{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:41:53Z","timestamp":1787240513881,"version":"build-2736575974"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bangerter-Rhyner foundation"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Fibromyalgia is characterized by chronic pain and a striking discrepancy between objective signs of tissue damage and severity of pain. Function and structural alterations in brain areas involved in pain processing may explain this feature. Previous case-control studies in fibromyalgia focused on acute pain processing using experimentally-evoked pain paradigms. Yet, these studies do not allow conclusions about chronic, stimulus-independent pain. Resting-state cerebral blood flow (rsCBF) acquired by arterial spin labelling (ASL) may be a more accurate marker for chronic pain. The objective was to integrate four different functional and structural neuroimaging markers to evaluate the neural correlate of chronic, stimulus-independent pain using a resting-state paradigm. In line with the pathophysiological concept of enhanced central pain processing we hypothesized that rsCBF is increased in fibromyalgia in areas involved in processing of acute pain. We performed an age matched case-control study of 32 female fibromyalgia patients and 32 pain-free controls and calculated group differences in rsCBF, resting state functional connectivity, grey matter volume and cortical thickness using whole-brain and region of interest analyses. We adjusted all analyses for depression and anxiety. As centrally acting drugs are likely to interfere with neuroimaging markers, we performed a subgroup analysis limited to patients not taking such drugs. We found no differences between cases and controls in rsCBF of the thalamus, the basal ganglia, the insula, the somatosensory cortex, the prefrontal cortex, the anterior cingulum and supplementary motor area as brain areas previously identified to be involved in acute processing in fibromyalgia. The results remained robust across all neuroimaging markers and when limiting the study population to patients not taking centrally acting drugs and matched controls. In conclusion, we found no evidence for functional or structural alterations in brain areas involved in acute pain processing in fibromyalgia that could reflect neural correlates of chronic stimulus-independent pain.<\/jats:p>","DOI":"10.1371\/journal.pone.0235879","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T15:17:20Z","timestamp":1612279040000},"page":"e0235879","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Altered central pain processing in fibromyalgia\u2014A multimodal neuroimaging case-control study using arterial spin labelling"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7792-8227","authenticated-orcid":true,"given":"Monika","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6007-8668","authenticated-orcid":true,"given":"Florian","family":"W\u00fcthrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Federspiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Wiest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklaus","family":"Egloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Reichenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristomenis","family":"Exadaktylos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"J\u00fcni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-6826","authenticated-orcid":true,"given":"Michele","family":"Curatolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Walther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"pone.0235879.ref001","article-title":"Burden of Illness and Treatment Patterns for Patients with Fibromyalgia","author":"RL Robinson","year":"2012","journal-title":"Pain Med"},{"issue":"6","key":"pone.0235879.ref002","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.3899\/jrheum.100594","article-title":"Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia","volume":"38","author":"F Wolfe","year":"2011","journal-title":"The Journal of rheumatology"},{"issue":"6","key":"pone.0235879.ref003","first-page":"1318","article-title":"Economic cost and epidemiological characteristics of patients with fibromyalgia claims","volume":"30","author":"RL Robinson","year":"2003","journal-title":"The Journal of rheumatology"},{"issue":"3","key":"pone.0235879.ref004","first-page":"475","article-title":"Fibromyalgia and quality of life: a comparative analysis","volume":"20","author":"CS Burckhardt","year":"1993","journal-title":"The Journal of rheumatology"},{"issue":"1","key":"pone.0235879.ref005","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/j.1742-1241.2007.01638.x","article-title":"The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12","volume":"62","author":"DL Hoffman","year":"2008","journal-title":"International journal of clinical practice"},{"issue":"2","key":"pone.0235879.ref006","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1136\/annrheumdis-2016-209724","article-title":"EULAR revised recommendations for the management of fibromyalgia","volume":"76","author":"GJ Macfarlane","year":"2017","journal-title":"Annals of the rheumatic diseases"},{"issue":"1","key":"pone.0235879.ref007","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.semarthrit.2014.01.001","article-title":"Central sensitization in fibromyalgia? 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