{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:18:18Z","timestamp":1792275498394,"version":"4.4.0"},"reference-count":101,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["K3_01_06"],"award-info":[{"award-number":["K3_01_06"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite functional connectivity network dysfunction among individuals with headaches, no studies have examined functional connectivity neural correlates and anatomical differences in coping with headaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study investigated inter\u2010individual variability in whole\u2010brain functional connectivity and anatomical differences among 37 individuals with primary headaches and 24 age\u2010 and gender\u2010matched controls, and neural correlates of psychological flexibility (PF) that was previously found to contribute to headache adjustment. Participants (84% women; <jats:italic>M<\/jats:italic> headache severity\u2009=\u20094\/10; <jats:italic>M<\/jats:italic> age\u2009=\u200943\u2009years) underwent functional magnetic resonance imaging scans and completed questionnaires to examine global and subnetwork brain areas, and their relations with PF components, controlling for age, gender, education, and head\u2010motion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seed and voxel\u2010based contrast analyses between groups showed atypical functional connectivity of regions involved in pain matrix and core resting\u2010state networks. Pain acceptance was the sole PF component that correlated with the cerebellum (<jats:italic>x<\/jats:italic>, <jats:italic>y<\/jats:italic>, <jats:italic>z<\/jats:italic>: 28, \u221272, \u221234, <jats:italic>p<\/jats:italic>\u2010false discovery rate\u2009&lt;0.001), where individuals with headaches showed higher grey matter density compared to controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The cerebellum, recently implicated in modulating emotional and cognitive processes, was indicated to process information resembling what individuals do when practicing pain acceptance. Our findings establish for the first time this connection of the cerebellum and its role in pain acceptance. We propose that pain acceptance might be a behavioural biomarker target that could modulate problematic headache perceptions and brain networks abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study highlights the potential use of emerging behavioural biomarkers in headache management, such as pain acceptance, and their role in modifying the headache experience. Notably, grey matter reorganization in the cerebellum and other known brain pain networks, could indicate brain networks that can be modified from targeted behavioural interventions to help decode the nociplastic mechanisms that predominates in headaches.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.4734","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T12:25:00Z","timestamp":1727785500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Neural correlates of pain acceptance and the role of the cerebellum: Functional connectivity and anatomical differences in individuals with headaches versus matched controls"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3501-4093","authenticated-orcid":false,"given":"Vasilis S.","family":"Vasiliou","sequence":"first","affiliation":[{"name":"Department of Psychology Royal Holloway, University of London  Egham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4531-3636","authenticated-orcid":false,"given":"Nikos","family":"Konstantinou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences Cyprus University of Technology  Limassol Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6201-182X","authenticated-orcid":false,"given":"Yiolanda","family":"Christou","sequence":"additional","affiliation":[{"name":"Neurology Clinic B\u2032 The Cyprus Institute of Neurology and Genetics  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3845-7439","authenticated-orcid":false,"given":"Savvas","family":"Papacostas","sequence":"additional","affiliation":[{"name":"Neurology Clinic B\u2032 The Cyprus Institute of Neurology and Genetics  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7928-8363","authenticated-orcid":false,"given":"Fofi","family":"Constantinidou","sequence":"additional","affiliation":[{"name":"Center for Applied Neuroscience, University of Cyprus  Nicosia Cyprus"},{"name":"Department of Psychology University of Cyprus  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5791-4362","authenticated-orcid":false,"given":"Eleni","family":"Heracleous","sequence":"additional","affiliation":[{"name":"Medical Diagnostic Center \u201cAyios Therissos\u201d  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3665-5271","authenticated-orcid":false,"given":"Ioannis","family":"Seimenis","sequence":"additional","affiliation":[{"name":"Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-7908","authenticated-orcid":false,"given":"Maria","family":"Karekla","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Cyprus  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.587018"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.11.006"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5062\u201008.2009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122\u2010022\u201000365\u20101"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aav0581"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12671\u2010020\u201001368\u20109"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465813000234"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2021.680531"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X17740794"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/11795735231205413"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102019\u2010321025"},{"issue":"2","key":"e_1_2_11_13_1","first-page":"129","article-title":"Pain assessment: Global use of the Brief Pain Inventory","volume":"23","author":"Cleeland C. 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