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We recorded 3T functional magnetic resonance imaging resting\u2010state data from 17 upper\u2010limb CRPS type 1 patients and 19 healthy control subjects to identify alterations of patients' SM1 function during spontaneous pain and to find out how the spatial distribution of these alterations were related to peripheral symptoms. Seed\u2010based correlations and independent component analyses indicated that patients' upper\u2010limb SM1 representation areas display (i) reduced interhemispheric connectivity, associated with the combined effect of intensity and spatial extent of limb pain, (ii) increased connectivity with the right anterior insula that positively correlated with the duration of CRPS, (iii) increased connectivity with periaqueductal gray matter, and (iv) disengagement from the other parts of the SM1 network. These findings, now reported for the first time in CRPS, parallel the alterations found in patients suffering from other chronic pain conditions or from limb denervation; they also agree with findings in healthy persons who are exposed to experimental pain or have used their limbs asymmetrically. Our results suggest that CRPS is associated with a sustained and somatotopically specific alteration of SM1 function, that has correspondence to the spatial distribution of the peripheral manifestations and to the duration of the syndrome.<\/jats:p>","DOI":"10.1002\/hbm.26513","type":"journal-article","created":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T17:58:47Z","timestamp":1697306327000},"page":"6258-6274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Somatotopic disruption of the functional connectivity of the primary sensorimotor cortex in complex regional pain syndrome type 1"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0690-9269","authenticated-orcid":false,"given":"Jaakko","family":"Hotta","sequence":"first","affiliation":[{"name":"Department of Neuroscience and Biomedical Engineering Aalto University School of Science  Espoo Finland"},{"name":"Aalto 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