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Here we conduct a multi-ancestry genome-wide association study meta-analysis across 2,563,755 individuals (54,629 cases and 2,509,126 controls) from 11 cohorts, identifying 26 risk loci for fibromyalgia. The strongest association was with a coding variant in\n                    <jats:italic>HTT<\/jats:italic>\n                    , the causal gene for Huntington\u2019s disease. Gene prioritization implicated the\n                    <jats:italic>HTT<\/jats:italic>\n                    regulator\n                    <jats:italic>GPR52<\/jats:italic>\n                    , as well as diverse genes with neural roles, including\n                    <jats:italic>DCC<\/jats:italic>\n                    ,\n                    <jats:italic>DRD2<\/jats:italic>\n                    \/\n                    <jats:italic>NCAM1<\/jats:italic>\n                    ,\n                    <jats:italic>MDGA2<\/jats:italic>\n                    and\n                    <jats:italic>CELF4<\/jats:italic>\n                    . Fibromyalgia heritability was exclusively enriched within brain tissues and neural cell types. Fibromyalgia showed strong, positive genetic correlation with a wide range of chronic pain, psychiatric and somatic disorders, including genetic correlations above 0.7 with low back pain, post-traumatic stress disorder and irritable bowel syndrome. Despite large sex differences in fibromyalgia prevalence, the genetic architecture of fibromyalgia was nearly identical between males and females. This study provides robust genetic evidence defining fibromyalgia as a central nervous system disorder, thereby establishing a biological framework for its complex pathophysiology and extensive clinical comorbidities.\n                  <\/jats:p>","DOI":"10.1038\/s41591-026-04492-6","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:01:55Z","timestamp":1785229315000},"page":"3060-3070","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The genetic architecture of fibromyalgia across 2.5 million 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S.F. is a consultant for Vertex Pharmaceuticals. B.G. has received research grants (paid to institution) from Sandoz, AbbVie, AlfaSigma and Eli Lilly. S.B. has ownership interests in Hoba Therapeutics Aps, Novo Nordisk A\/S, Lundbeck A\/S and Eli Lilly and Co. C.E. has received unrestricted research grants from Novo Nordisk and Abbott Diagnostics (administered by Aarhus University Hospital; no personal fees received). G.B., T.E.T., G.E.T., T.A.O., S.S., H.S., I.J., A.T.S., G.T., L.S., U.T., P.S. and D.F.G. are employees of Amgen deCODE Genetics. The other authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}