Effects of genotype on TENS effectiveness in controlling knee pain in persons with mild to moderate osteoarthritis

Abstract

Background

This study examined the extent to which genetic variability modifies Transcutaneous Electrical Nerve Stimulation (TENS) effectiveness in osteoarthritic knee pain.

Methods

Seventy‐five participants with knee osteoarthritis were randomly assigned to either: 1) High Frequency TENS, 2) Low Frequency TENS, or 3) Transient Placebo TENS. Pain measures were collected pre‐ and post‐treatment. Participants were genotyped on genes implicated in central or peripheral pain pathways: NGFB, NTRK1, EDNRA, EDNRB, EDN1, OPRM1, TAC1, TACR1, BDNF, BDKRB1, 5HTT, COMT, ESR2, IL6, and IL1B. Genetic association using linear regression modeling was performed separately for the transient placebo TENS subjects, and within the High Frequency TENS + Low Frequency TENS participants, including TENS level as a covariate.

Results

In the placebo group, SNPs rs165599 (COMT) was significantly associated with an increased heat pain threshold (β = ‐1.87; p = .003) and rs6827096 (EDNRA) with an increased resting pain (β = 2.68; p = .001). Within the treatment groups, TENS effectiveness was reduced by the SNP rs6537485 (EDNRA) minor allele in relationship to mechanical sensation (β = 184.13; p = 5.5E‐9). Individuals with the COMT rs4680 minor allele reported lowered pain at rest after TENS (β = ‐42.30; p=.001), with a higher magnitude of pain reduction (28 unit difference) in the low‐frequency TENS group compared to the high‐frequency TENS group (β = 28.37; p = .0004).

Conclusions

EDNRA and COMT are implicated in osteoarthritic knee pain and provide a basis for tailoring TENS interventions according to individual characteristics.

from Wiley: European Journal of Pain: Table of Contents https://ift.tt/34atmkK
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