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Here we focused on the primary somatosensory system (SS) involved in pain processing, namely the ventroposterolateral thalamus (VPL) and the primary somatosensory cortex (SI). We evaluated, using MRI, three specific processes: (a) somatotopy of changes in the SS for different pain origins (viz., foot vs. arm); (b) differences in acute (ankle sprain versus complex regional pain syndrome\u2010CRPS); and (c) differences of the effects of CRPS on SS in pediatric versus adult patients. In all cases, age\u2010 and sex\u2010matched individuals were used as controls. Our results suggest a shift in concurrent gray matter density (GMD) and resting functional connectivity strengths (rFC) across pediatric and adult CRPS with (a) differential patterns of GMD (VPL) and rFC (SI) on SS in pediatric vs. adult patterns that are consistent with upper and lower limb somatotopical organization; and (b) widespread GMD alterations in pediatric CRPS from sensory, emotional and descending modulatory processes to more confined sensory\u2010emotional changes in adult CRPS and rFC patterns from sensory\u2010sensory alterations in pediatric populations to a sensory\u2010emotional change in adult populations. These results support the idea that pediatric and adult CRPS are differentially represented and may reflect underlying differences in pain chronification across age groups that may contribute to the well\u2010known differences between child and adult pain vulnerability and resilience.<\/jats:p>","DOI":"10.1002\/hbm.24709","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T11:40:21Z","timestamp":1562931621000},"page":"4381-4396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Shifting brain circuits in pain chronicity"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8025-3080","authenticated-orcid":false,"given":"Andrew M.","family":"Youssef","sequence":"first","affiliation":[{"name":"Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital  Boston Massachusetts"},{"name":"Department of Anesthesia Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Azqueta\u2010Gavaldon","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Physical Medicine and Rehabilitation Medical Centre of University of Munich  Munich Germany"},{"name":"Interdisciplinary Pain Unit Medical Centre of University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie E.","family":"Silva","sequence":"additional","affiliation":[{"name":"Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital  Boston Massachusetts"},{"name":"Department of Anesthesia Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Barakat","sequence":"additional","affiliation":[{"name":"Center for Pain and the Brain, 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