part in decreasing or increasing pain. Also,
some surgeons believe that smoking can interfere with spinal bone healing. Information from
this study will help resolve this question.
Many patients have persistent pain one year after herniated lumbar disc even when the disc
is surgically removed or shrinks spontaneously. We hypothesize that the risk of persistent
pain is modified by common variations in genes related to inflammation and pain processing.
We propose to collect blood for DNA analysis from up to 500 patients who have been followed
for 10 years after the onset of severe sciatica in the Maine Lumbar Spine Study. Based on
the pain research literature, Human Genome databases, and gene studies in NIAAA's Laboratory
of Neurogenetics, we will prioritize approximately 100 candidate genes with variants that
affect the function of their proteins. We will type patients' DNA for these variants and
compare their clinical data with their genotype at each candidate gene to see if common
variants increase or decrease the risk of chronic pain. The primary phenotype variable will
be the amount of persistent leg pain one year after pain onset, Identification of such
associations, if replicated in future studies, may help to prioritize targets for drug
treatments or identify genetic tests that can predict the prognosis of acute sciatica and
assist in treatment choice.
is surgically removed or shrinks spontaneously. We hypothesize that the risk of persistent
pain is modified by common variations in genes related to inflammation and pain processing.
We propose to collect blood for DNA analysis from up to 500 patients who have been followed
for 10 years after the onset of severe sciatica in the Maine Lumbar Spine Study. Based on
the pain research literature, Human Genome databases, and gene studies in NIAAA's Laboratory
of Neurogenetics, we will prioritize approximately 100 candidate genes with variants that
affect the function of their proteins. We will type patients' DNA for these variants and
compare their clinical data with their genotype at each candidate gene to see if common
variants increase or decrease the risk of chronic pain. The primary phenotype variable will
be the amount of persistent leg pain one year after pain onset, Identification of such
associations, if replicated in future studies, may help to prioritize targets for drug
treatments or identify genetic tests that can predict the prognosis of acute sciatica and
assist in treatment choice.
- INCLUSION CRITERIA:
Presented to Maine orthopedic or neurosurgeon approximately 10 years ago with complaint of
sciatica and was enrolled in Maine Lumbar Spine Study.
Outcome dataset includes ratings of low back and leg pain at baseline and at least one
followup evaluation.
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