Background/Purpose: Telomere length is considered a marker of cellular aging and has been linked to an increased risk for morbidity and mortality. Psychosocial factors associated with shortened telomeres (e.g., obesity, depression, anxiety, trauma) are also common in chronic pain; yet, little is known about telomere length in pain populations. Thus, a preliminary investigation was conducted in fibromyalgia.

Methods: Leukocyte telomere length was evaluated in 66 women with fibromyalgia and 22 healthy female controls. Participants were from a convenience sample of individuals who underwent a blood draw and completed questionnaires including the Brief Pain Inventory (BPI) and Center for Epidemiologic Studies Depression Scale (CESD). A subgroup of fibromyalgia patients underwent quantitative sensory testing (QST; n=12) and neuroimaging (voxel-based morphometry; n=12). Telomere length was measured using the quantitative polymerase chain reaction method.

Results: Although patients had shorter telomere length than controls, the difference was not statistically significant. However, higher levels of pain within fibromyalgia were associated with shorter telomere length (r_partial = -.267, p = 0.039). In a comparison of patients categorized as having higher levels of pain (BPI ≥ 5/10; n = 30) and lower levels of pain (BPI < 5/10; n = 31), those with higher levels of pain were more likely to have shorter telomere length than those with low levels of pain despite chronological age (F = 5.39, p = 0.024). In a similar comparison of telomere length between those with likely depression (CESD scores ≥ 19; n = 24) and those likely without depression (CESD scores < 19; n = 42), no significant group differences were detected (p = 0.175). However, when pain and depression were combined, patients categorized as high-pain/high-depression had an age-adjusted telomere length 265 base pairs shorter than those with low-pain/low-depression (p=0.043); a difference consistent with over six years of chronological aging. In the subset tested, telomere length was also related to experimentally-induced pain threshold (r_partial=.728, p=0.017), mild pain (r_partial=.642, p=0.045) and slightly intense pressure pain (r_partial=.706, p=0.023), as well as gray matter volume (e.g., primary somatosensory cortex: r=.725, p<0.05 corrected), such that patients with shorter telomeres tended to be more sensitive to evoked pressure pain and have less gray matter volume in pain processing regions of the brain.

Conclusion: Our data suggest that pain in fibromyalgia is associated with shortened telomere length. These effects are largely independent of other factors commonly associated with telomere shortening.  Interestingly, short telomere length was directly related to evoked pain sensitivity and altered brain structure. Although these findings are preliminary, they suggest that pain may accelerate cellular aging.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/pain-is-associated-with-telomere-shortening-in-women-with-fibromyalgia/