Neural correlates of aberrant pain processing and modulation in fibromyalgia: a simultaneous spinal cord-brain fMRI study

Motivation: Dysfunctions in the endogenous pain modulation system contribute to chronic pain. Information on affected spinal cord and brain areas and their intricate interplay is largely missing. Goal(s): To identify corticospinal correlates of aberrant pain processing and modulation in fibromyalgia (FM). Approach: We used simultaneous spinal cord-brain fMRI paired with noxious heat stimulations and a gripping task to investigate deficient motor-related pain modulation in FM compared to age-/sex-matched pain-free healthy volunteers (HV). Results: We demonstrated elevated activation in pain-modulatory brain areas (i.e., prefrontal/primary motor cortex) in HV versus FM, and increased nociceptive signaling in spinal dorsal horns in FM versus HV, during combined stimulation-gripping. Impact: Identification of dysfunctional networks involved in pain modulation along the neuroaxis might present promising neural targets for more efficient treatment of chronic pain (e.g., non-invasive brain or spinal cord stimulation) and advance the development of pain biomarkers and precision medicine.