Reduced Cortico‐Cortical Resting‐State Connectivity in Sensory Systems Related to Bodily Pain in Juvenile Fibromyalgia

Abstract

ObjectiveJuvenile‐onset fibromyalgia (JFM) is a paradigmatic chronic pain condition for which the underlying neurobiological substrates are poorly understood. This study examined, for the first time, data‐driven resting‐state functional connectivity (rsFC) alterations in 37 female adolescents with JFM compared with 43 healthy female adolescents and identified associations with bodily pain.MethodsWhole‐brain voxel‐wise rsFC alterations were assessed using the intrinsic connectivity contrast, a measure of node centrality at each voxel, and seed‐based analyses for interpretability. We studied the relationship between rsFC alterations in somatosensory systems and the location and extension of bodily pain.ResultsAdolescents with JFM had voxel‐wise rsFC reductions in the paracentral lobule (PCL)/primary somatosensory cortex (S1) (T = 4.89, family‐wise error corrected p‐value (pFWE) < 0.001) and left midcingulate cortex (T = 4.67, pFWE = 0.043). Post hoc analyses revealed reduced rsFC spanning major cortical sensory hubs (T > 4.4, pFWE < 0.030). Cortico‐cortical rsFC reductions within PCL/S1 in JFM occurred in locations innervated by bodily areas where the pain was most frequent (F = 3.15; positive false discovery rate = 0.029) and predicted widespread pain (T > 4.4, pFWE < 0.045). Conversely, adolescents with JFM had increases in PCL/S1–thalamus (T = 4.75, pFWE = 0.046) and PCL/S1–anterior insula rsFC (T = 5.13, pFWE = 0.039).ConclusionReduced cortico‐cortical sensory integration involving PCL/S1 and spanning the sensory systems may underly critical pain sensory features in youth with JFM. Reduced sensory integration is paralleled by augmented cross‐talk between sensory and affective/salience‐processing regions, potentially indicating a shift toward more affectively colored sensory experiences to the detriment of specific sensory discrimination.