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Nevertheless, the current knowledge on specific neural circuitries that may occur in different CMP subgroups is limited, which in turn limits the understanding of the encephalon mechanisms associated with persistent pain and clinical heterogeneity. This systematic review (CRD42022382309) and activation likelihood estimation (ALE) meta\u2010analysis of observational functional magnetic resonance imaging (fMRI) studies on human encephalon aimed to characterize specific patterns of connectomic reorganization in different CMP subgroups. PubMed, Web of Science, and Scopus databases were searched. Two independent reviewers read titles and abstracts, full texts, assessed methodological quality using the Newcastle\u2013Ottawa scale, and extracted\n                    <jats:italic>X<\/jats:italic>\n                    ,\n                    <jats:italic>Y<\/jats:italic>\n                    , and\n                    <jats:italic>Z<\/jats:italic>\n                    coordinates. The data analyses were conducted using the GingerALE 3.0.2 software and complemented by frequency analyses. All neuroanatomical coordinates used in the ALE meta\u2010analyses were standardized to the Montreal Neurological Institute 152 space. A 95% confidence interval (CI) for the family\u2010wise error (FWE) rate was applied using an initial uncorrected voxel\u2010level threshold of\n                    <jats:italic>p<\/jats:italic>\n                    \u2009 &lt; 0.001, together with 1000 permutation tests and a minimum cluster volume of \u2265200\u2009mm\n                    <jats:sup>3<\/jats:sup>\n                    . In total, 43 studies out of 5543 records met the inclusion criteria and none presented a very high risk of bias. The seven encephalon regions comprising the basic neural circuitry of CMP (somatosensory cortex, motor cortex, anterior cingulate cortex, insula, prefrontal cortex, thalamus, and cerebellum) correspond to an integrated connectomic hub that coordinates sensory\u2013motor discriminative, affective\u2010emotional, and cognitive\u2010motivational processing. Additionally, 13 other regions are specifically recruited in distinct conditions of CMP. These parallel connections expand the processing network and add dimensions related to reward, memory, descending pain modulation, and attention. This dynamic reorganization reflects a pattern of cross\u2010modal plasticity with maladaptive mechanisms.\n                  <\/jats:p>","DOI":"10.1155\/np\/5301861","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T01:21:03Z","timestamp":1778289663000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Connectomic Mapping of Chronic Musculoskeletal Pain: Neural Circuitries Identified Through a Systematic Review and ALE Meta\u2010Analysis"],"prefix":"10.1155","volume":"2026","author":[{"given":"Jeffeson Hildo Medeiros de","family":"Queiroz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel Mesquita da Concei\u00e7\u00e3o","family":"Bahia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcio 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