{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:00:46Z","timestamp":1768341646049,"version":"3.49.0"},"reference-count":72,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Fibromyalgia and provoked vestibulodynia are two chronic pain conditions that disproportionately affect women. The mechanisms underlying the pain in these conditions are still poorly understood, but there is speculation that both may be linked to altered central sensitization and autonomic regulation. Neuroimaging studies of these conditions focusing on the brainstem and spinal cord to explore changes in pain regulation and autonomic regulation are emerging, but none to date have directly compared pain and autonomic regulation in these conditions. This study compares groups of women with fibromyalgia and provoked vestibulodynia to healthy controls using a threat\/safety paradigm with a predictable noxious heat stimulus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Functional magnetic resonance imaging data were acquired at 3 tesla in the cervical spinal cord and brainstem with previously established methods. Imaging data were analyzed with structural equation modeling and ANCOVA methods during: a period of noxious stimulation, and a period before the stimulation when participants were expecting the upcoming pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results demonstrate several similarities and differences between brainstem\/spinal cord connectivity related to autonomic and pain regulatory networks across the three groups in both time periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Based on the regions and connections involved in the differences, the altered pain processing in fibromyalgia appears to be related to changes in how autonomic and pain regulation networks are integrated, whereas altered pain processing in provoked vestibulodynia is linked in part to changes in arousal or salience networks as well as changes in affective components of pain regulation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2023.1171160","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T04:55:50Z","timestamp":1684731350000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Distinct neural signaling characteristics between fibromyalgia and provoked vestibulodynia revealed by means of functional magnetic resonance imaging in the brainstem and spinal cord"],"prefix":"10.3389","volume":"4","author":[{"given":"Gabriela","family":"Ioachim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard J. M.","family":"Warren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn M.","family":"Powers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Staud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline F.","family":"Pukall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick W.","family":"Stroman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,22]]},"reference":[{"key":"B1","first-page":"53","article-title":"Chronic pain at ages 12 to 44","volume-title":"Health Rep","author":"Ramage-Morin","year":"2010"},{"key":"B2","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1155\/2013\/918216","article-title":"2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary","volume":"18","author":"Fitzcharles","year":"2013","journal-title":"Pain Res Manag"},{"key":"B3","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/j.jpain.2018.02.009","article-title":"Symptoms of fibromyalgia according to the 2016 revised fibromyalgia criteria in chronic pain patients referred to multidisciplinary pain rehabilitation: influence on clinical and experimental pain sensitivity","volume":"19","author":"Plesner","year":"2018","journal-title":"J Pain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1016\/j.jpain.2021.02.009","article-title":"Fibromyalgia patients are not only hypersensitive to painful stimuli but also to acoustic stimuli","volume":"22","author":"Staud","year":"2021","journal-title":"J Pain"},{"key":"B5","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1097\/AOG.0000000000001359","article-title":"2015 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia","volume":"127","author":"Bornstein","year":"2016","journal-title":"Obstet Gynecol"},{"key":"B6","first-page":"812","article-title":"[The new consensus terminology of chronic vulvar pain and vulvodynia]","volume":"158","author":"Bornstein","year":"2019","journal-title":"Harefuah"},{"key":"B7","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.jsxm.2015.12.021","article-title":"Vulvodynia: definition, prevalence, impact, and pathophysiological factors","volume":"13","author":"Pukall","year":"2016","journal-title":"J Sex Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1097\/j.pain.0000000000001532","article-title":"Altered gray matter volume in sensorimotor and thalamic regions associated with pain in localized provoked vulvodynia: a voxel-based morphometry study","volume":"160","author":"Bhatt","year":"2019","journal-title":"Pain"},{"key":"B9","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/S0304-3959(01)00442-0","article-title":"Vestibular tactile and pain thresholds in women with vulvar vestibulitis syndrome","volume":"96","author":"Pukall","year":"2002","journal-title":"Pain"},{"key":"B10","first-page":"3","article-title":"One year in review 2020: fibromyalgia","volume":"38","author":"Bazzichi","year":"2020","journal-title":"Clin Exp Rheumatol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"131","DOI":"10.2174\/1573397111666150619095007","article-title":"Fibromyalgia: the prototypical central sensitivity syndrome","volume":"11","author":"Boomershine","year":"2015","journal-title":"Curr Rheumatol Rev"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1002\/hbm.23106","article-title":"FMRI Of spinal and supra-spinal correlates of temporal pain summation in fibromyalgia patients","volume":"37","author":"Bosma","year":"2016","journal-title":"Hum Brain Mapp"},{"key":"B13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.semarthrit.2014.01.001","article-title":"Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI","volume":"44","author":"Cagnie","year":"2014","journal-title":"Semin Arthritis Rheum"},{"key":"B14","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1097\/01.j.pain.0000461289.65571.54","article-title":"Disease-related differences in resting-state networks: a comparison between localized provoked vulvodynia, irritable bowel syndrome, and healthy control subjects","volume":"156","author":"Gupta","year":"2015","journal-title":"Pain"},{"key":"B15","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1016\/j.jpain.2013.01.767","article-title":"Augmented central pain processing in vulvodynia","volume":"14","author":"Hampson","year":"2013","journal-title":"J Pain"},{"key":"B16","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.pain.2005.02.020","article-title":"Neural correlates of painful genital touch in women with vulvar vestibulitis syndrome","volume":"115","author":"Pukall","year":"2005","journal-title":"Pain"},{"key":"B17","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1152\/jn.00276.2021","article-title":"Spinal cord neural activity of fibromyalgia patients and healthy controls during temporal summation of pain: an fMRI study","volume":"126","author":"Staud","year":"2021","journal-title":"J Neurophysiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1016\/j.ejpain.2008.02.002","article-title":"Brain activity associated with slow temporal summation of C-fiber evoked pain in fibromyalgia patients and healthy controls","volume":"12","author":"Staud","year":"2008","journal-title":"Eur J Pain"},{"key":"B19","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1016\/j.jpain.2007.06.006","article-title":"Temporal summation of second pain and its maintenance are useful for characterizing widespread central sensitization of fibromyalgia patients","volume":"8","author":"Staud","year":"2007","journal-title":"J Pain"},{"key":"B20","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S0304-3959(00)00432-2","article-title":"Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome","volume":"91","author":"Staud","year":"2001","journal-title":"Pain"},{"key":"B21","doi-asserted-by":"publisher","first-page":"682483","DOI":"10.3389\/fpain.2021.682483","article-title":"An investigation of descending pain modulation in women with provoked vestibulodynia (PVD): alterations of spinal cord and brainstem connectivity","volume":"2","author":"Yessick","year":"2021","journal-title":"Front Pain Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1038\/s41572-020-0164-2","article-title":"Vulvodynia","volume":"6","author":"Bergeron","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"B23","first-page":"105","article-title":"Fibromyalgia and the concept of resilience","author":"Casale","year":"2019","journal-title":"Clin Exp Rheumatol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"862976","DOI":"10.3389\/fneur.2022.862976","article-title":"Altered pain in the brainstem and spinal cord of fibromyalgia patients during the anticipation and experience of experimental pain","volume":"13","author":"Ioachim","year":"2022","journal-title":"Front Neurol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s10286-011-0150-6","article-title":"A comprehensive study of autonomic dysfunction in the fibromyalgia patients","volume":"22","author":"Kulshreshtha","year":"2012","journal-title":"Clin Auton Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3390\/biomedicines5020022","article-title":"New insights into the pathophysiology and treatment of fibromyalgia","volume":"5","author":"Schmidt-Wilcke","year":"2017","journal-title":"Biomedicines"},{"key":"B27","doi-asserted-by":"publisher","first-page":"457618","DOI":"10.1155\/2014\/457618","article-title":"Pain symptoms in fibromyalgia patients with and without provoked vulvodynia","volume":"2014","author":"Ghizzani","year":"2014","journal-title":"Pain Res Treat"},{"key":"B28","doi-asserted-by":"publisher","first-page":"751.e1","DOI":"10.1016\/j.ajog.2016.06.047","article-title":"Relationship between nongenital tender point tenderness and intravaginal muscle pain intensity: ratings in women with provoked vestibulodynia and implications for treatment","volume":"215","author":"Phillips","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1097\/01.ajp.0000210903.67849.af","article-title":"Tender point examination in women with vulvar vestibulitis syndrome","volume":"22","author":"Pukall","year":"2006","journal-title":"Clin J Pain"},{"key":"B30","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1097\/AOG.0b013e31825957cf","article-title":"Relationship between vulvodynia and chronic comorbid pain conditions","volume":"120","author":"Reed","year":"2012","journal-title":"Obstet Gynecol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"568","DOI":"10.3390\/brainsci10090568","article-title":"Coordinated human brainstem and spinal cord networks during the expectation of pain have elements unique from resting-state effects","volume":"10","author":"Ioachim","year":"2020","journal-title":"Brain Sci"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1097\/j.pain.0000000000001302","article-title":"Pain processing in the human brainstem and spinal cord before, during and after the application of noxious heat stimuli","volume":"159","author":"Stroman","year":"2018","journal-title":"Pain"},{"key":"B33","doi-asserted-by":"publisher","first-page":"100068","DOI":"10.1016\/j.ynpai.2021.100068","article-title":"Investigation of the neural basis of expectation-based analgesia in the human brainstem and spinal cord by means of functional magnetic resonance imaging","volume":"10","author":"Stroman","year":"2021","journal-title":"Neurobiol Pain"},{"key":"B34","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 fibromyalgia diagnostic criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin Arthritis Rheum"},{"key":"B35","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1038\/ncprheum0221","article-title":"Therapy insight: fibromyalgia\u2013a different type of pain needing a different type of treatment","volume":"2","author":"Dadabhoy","year":"2006","journal-title":"Nat Clin Pract Rheumatol"},{"key":"B36","author":"Spielberger","year":""},{"key":"B37","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1001\/archpsyc.1961.01710120031004","article-title":"An inventory for measuring depression","volume":"4","author":"Beck","year":"1961","journal-title":"Arch Gen Psychiatry"},{"key":"B38","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1037\/1040-3590.7.4.524","article-title":"The pain catastrophizing scale: development and validation","volume":"7","author":"Sullivan","year":"1995","journal-title":"Psychol Assess"},{"key":"B39","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.pain.2009.02.007","article-title":"Development and initial validation of an expanded and revised version of the short-form McGill pain questionnaire (SF-MPQ-2)","volume":"144","author":"Dworkin","year":"2009","journal-title":"Pain"},{"key":"B40","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.jsxm.2016.01.020","article-title":"Vulvodynia: assessment and treatment","volume":"13","author":"Goldstein","year":"2016","journal-title":"J Sex Med"},{"key":"B41","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1152\/jn.1997.78.2.992","article-title":"Characteristics of temporal summation of second pain sensations elicited by brief contact of glabrous skin by a preheated thermode","volume":"78","author":"Vierck","year":"1997","journal-title":"J Neurophysiol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"5038","DOI":"10.1002\/hbm.22993","article-title":"Neural correlates of temporal summation of second pain in the human brainstem and spinal cord","volume":"36","author":"Bosma","year":"2015","journal-title":"Hum Brain Mapp"},{"key":"B43","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3390\/brainsci8090173","article-title":"Ten key insights into the use of spinal cord fMRI","volume":"8","author":"Powers","year":"2018","journal-title":"Brain Sci"},{"key":"B44","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1097\/j.pain.0000000000001302","article-title":"Pain processing in the human brainstem and spinal cord before, during, and after the application of noxious heat stimuli","volume":"159","author":"Stroman","year":"2018","journal-title":"Pain"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e89086","DOI":"10.1371\/journal.pone.0089086","article-title":"Slow temporal summation of pain for assessment of central pain sensitivity and clinical pain of fibromyalgia patients","volume":"9","author":"Staud","year":"2014","journal-title":"PLoS One"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1002\/jmri.24656","article-title":"Spinal cord response to stepwise and block presentation of thermal stimuli: a functional MRI study","volume":"41","author":"Bosma","year":"2015","journal-title":"J Magn Reson Imaging"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1016\/j.mri.2009.05.038","article-title":"Spinal fMRI investigation of human spinal cord function over a range of innocuous thermal sensory stimuli and study-related emotional influences","volume":"27","author":"Stroman","year":"2009","journal-title":"Magn Reson Imaging"},{"key":"B48","doi-asserted-by":"publisher","first-page":"e0167317","DOI":"10.1371\/journal.pone.0167317","article-title":"Continuous descending modulation of the spinal cord revealed by functional MRI","volume":"11","author":"Stroman","year":"2016","journal-title":"PLoS One"},{"key":"B49","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1097\/LGT.0000000000000267","article-title":"Multimodal vulvar and peripheral sensitivity among women with vulvodynia: a case-control study","volume":"21","author":"Reed","year":"2017","journal-title":"J Low Genit Tract Dis"},{"key":"B50","doi-asserted-by":"publisher","first-page":"S291","DOI":"10.1007\/s00586-007-0582-9","article-title":"Vertebral artery anomaly with entry at C4\u2013avoiding a surgical pitfall: a case report","volume":"17","author":"Muller","year":"2008","journal-title":"Eur Spine J"},{"key":"B51","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.mri.2014.01.007","article-title":"Assessment of data acquisition parameters, and analysis techniques for noise reduction in spinal cord fMRI data","volume":"32","author":"Bosma","year":"2014","journal-title":"Magn Reson Imaging"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1016\/j.jpain.2014.07.006","article-title":"Music modulation of pain perception and pain-related activity in the brain, brain stem, and spinal cord: a functional magnetic resonance imaging study","volume":"15","author":"Dobek","year":"2014","journal-title":"J Pain"},{"key":"B53","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.1002\/mrm.26606","article-title":"Confirmation of resting-state BOLD fluctuations in the human brainstem and spinal cord after identification and removal of physiological noise","volume":"78","author":"Harita","year":"2017","journal-title":"Magn Reson Med"},{"key":"B54","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1109\/CVPR.2009.5206571","article-title":"Image registration by minimization of residual complexity","author":"Myronenko","year":"2009","journal-title":"Proc Cvpr Ieee"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1882","DOI":"10.1109\/TMI.2010.2053043","article-title":"Intensity-Based image registration by minimizing residual complexity","volume":"29","author":"Myronenko","year":"2010","journal-title":"Ieee T Med Imaging"},{"key":"B56","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.neuroscience.2015.08.059","article-title":"Inter-individual differences in pain processing investigated by functional magnetic resonance imaging of the brainstem and spinal cord","volume":"307","author":"Khan","year":"2015","journal-title":"Neuroscience"},{"key":"B57","volume-title":"Clinical anatomy of the cervical spine","author":"Lang","year":"1993"},{"key":"B58","first-page":"417","article-title":"Fila radicularia of the ventral and dorsal radices of the human spinal cord","volume":"128","author":"Lang","year":"1982","journal-title":"Gegenbaurs Morphol Jahrb"},{"key":"B59","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/978-3-211-73971-6","volume-title":"Internal architechture of the brain stem with key axial sections: Duvernoy\u2019s atlas of the human brain stem and cerebellum","author":"Naidich","year":"2009"},{"key":"B60","volume-title":"Co-planar stereotaxic atlas of the human brain","author":"Talairach","year":"1988"},{"key":"B61","volume-title":"Gray\u2019s anatomy: the anatomical basis of medicine and surgery, vol. 38th","author":"Williams","year":"1995"},{"key":"B62","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1038\/nrn894","article-title":"How do you feel? Interoception: the sense of the physiological condition of the body","volume":"3","author":"Craig","year":"2002","journal-title":"Nat Rev Neurosci"},{"key":"B63","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.neuroscience.2019.02.009","article-title":"Investigation of resting-state BOLD networks in the human brainstem and spinal cord","volume":"404","author":"Harita","year":"2019","journal-title":"Neuroscience"},{"key":"B64","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1089\/brain.2018.0659","article-title":"Comparing coordinated networks across the brainstem and spinal cord in the resting state and altered cognitive state","volume":"9","author":"Ioachim","year":"2019","journal-title":"Brain Connect"},{"key":"B65","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1615\/CritRevBiomedEng.2017020438","article-title":"Validation of structural equation modeling methods for functional MRI data acquired in the human brainstem and spinal cord","volume":"44","author":"Stroman","year":"2016","journal-title":"Crit Rev Biomed Eng"},{"key":"B66","doi-asserted-by":"publisher","first-page":"381","DOI":"10.2147\/JPR.S290795","article-title":"How fMRI analysis using structural equation modeling techniques can improve our understanding of pain processing in fibromyalgia","volume":"14","author":"Warren","year":"2021","journal-title":"J Pain Res"},{"key":"B67","doi-asserted-by":"publisher","first-page":"T93","DOI":"10.1016\/j.jpain.2016.06.002","article-title":"Overlapping chronic pain conditions: implications for diagnosis and classification","volume":"17","author":"Maixner","year":"2016","journal-title":"J Pain"},{"key":"B68","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/S0301-0082(02)00009-6","article-title":"Descending control of pain","volume":"66","author":"Millan","year":"2002","journal-title":"Prog Neurobiol"},{"key":"B69","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.neuroimage.2013.02.027","article-title":"Picture novelty attenuates semantic interference and modulates concomitant neural activity in the anterior cingulate cortex and the locus coeruleus","volume":"74","author":"Krebs","year":"2013","journal-title":"NeuroImage"},{"key":"B70","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.neuroimage.2016.06.011","article-title":"Spontaneous pupil dilations during the resting state are associated with activation of the salience network","volume":"139","author":"Schneider","year":"2016","journal-title":"NeuroImage"},{"key":"B71","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3389\/fnana.2017.00015","article-title":"The brainstem in emotion: a review","volume":"11","author":"Venkatraman","year":"2017","journal-title":"Front Neuroanat"},{"key":"B72","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/S0301-0082(01)00025-9","article-title":"The medullary dorsal reticular nucleus as a pronociceptive centre of the pain control system","volume":"66","author":"Lima","year":"2002","journal-title":"Prog Neurobiol"}],"container-title":["Frontiers in Pain Research"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2023.1171160\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T04:55:57Z","timestamp":1684731357000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2023.1171160\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,22]]},"references-count":72,"alternative-id":["10.3389\/fpain.2023.1171160"],"URL":"https:\/\/doi.org\/10.3389\/fpain.2023.1171160","relation":{},"ISSN":["2673-561X"],"issn-type":[{"value":"2673-561X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,22]]},"article-number":"1171160"}}