Disclosures: Jeremy S. Holden, BSA: No financial relationships or conflicts of interest

Objective: The effects of many genes involved in the pathogenesis of chronic low back pain (CLBP) are not fully understood. Characterization of these genes is important to determine sources of pain-related racial disparities. This study aims to determine if variations of the serotonin receptor gene HTR2A, which was implicated in psychological and pain disorders, correlate to differences in clinical measures of patients with CLBP in the PRECISION Pain Research Registry.

Design: Cross-sectionalSetting : Online nationwide research registryParticipants : The base population includes 283 (68.4%) Caucasians and 131 (31.6%) African Americans. Patients from the base population were genotyped for their haplotype in 2 haploblocks of the HTR2A gene: A (rs6313;A/G, rs6311;T/C, rs1928040;A/G, rs9567746;A/G) and B (rs7997012;A/G, rs7330636;T/C).

Interventions: Not applicable

Main Outcome Measures: Roland-Morris Disability Questionnaire (RMDQ); Numerical Rating Scale (NRS) for pain intensity; sleep disturbance, pain, anxiety, depression, and low energy (SPADE) score and individual anxiety and depression measures of the Patient-Reported Outcomes Measurement Information System (PROMIS-29); pain catastrophizing score (PCS); pain self-efficacy (PSEQ)

Results: Race-specific Kruskal-Wallis analyses demonstrated differences in scores for the RMDQ (p=0.04), PCS (p=0.04), and PSEQ (p < 0.01) within haploblock A for African Americans. ATAA/ACAA and ATAA/GTAA haplotypes tended to have lower disability, less catastrophizing, and higher self-efficacy. There were also differences in the RMDQ (p=0.02) and PSEQ (p < 0.01) scores within haploblock B for Caucasians. A GC/GC haplotype was associated with lower disability and higher self-efficacy. Multivariate regressions showed having at least one GC allele in haploblock B was associated with lower pain intensity after adjusting for additional variables (beta=-0.59; p=0.02).Conclusions: Haplotypes of HTR2A may have a relationship with the pain intensity, disability, and pain response of CLBP patients. There may be complex pain phenotypes formed by SNPs of the gene that underlie both psychological and physical handling of pain. Further studies would look at additional race-specific factors and their interplay with HTR2A.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/race-specific-differences-in-outcome-measures-for-chronic-low-back-pain-patients-with-htr2a-variations/