Recovery after a lumbar disc herniation is dependent on a gender and OPRM1 Asn40Asp genotype interaction
Bibliographic record
Abstract
Abstract Background/aims The μ-opioid receptor (OPRM1) is the major target of endogenous opioid peptides and opioid analgesic agents. An important single nucleotide polymorphism (SNP) in this gene is the functional SNP, rs1799971, leading to a substitution of asparagine (Asn) to aspartic acid (Asp) at codon 40 in exon 1. Previous studies have suggested that this SNP may give different phenotypes in males and females. In the present study we therefore investigated whether the OPRM1 Asn40Asp SNP, grouped by gender, could predict clinical outcome regarding progression of pain intensity and disability in patients with discogenic low back pain and sciatica. Methods Patients ( n = 252) with lumbar disc herniation and sciatic pain, all European-caucasian, were recruited from Oslo University Hospital Ullevål and Haukeland University Hospital. Blood samples were drawn, genomic DNA isolated and the OPRM1 Asn40Asp SNP was detected by TaqMan methodology. Pain intensity and functional consequences were rated on a visual analogue scale (VAS), by McGill Sensory and by Oswestry Disability Index (ODI) over a 12 months period (inclusion, 6 weeks, 6 months and 12 months). Results The genotype */Asp was associated with more pain in women, but seemed to protect the men from pain after lumbar disc herniation. Wildtype Asn/Asn women and men reported similar pain ratings. Analysis of the recovery for the four groups; women Asn/Asn, women */Asp, men Asn/Asn and men */Asp, showed that the */Asp women had a significantly slower recovery, i.e., pain intensity over time than the */Asp men (VAS activity score p = 0.002, McGill sense score p = 0.021, ODI p = 0.205, rmANOVA including covariates smoke, treatment and age with p ≤ 0.1). Conclusion The present data suggest that the OPRM1 Asp variant increases the pain intensity in women, but have the opposite effect on men the first year after a disc herniation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".