• A Burri, S Ogata, D Rice, and WilliamsF M KFMKDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK..
• Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
• Eur J Pain. 2018 Sep 1; 22 (8): 1439-1447.

BackgroundWhile genetic influences on chronic pain have been repeatedly demonstrated, we do not know whether these effects are stable or dynamic over time.AimsTo determine the temporal pattern of genetic and environmental effects to individual differences in chronic pain over 12 years, we use a sample of n = 961 female twins.MethodsData on chronic pain were collected in 2004 (T1) and 2016 (T2) using the same comprehensive body map which divides the body into 31 distinct anatomical areas. Multivariate twin analyses for repeated measures were conducted to track changes in genetic and environmental influences.ResultsHeritability for chronic pain was 63% at baseline and 55% at follow-up. The best-fitting AE Cholesky model revealed one genetic factor explaining 62% of variance in chronic pain at T1 and 11% at T2. No additional genetic factors explaining the variance in chronic pain at T2 could be detected. Furthermore, a unique environmental factor (E1) explaining 37% of the variance in chronic pain at T1 and 12% at T2 and an additional environmental factor (E2) explaining 77% of the variance at T2 were found.ConclusionWe demonstrate for the first time that the same genetic influences are operative over time and that novel environmental factors are important in pain maintenance. The findings highlight the value of more in depth exploration of these non-shared environmental influences that could provide clues to the mechanisms behind remittance and/or maintenance of chronic pain. The identification of important environmental influences could point to novel therapeutic interventions in future.SignificanceThe variability in chronic pain is mainly explained by new environmental factors influencing incidence, aggravation and/or chronic pain remission. Integration of these findings may provide a useful conceptual framework for the treatment and prevention of pain and pain chronification.© 2018 European Pain Federation - EFIC®.

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