Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity
Open accessAbstract
Objective: Fibromyalgia (FM) is considered to be the prototypical central chronic pain syndrome and is associated with widespread pain that fluctuates spontaneously. Multiple studies have demonstrated altered brain activity in these patients. The objective of this study was to investigate the degree of connectivity between multiple brain networks in patients with FM, as well as how activity in these networks correlates with the level of spontaneous pain. Methods: Resting‐state functional magnetic resonance imaging (FMRI) data from 18 patients with FM and 18 age‐matched healthy control subjects were analyzed using dual‐regression independent components analysis, which is a data‐driven approach for the identification of independent brain networks. Intrinsic, or resting‐state, connectivity was evaluated in multiple brain networks: the default mode network (DMN), the executive attention network (EAN), and the medial visual network (MVN), with the MVN serving as a negative control. Spontaneous pain levels were also analyzed for covariance with intrinsic connectivity. Results: Patients with FM had greater connectivity within the DMN and right EAN (corrected P [ P corr ] < 0.05 versus controls), and greater connectivity between the DMN and the insular cortex, which is a brain region known to process evoked pain. Furthermore, greater intensity of spontaneous pain at the time of the FMRI scan correlated with greater intrinsic connectivity between the insula and both the DMN and right EAN ( P corr < 0.05). Conclusion: These findings indicate that resting brain activity within multiple networks is associated with spontaneous clinical pain in patients with FM. These findings may also have broader implications for how subjective experiences such as pain arise from a complex interplay among multiple brain networks.
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Chronic pain is associated with elevated functional connectivity among the DMN, FPN, and SN.
“Not only does each network independently demonstrate changes in functional connectivity in response to different types of chronic pain stimuli, it has been demonstrated that there is elevated functional connectivity among the DMN, FPN, and SN in individuals suffering from CMP [12,13,14,15,16,17,18].”
From Graph theory analysis of induced neural plasticity post-Acceptance and Commitment Therapy for chronic pain (2020) · cites this paper as [16]
The Results (page unavailable) report elevated connectivity within the DMN and right executive attention network—a frontoparietal network—in fibromyalgia, as well as increased connectivity between each of those networks and the insula with greater spontaneous pain. The paper does not evaluate the salience network as a network or demonstrate elevated connectivity among all three networks. (LLM, conf=0.87)
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“…it has been demonstrated that there is elevated functional connectivity among the DMN, FPN, and SN in individuals suffering from CMP (Cauda et al., 2014; Cottam et al., 2016; Doll et al., 2015; Hemington et al., 2016; Napadow et al., 2010; van Ettinger-Veenstra et al., 2019; Zhao et al., 2017).”
BackgroundInfluentialKim, K.-W., Park, K., Park, H.-J., Jahng, G.-H., Jo, D.-J., Cho, J.-H., Song, E.-M., Shin, W.-C., Yoon, Y.-J., Kim, S.-J., et al. (2019) · Trials · doi:10.1186/s13063-018-3164-8 · Cited by 13 · see citing works
Self-citationAdvancing insights into fibromyalgia: an updated review of diagnosis and differential diagnosis
Segura-Jiménez, V. (2026) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2026.2733188
Central Sensitization and Small-fiber Neuropathy Are Associated in Patients With Fibromyalgia
Dumolard, A., Lefaucheur, J.-P., Hodaj, E., Liateni, Z., Payen, J.-F., & Hodaj, H. (2023) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000001085 · Cited by 26 · see citing works
- Authors
- Napadow, V., LaCount, L., Park, K., As‐Sanie, S., Clauw, D. J., & Harris, R. E.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- Kyung Hee University (KR)
- University of Michigan (US)
- Venue
- Arthritis & Rheumatism
- Publisher
- Wiley
- Published
- 2010-08
- Volume
- 62
- Issue
- 8
- Pages
- 2545-2555
- ISSN
- 0004-3591 (ISSN-L)
- 1529-0131
- PMC
- PMC2921024
- OpenAlex
- W2142829723
- Cited by
- 645
- References
- 53
- Citations by year
- 2026: 36 · 2025: 42 · 2024: 31 · 2023: 30 · 2022: 41 · 2021: 40 · 2020: 49 · 2019: 46 · 2018: 43 · 2017: 43 · 2016: 54 · 2015: 41 · 2014: 47 · 2013: 42 · 2012: 30
- FWCI
- 19.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Arthritis & Rheumatism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- U.S. Department of Defense (W81XWH)
- Pfizer
- Deutsches Krebsforschungszentrum
- National Institutes of Health (W81XWH)
- U.S. Public Health Service (K01-A002166)
- National Center for Complementary and Alternative Medicine
- National Center for Research Resources (P41-RR-14075, M01RR001066, P41RR014075, M01-RR01066)
- National Center for Complementary and Integrative Health (R01AT004714, F05AT003770, K01AT001111, K01-AT-01111, K01AT002166, P01AT002048)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- fibromyalgia, intrinsic brain connectivity, resting-state functional connectivity, chronic pain, spontaneous pain, default mode network, insula, pain intensity, central pain
- MeSH terms
- Adult, Aged, Analysis of Variance, Brain, Brain Mapping, Chronic Disease, Female, Fibromyalgia, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Middle Aged, Nerve Net, Pain, Pain Measurement, Regression Analysis, Severity of Illness Index
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