Genetic Test Reveals High, or Low, Pain Perception

A new genetic analysis test may be able to identify which patients have a high or a low predisposition for pain perception, according to the results of a new study.

“This analysis can be used as an objective guidepost to interpret more subjective numerical rating scales of pain,” lead author Tobore Onojjighofia, MD, MPH, with Proove Biosciences, told ConsultantLive before his presentation at the American Academy of Neurology annual meeting in Philadelphia.

“When a patient provides a rating of his or her pain from 0 to 10, a doctor can use the Proove Pain Perception test to better understand whether the patient's perception of the pain as a 2 or an 8 is really a function of the injury or more a function of the brain’s perception of the pain,” Dr Onojjighofia said. “This can guide appropriate interventions, treatments, and supportive care.”

Dr Onojjighofia and colleagues evaluated more than 2700 persons with a diagnosis of chronic pain for certain genes, in particular, COMT, DRD2, DRD1, and OPRK1, and conducted a multicenter, cross-sectional analysis of genotype with the Pain Visual Analog Scale. The patients, who were taking prescription opioid pain medications, rated their perception of pain on a scale from 0 to 10. Persons who rated their pain as 0 were not included in the study.

Low pain perception was defined as a score of 1, 2, or 3; moderate pain perception was a score of 4, 5, or 6; and high pain perception was a score of 7, 8, 9, or 10. Of the participants, 9% had low pain perception, 46% had moderate pain perception, and 45% had high pain perception.

The researchers found that the DRD1 gene variant was 33% more prevalent in the low pain group than in the high pain group. Among persons with a moderate pain perception, the COMT and OPRK variants were, respectively, 25% and 19% more often found than in those with a high pain perception. The DRD2 variant was 25% more common among those with a high pain perception compared with persons who had moderate pain.

“Clearly, these findings from our retrospective analysis provide a multifactorial target for potential therapeutics in the future, which is also something we are looking into,” said Dr Onojjighofia. “Identifying whether a person has these 4 genes could help doctors better understand a patient’s perception of pain.”

He added: “With the world's largest practice-based evidence in the genetics of pain medicine, we continue to research and evaluate the clinical validity of various genotypes and phenotypes associated with outcomes. We will continue to refine and expand the appropriate application of this assay, as well as develop new tests.”

Proove Biosciences provides proprietary genetic testing services. The organization has several assays on the market to help primary care physicians identify patients at elevated risk for the misuse of narcotics and identify patients with impaired drug metabolism and now the new pain test.

“These are valuable tools to provide information or proof to improve clinical decisions,” said Dr Onojjighofia.