measured was also pre-morbid which is an important variable. Without
pre-morbid data it is difficult to measure whether the effect can be
attributed directly to a disease process. As well many instruments
measuring psychological distress include undifferentiated physical
symptoms. Physical symptoms of disease can be mistaken for
psychological symptoms as well as vice versa - either way confounding
the data and thus the conclusions. This is particularly true when only
so-called physical symptoms of distress are present.
COMT Val158Met enzyme polymorphism is hypothesized in molecular
psychiatry to be associated with neuropsychiatric disorders as well as
pain, however the literature is mixed. It is also hypothesized that
this gene variant may give rise to multiple physiological
abnormalities that separately contribute to other diseases, or it may
produce a single deficit that is common to these disorders. The same
polymorphism has been shown to affect executive function and the
physiology of the prefrontal cortex in humans, probably by affecting
prefrontal dopamine signalling.
Health Psychol. 2011 Sep 5. [Epub ahead of print]
Psychological distress in fibromyalgia patients: A role for
Catechol-O-Methyl-Transferase Val158Met polymorphism.
Desmeules J, Piguet V, Besson M, Chabert J, Rapiti E, Rebsamen M,
Rossier MF, Curtin F, Dayer P, Cedraschi C.
Abstract
Objective: Fibromyalgia (FM) has been related to biochemical
alterations, central pain sensitization and psychological distress.
Among genetic and environmental hypotheses, a role was suggested for
catechol-O-methyl-transferase (COMT), a modulator in the metabolism of
monoaminergic neurotransmitters.
Method: This study compared the COMT Val158Met enzyme polymorphism
(rs4680) of 198 FM patients to 99 pain-free controls. Psychological
and functional aspects were assessed through investigating anxiety,
depression, catastrophizing, perceived health, and functional status.
Results: The distribution of the COMT Val158Met polymorphism was
similar in FM and controls. Out of 198 patients, 137 were able to stop
medication before evaluation.
In these patients, the COMT Val158Met genotype was associated with
specific psychological profiles. The Met/Met subgroup scored
systematically worse on all psychological and functional variables.
All variables displayed a "genotype-trend effect" with the Met/Met and
Val/Val subgroups at the two ends of the scores. Genotypes
distribution in the 61 patients unable to stop medication was
significantly different from that of patients able to stop medication
and controls (p = .002 and p = .018, respectively) with an increase in
the proportion of the Met/Met genotype associated to the lowest COMT
activity.
These results suggest a possible role of COMT Val158Met polymorphism
in the psychological distress observed in FM.
Conclusions: The association of COMT genotype with psychological
distress may be of importance as identifying subgroups is a challenge
in the diagnosis and treatment of fibromyalgia patients. This
association may contribute to open new perspectives into the
understanding of the pathophysiology of fibromyalgia and
stress-related genes. (PsycINFO Database Record (c) 2011 APA, all
rights reserved).
PMID: 21895373 [PubMed - as supplied by publisher]
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