{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:08:02Z","timestamp":1768568882710,"version":"3.49.0"},"posted":{"date-parts":[[2024,6,6]]},"group-title":"Pain Medicine","reference-count":50,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,6,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Juvenile fibromyalgia (JFM) is a chronic pain syndrome predominantly affecting adolescent girls. Resilience may be a protective factor in coping with pain, reducing affective burden, and promoting positive outlooks. Brain regions affected in JFM overlap with those linked to resilience, particularly in the default-mode network (DMN). We investigate the role of resilience on core somatic and affective symptoms in JFM and assess the neurophysiological substrates for the first time.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Forty-one girls with JFM and 40 pain-free adolescents completed a resting-state fMRI assessment and self-report questionnaires. We used clustering analyses to group JFM participants based on resilience, and principal component analyses to summarize core somatic and affective symptoms. We estimated whole-brain and within-DMN connectivity and assessed differences between higher and lower resilience JFM groups and compared their connectivity patterns to pain-free participants.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The higher resilience JFM group had less affective (T=4.03; p&lt;.001) but similar core somatic symptoms (T=1.05; p=.302) than the lower resilience JFM group. They had increased whole-brain (T\u2019s&gt;3.90, pFDR\u2019s&lt;.03) and within-DMN (T=2.20, p=.03) connectivity strength, and higher connectivity between DMN nodes and self-referential, regulatory, and reward-processing regions. Conversely, higher DMN-premotor connectivity was observed in the lower resilience group.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>JFM participants with higher resilience were protected affectively but not in core somatic symptoms. Greater resilience was accompanied by higher signal integration within the DMN, a network central to internally oriented attention and flexible attention shifting. Crucially, the connectivity pattern in highly resilient patients resembled that of pain-free adolescents, which was not the case for the lower resilience group.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.06.05.24308376","type":"posted-content","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T06:50:15Z","timestamp":1718002215000},"source":"Crossref","is-referenced-by-count":2,"title":["Neurophysiology of Resilience in Juvenile Fibromyalgia"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4731-4811","authenticated-orcid":false,"given":"Maria","family":"Su\u00f1ol","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sa\u00fcl","family":"Pascual-Diaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Dudley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Payne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Ting","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susmita","family":"Kashikar-Zuck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Coghill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"L\u00f3pez-Sol\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"issue":"5","key":"2024061621250839000_2024.06.05.24308376v1.1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1002\/acr.24202","article-title":"Modified 2016 American College of Rheumatology Fibromyalgia Criteria, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy, and the Prevalence of Fibromyalgia","volume":"73","year":"2021","journal-title":"Arthritis Care Res"},{"issue":"169","key":"2024061621250839000_2024.06.05.24308376v1.2","first-page":"181","article-title":"American College of Rheumatology Adult Fibromyalgia Criteria for Use in an Adolescent Female Population with Juvenile Fibromyalgia","volume":"2016","year":"2010","journal-title":"J Pediatr"},{"issue":"2","key":"2024061621250839000_2024.06.05.24308376v1.3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/j.pain.0000000000001415","article-title":"Long-term outcomes of adolescents with juvenile-onset fibromyalgia into adulthood and impact of depressive symptoms on functioning over time","volume":"160","year":"2019","journal-title":"Pain"},{"key":"2024061621250839000_2024.06.05.24308376v1.4","doi-asserted-by":"publisher","DOI":"10.1007\/BF02879899"},{"key":"2024061621250839000_2024.06.05.24308376v1.5","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-010-0095-9"},{"key":"2024061621250839000_2024.06.05.24308376v1.6","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jpeds.2019.03.006","article-title":"The Role of Patient and Parental Resilience in Adolescents with Chronic Musculoskeletal Pain","volume":"210","year":"2019","journal-title":"J Pediatr"},{"issue":"1","key":"2024061621250839000_2024.06.05.24308376v1.7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12969-020-00487-w","article-title":"Suicidal risk and resilience in juvenile fibromyalgia syndrome: a cross-sectional cohort study","volume":"19","year":"2021","journal-title":"Pediatr Rheumatol Online J"},{"issue":"2","key":"2024061621250839000_2024.06.05.24308376v1.8","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/art.42691","article-title":"Reduced Cortico-Cortical Resting-State Connectivity in Sensory Systems Related to Bodily Pain in Juvenile Fibromyalgia","volume":"76","year":"2024","journal-title":"Arthritis Rheumatol"},{"issue":"7","key":"2024061621250839000_2024.06.05.24308376v1.9","first-page":"1284","article-title":"Brain Structural Changes During Juvenile Fibromyalgia: Relationships With Pain","volume":"74","year":"2022","journal-title":"Fatigue, and Functional Disability. Arthritis Rheumatol"},{"key":"2024061621250839000_2024.06.05.24308376v1.10","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.neubiorev.2021.11.001","article-title":"Resilience and young people\u2019s brain structure, function and connectivity: A systematic review","volume":"132","year":"2022","journal-title":"Neurosci Biobehav Rev"},{"key":"2024061621250839000_2024.06.05.24308376v1.11","doi-asserted-by":"crossref","unstructured":"Zhang L , Rakesh D , Cropley V , Whittle S . Neurobiological correlates of resilience during childhood and adolescence - A systematic review. Clin Psychol Rev. 2023;105:102333.","DOI":"10.1016\/j.cpr.2023.102333"},{"key":"2024061621250839000_2024.06.05.24308376v1.12","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2015.0388"},{"key":"2024061621250839000_2024.06.05.24308376v1.13","doi-asserted-by":"crossref","unstructured":"Thomas SA , Ryan SK , Gilman J . Resting state network connectivity is associated with cognitive flexibility performance in youth in the Adolescent Brain Cognitive Development Study. Neuropsychologia. 2023;191:108708.","DOI":"10.1016\/j.neuropsychologia.2023.108708"},{"key":"2024061621250839000_2024.06.05.24308376v1.14","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1364.028"},{"key":"2024061621250839000_2024.06.05.24308376v1.15","doi-asserted-by":"publisher","DOI":"10.1177\/1745691612436694"},{"key":"2024061621250839000_2024.06.05.24308376v1.16","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000157"},{"key":"2024061621250839000_2024.06.05.24308376v1.17","doi-asserted-by":"crossref","unstructured":"Jones SA , Morales AM , Holley AL , Wilson AC , Nagel BJ . Default mode network connectivity is related to pain frequency and intensity in adolescents. Neuroimage Clin. 2020;27:102326.","DOI":"10.1016\/j.nicl.2020.102326"},{"key":"2024061621250839000_2024.06.05.24308376v1.18","doi-asserted-by":"publisher","DOI":"10.1177\/1073858411403316"},{"key":"2024061621250839000_2024.06.05.24308376v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2012.10.008"},{"key":"2024061621250839000_2024.06.05.24308376v1.20","doi-asserted-by":"crossref","unstructured":"Davey CG , Fornito A , Pujol J , Breakspear M , Schmaal L , Harrison BJ . Neurodevelopmental correlates of the emerging adult self. Dev Cogn Neurosci. 2019;36:100626.","DOI":"10.1016\/j.dcn.2019.100626"},{"issue":"1","key":"2024061621250839000_2024.06.05.24308376v1.21","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12969-019-0375-9","article-title":"Weiss JE, for the CARRA Registry Investigators. Pain, functional disability, and their Association in Juvenile Fibromyalgia Compared to other pediatric rheumatic diseases","volume":"17","year":"2019","journal-title":"Pediatr Rheumatol Online J"},{"key":"2024061621250839000_2024.06.05.24308376v1.22","doi-asserted-by":"publisher","DOI":"10.1002\/art.30644"},{"key":"2024061621250839000_2024.06.05.24308376v1.23","doi-asserted-by":"crossref","unstructured":"Kashikar-Zuck S , Briggs MS , Bout-Tabaku S , et al. Randomized clinical trial of Fibromyalgia Integrative Training (FIT teens) for adolescents with juvenile fibromyalgia - Study design and protocol. Contemp Clin Trials. 2021;103:106321.","DOI":"10.1016\/j.cct.2021.106321"},{"key":"2024061621250839000_2024.06.05.24308376v1.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.07.039"},{"issue":"7","key":"2024061621250839000_2024.06.05.24308376v1.25","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1038\/s41583-020-0310-6","article-title":"Qualitative sex differences in pain processing: emerging evidence of a biased literature","volume":"21","year":"2020","journal-title":"Nat Rev Neurosci"},{"key":"2024061621250839000_2024.06.05.24308376v1.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.03.053"},{"key":"2024061621250839000_2024.06.05.24308376v1.27","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/acr.24197","article-title":"Measures of Juvenile Fibromyalgia","volume":"72","year":"2020","journal-title":"Arthritis Care Res"},{"key":"2024061621250839000_2024.06.05.24308376v1.28","doi-asserted-by":"publisher","DOI":"10.1037\/t19482-000"},{"key":"2024061621250839000_2024.06.05.24308376v1.29","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199910000-00011"},{"key":"2024061621250839000_2024.06.05.24308376v1.30","doi-asserted-by":"publisher","DOI":"10.1080\/15298860309027"},{"key":"2024061621250839000_2024.06.05.24308376v1.31","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2012.0073"},{"key":"2024061621250839000_2024.06.05.24308376v1.32","unstructured":"Core Team R. R: A language and environment for statistical computing [computer software]. Vienna, Austria: R Foundation for Statistical Computing. 2021."},{"key":"2024061621250839000_2024.06.05.24308376v1.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.06.075"},{"key":"2024061621250839000_2024.06.05.24308376v1.34","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhw157"},{"key":"2024061621250839000_2024.06.05.24308376v1.35","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00338.2011"},{"key":"2024061621250839000_2024.06.05.24308376v1.36","unstructured":"Field A . Discovering Statistics Using IBM spss statistics. Thousand Oaks, CA. November 2017."},{"key":"2024061621250839000_2024.06.05.24308376v1.37","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20271"},{"key":"2024061621250839000_2024.06.05.24308376v1.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.12.019"},{"key":"2024061621250839000_2024.06.05.24308376v1.39","doi-asserted-by":"publisher","DOI":"10.1093\/scan\/nsp052"},{"key":"2024061621250839000_2024.06.05.24308376v1.40","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.06481"},{"key":"2024061621250839000_2024.06.05.24308376v1.41","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt162"},{"key":"2024061621250839000_2024.06.05.24308376v1.42","doi-asserted-by":"crossref","unstructured":"Galvez-S\u00e1nchez CM , Reyes Del Paso GA, Duschek S. Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem. Front Psychol. 2018;9:377.","DOI":"10.3389\/fpsyg.2018.00377"},{"key":"2024061621250839000_2024.06.05.24308376v1.43","doi-asserted-by":"publisher","DOI":"10.1002\/art.34412"},{"key":"2024061621250839000_2024.06.05.24308376v1.44","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.nicl.2017.10.019","article-title":"Disruption of default mode network dynamics in acute and chronic pain states","volume":"17","year":"2018","journal-title":"Neuroimage Clin"},{"key":"2024061621250839000_2024.06.05.24308376v1.45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106133"},{"key":"2024061621250839000_2024.06.05.24308376v1.46","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113560"},{"key":"2024061621250839000_2024.06.05.24308376v1.47","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.nicl.2018.02.003","article-title":"\u201cMotoring in idle\u201d: The default mode and somatomotor networks are overactive in children and adolescents with functional neurological symptoms","volume":"18","year":"2018","journal-title":"Neuroimage Clin"},{"key":"2024061621250839000_2024.06.05.24308376v1.48","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1108241108"},{"issue":"1","key":"2024061621250839000_2024.06.05.24308376v1.49","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1002\/art.42672","article-title":"A Randomized Controlled Neuroimaging Trial of Cognitive Behavioral Therapy for Fibromyalgia Pain","volume":"76","year":"2024","journal-title":"Arthritis Rheumatol"},{"key":"2024061621250839000_2024.06.05.24308376v1.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2021.08.027"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2024.06.05.24308376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:02:34Z","timestamp":1768507354000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2024.06.05.24308376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,6]]},"references-count":50,"URL":"https:\/\/doi.org\/10.1101\/2024.06.05.24308376","relation":{"is-preprint-of":[{"id-type":"doi","id":"10.1097\/j.pain.0000000000003562","asserted-by":"subject"}]},"subject":[],"published":{"date-parts":[[2024,6,6]]},"subtype":"preprint"}}