{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:17:26Z","timestamp":1784099846233,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH076136"],"award-info":[{"award-number":["R01 MH076136"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1\u2010TR\u2010002386"],"award-info":[{"award-number":["TL1\u2010TR\u2010002386"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01 DA035484"],"award-info":[{"award-number":["R01 DA035484"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Heightened sensitivity to noxious stimulation is a hallmark of chronic pain. Emerging evidence suggests heightened unpleasantness to non\u2010noxious (eg, auditory) aversive stimulation also characterizes chronic pain, but its magnitude, neural mechanisms, and treatment modifiability remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared behavioral and neural responses to auditory and pressure stimulation in 142 adults with chronic back pain (CBP) relative to 51 pain\u2010free controls. CBP patients then entered a randomized trial of pain reprocessing therapy (PRT) versus placebo and usual care. During functional magnetic resonance imaging, participants experienced low\u2010 and high\u2010intensity aversive sounds and mechanical pressure and provided unpleasantness ratings. Univariate analyses examined responses in primary sensory, sensory\u2010integrative, and midline default mode network regions. Multivariate analyses tested 4 a priori whole\u2010brain patterns, including patterns predictive of fibromyalgia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CBP patients versus healthy controls reported heightened unpleasantness to auditory stimuli (Hedges'\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.95\u20131.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and mechanical pressure (\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.49\u20130.66;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For patients versus controls, auditory stimulation revealed hyperresponsivity in primary auditory cortex and insula, hyporesponsivity in the precuneus and medial prefrontal cortex (\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.33\u20130.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and increased expression of generalized and auditory\u2010specific aversive processing patterns (\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.33\u20130.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and of fibromyalgia\u2010derived multisensory sensitivity patterns (\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20090.43\u20130.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Longitudinal analysis found that PRT versus placebo led to reduced unpleasantness of low\u2010intensity auditory stimulation, along with increased medial prefrontal cortex responses for PRT versus usual care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>CBP is associated with pronounced auditory hyperresponsivity via modality\u2010specific and modality\u2010general neural pathways, and brain mechanisms overlap with fibromyalgia. PRT versus control produced small reductions in this hyperresponsivity, suggesting potential for PRT to yield broader \u201ccentral desensitization\u201d. ANN NEUROL 20269999:n\/a\u2013n\/a<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78183","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:37:26Z","timestamp":1772962646000},"page":"1555-1567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Auditory Hyperresponsivity in Chronic Back Pain: A Randomized Controlled Trial of Pain Reprocessing Therapy"],"prefix":"10.1002","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8719-6688","authenticated-orcid":false,"given":"Alina E. C.","family":"Panzel","sequence":"first","affiliation":[{"name":"Department of Systems Neuroscience University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Max Planck School of Cognition  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"B\u00fcchel","sequence":"additional","affiliation":[{"name":"Department of Systems Neuroscience University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Max Planck School of Cognition  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Leroux","sequence":"additional","affiliation":[{"name":"School of Public Health University of Colorado Anschutz Medical Campus  Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor D.","family":"Wager","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences Dartmouth College  Hanover NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoni K.","family":"Ashar","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine University of Colorado Anschutz Medical Campus  Aurora CO 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