Genetic variations in the catechol-o-methyltransferase (COMT) gene have been associated with experimental pain and risk of chronic pain development, but no studies have examined genetic predictors of neck pain intensity and other patient characteristics after motor vehicle collision (MVC). We evaluated the association between COMT genotype and acute neck pain intensity and other patient characteristics in 89 Caucasian individuals presenting to the emergency department (ED) after MVC. In the ED in the hours after MVC, individuals with a COMT pain vulnerable genotype were more likely to report moderate to severe musculoskeletal neck pain (76% vs. 41%, RR = 2.11 (1.33 - 3.37)), moderate or severe headache (61% vs. 33%, RR = 3.15 (1.05 – 9.42), and moderate or severe dizziness (26% vs. 12%, RR = 1.97 (1.19 – 3.21)). Individuals with a pain vulnerable genotype also experienced more dissociative symptoms in the ED, and estimated a longer time to physical recovery (median 14 vs. 7 days, p = .002) and emotional recovery (median 8.5 vs. 7 days, p = .038). These findings suggest that genetic variations affecting stress response system function influence the somatic and psychological response to MVC, and provide the first evidence of genetic risk for clinical symptoms after MVC
