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Related Experiment Video

Updated: Jul 14, 2026

A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
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A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers

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Structural and Functional Neuroimaging Findings in Fibromyalgia: A Systematic Review.

Flávio Antônio Duboc Flutt1,2, João Pedro de Melo Cortez1,3, Lucas Rego Ramos4

  • 1Pain Center, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.

European Journal of Pain (London, England)
|July 12, 2026
PubMed
Summary

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Fibromyalgia (FM) involves widespread brain changes, particularly in pain processing and control systems. Task-based neuroimaging reveals amplified pain signals and weakened descending modulation as key indicators in FM patients.

Area of Science:

  • Neuroscience
  • Radiology
  • Pain Medicine

Background:

  • Fibromyalgia (FM) is a chronic pain condition linked to central nervous system dysfunction.
  • Neuroimaging findings in FM are inconsistent across different methodologies.
  • Identifying reproducible brain alterations is crucial for understanding FM pathophysiology.

Purpose of the Study:

  • To systematically review and identify reproducible cross-modal neuroimaging alterations in adults with fibromyalgia.
  • To compare findings from structural MRI, diffusion imaging, and functional MRI (fMRI) studies.
  • To clarify the most consistent neurobiological changes associated with FM.

Main Methods:

  • Systematic review following PROSPERO and PRISMA 2020 guidelines.
  • Searched PubMed, EMBASE, Web of Science, and VHL/BVS for studies from 2010-2025.

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Last Updated: Jul 14, 2026

A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers
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  • Included studies comparing FM patients (any ACR criteria) with healthy controls using quantitative structural MRI, diffusion/structural connectivity, or resting-state/task-based fMRI.

    • Main Results:

    • Morphometry consistently showed reduced grey matter in anterior cingulate, insula, and prefrontal cortices.
    • Diffusion imaging yielded sparse and inconsistent white-matter alterations.
    • Task-based fMRI demonstrated hyper-responsivity in nociceptive networks and impaired top-down modulation (rACC-PAG/brainstem).
    • Resting-state fMRI findings were highly heterogeneous and contradictory.

    Conclusions:

    • Fibromyalgia exhibits distributed brain alterations, not a single biomarker.
    • Task-evoked nociceptive amplification and impaired descending modulation are the most coherent cross-study signals.
    • Harmonized, longitudinal multimodal neuroimaging studies are needed to establish reliable biomarkers for FM.