Genetic variants associated with development of TMD and its intermediate phenotypes: The genetic architecture of TMD in the OPPERA prospective cohort study

Shad B. Smith, Ellen Mir, Eric Bair, Gary D. Slade, Ronald Dubner, Roger B. Fillingim, Joel D. Greenspan, Richard Ohrbach, Charles Knott, Bruce Weir, William Maixner, Luda Diatchenko

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Genetic risk factors are believed to combine with environmental exposures and contribute to the risk of developing temporomandibular disorder (TMD). In this prospective cohort study, 2,737 people without TMD were assessed for common genetic variation in 358 genes known to contribute to nociceptive pathways, inflammation, and affective distress. During a median follow-up period of 2.8 years, 260 people developed first-onset TMD. Hazard ratios were computed as measures of association between 2,924 single-nucleotide polymorphisms and TMD incidence. After correction for multiple testing, no single single-nucleotide polymorphism was significantly associated with risk of onset TMD. However, several single-nucleotide polymorphisms exceeded Bonferroni correction for multiple comparison or false discovery rate thresholds (.05, .1, or .2) for association with intermediate phenotypes shown to be predictive of TMD onset. Nonspecific orofacial symptoms were associated with voltage-gated sodium channel, type I, alpha subunit (SCN1A, rs6432860, P = 2.77 × 10 -5) and angiotensin I-converting enzyme 2 (ACE2, rs1514280, P = 4.86 × 10-5); global psychological symptoms with prostaglandinendoperoxide synthase 1 (PTGS1, rs3842803, P = 2.79 × 10 -6); stress and negative affectivity with amyloid-b (A4) precursor protein (APP, rs466448, P = 4.29 × 10-5); and heat pain temporal summation with multiple PDZ domain protein (MPDZ, rs10809907, P = 3.05 × 10-5). The use of intermediate phenotypes for complex pain diseases revealed new genetic pathways influencing risk of TMD. Perspective: This article reports the findings of a large candidate gene association study of firstonset TMD and related intermediate phenotypes in the OPPERA Study. Although no genetic markers predicted TMD onset, several genetic risk factors for clinical, psychological, and sensory phenotypes associated with TMD onset were observed.

Original languageEnglish (US)
Pages (from-to)T91-T101
JournalJournal of Pain
Issue number12 SUPPL.
StatePublished - Dec 2013
Externally publishedYes


  • Chronic pain
  • Genetic risk factors
  • Incidence
  • Intermediate phenotypes
  • Temporomandibular disorder

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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