The cingulate–mitochondrial–resonome axis: a conceptual framework integrating rehabilitation, interoception, and affective–motor processing in canine chronic pain

Chronic musculoskeletal disease in Canis lupus familiaris (dogs) is associated not only with biomechanical dysfunction but also with alterations in autonomic regulation, affective processing, movement behavior, and chronic pain adaptation. Current rehabilitation models primarily emphasize peripheral tissue healing and biomechanics while placing less emphasis on interactions among interoception, nociception, autonomic regulation, and affective-motor processing. The objective of this Hypothesis and Theory article is to present the Cingulate–Mitochondrial–Resonome Axis (CMRA), a systems-level framework proposing that rehabilitation acts in part by restoring the coherence and organization of interoceptive signaling (the resonome), thereby influencing cingulate-mediated affective, autonomic, nociceptive, and motor regulation. Building conceptually upon the Feelings of Knowing–Fundamental Interoceptive Patterns (FoK–FIP) theory, the CMRA framework proposes that distributed interactions among connective tissue, autonomic, sensorimotor, and bioenergetic systems contribute to organism-level adaptation during rehabilitation. The central hypothesis is that restoration of interoceptive coherence serves as a candidate mediating variable linking peripheral rehabilitation interventions to central neurocognitive and behavioral change. Within this framework, functional improvements may occur despite persistent structural pathology, and rehabilitation-induced effects may extend beyond predictions made by strictly local biomechanical models. These predictions distinguish the CMRA framework from conventional structure-centered rehabilitation models and generate experimentally testable hypotheses for future investigation. The manuscript further proposes that rehabilitation-associated physiological changes may be reflected by multimodal measures including infrared thermography, quantitative gait analysis, and validated behavioral assessments. While these measures are not specific to CMRA and may also reflect established mechanisms such as altered biomechanics, reduced inflammation, central sensitization, and predictive processing, the framework predicts coordinated changes across multiple domains consistent with improved interoceptive organization. The CMRA framework is presented as a testable theoretical model rather than an established mechanistic explanation. Although the proposed role of large-scale endogenous electromagnetic organization remains speculative and incompletely validated, the framework generates falsifiable predictions regarding rehabilitation-associated changes in behavior, autonomic regulation, gait function, and chronic pain adaptation across species.