{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:25:05Z","timestamp":1788449105250,"version":"build-2803163510"},"reference-count":139,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Fibromyalgia (FM) is a nociplastic chronic pain syndrome in which neuroimaging indicates central nervous system involvement, yet findings remain inconsistent across methods. We systematically reviewed structural and functional neuroimaging studies in adults with FM to identify the most reproducible cross\u2010modal alterations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Databases and Data Treatment<\/jats:title>\n                    <jats:p>Following a PROSPERO\u2010registered protocol (CRD420251234980) and PRISMA 2020, we searched PubMed, EMBASE, Web of Science and VHL\/BVS for English\u2010language studies published between 1 January 2010 and 16 October 2025. Eligible studies compared FM (any American College of Rheumatology criteria) with healthy controls and reported quantitative structural MRI, diffusion\/structural connectivity or resting\u2010state\/task\u2010based fMRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety\u2010one studies were included (24 morphometry, 8 diffusion\/structural connectivity, 32 resting\u2010state fMRI, 40 task\u2010based fMRI). Morphometry most consistently showed reduced grey matter volume or cortical thickness in anterior cingulate, insular and prefrontal\/orbitofrontal cortices, with recurrent reductions in temporal cortex, posterior cingulate, amygdala and hippocampus; thalamic increases were less frequent. Diffusion findings were sparse and bidirectional, yielding no stable white\u2010matter alterations. Resting\u2010state fMRI was highly heterogeneous, with contradictory default\u2010mode, salience\/insula and periaqueductal grey (PAG)\u2010related connectivity changes. Task\u2010based fMRI provided the clearest support for central sensitization, showing hyper\u2010responsivity of nociceptive networks with dysregulated prefrontal engagement and weakened rostral anterior cingulate cortex (rACC)\u2013PAG\/brainstem descending modulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FM shows distributed brain alterations, with the most robust signals reflecting nociceptive amplification and impaired top\u2010down control. Harmonized longitudinal multimodal studies are needed to establish reliable biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>This systematic review shows that fibromyalgia neuroimaging findings are not best explained by a single biomarker, but by distributed alterations across pain\u2010processing, modulatory and affective\u2010cognitive systems. By comparing structural MRI, diffusion imaging, resting\u2010state fMRI and task\u2010based fMRI, the review identifies task\u2010evoked nociceptive amplification and impaired descending modulation as the most coherent cross\u2010study signal, while clarifying why resting\u2010state and diffusion findings remain difficult to translate clinically.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70331","type":"journal-article","created":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T16:00:41Z","timestamp":1783872041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structural and Functional Neuroimaging Findings in Fibromyalgia: A Systematic Review"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7743-5517","authenticated-orcid":false,"given":"Fl\u00e1vio Ant\u00f4nio Duboc","family":"Flutt","sequence":"first","affiliation":[{"name":"Pain Center, Rio de 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