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Our recent investigations of pain modulation with individually adjusted nociceptive stimuli have confirmed the mechanical and thermal hyperalgesia of FM patients but failed to detect abnormalities of pain summation or descending pain inhibition. Furthermore, our functional magnetic resonance imaging evaluations of spinal and brainstem pain processing during application of sensitivity-adjusted heat stimuli demonstrated similar temporal patterns of spinal cord activation in FM and HC participants. However, detailed modeling of brainstem activation showed that BOLD activity during \u201cpain summation\u201d was increased in FM subjects, suggesting differences in brain stem modulation of nociceptive stimuli compared to HC. Whereas these differences in brain stem activation are likely related to the hypersensitivity of FM patients, the overall central pain modulation of FM showed no significant abnormalities. These findings suggest that FM patients are hyperalgesic but modulate nociceptive input as effectively as HC.<\/jats:p>","DOI":"10.3389\/fpain.2023.1284103","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T07:54:15Z","timestamp":1701762855000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Fibromyalgia is associated with hypersensitivity but not with abnormal pain modulation: evidence from QST trials and spinal fMRI"],"prefix":"10.3389","volume":"4","author":[{"given":"Roland","family":"Staud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melyssa M.","family":"Godfrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick W.","family":"Stroman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised international association for the study of pain definition of pain: concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A classification of chronic pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"B3","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1097\/j.pain.0000000000001390","article-title":"The IASP classification of chronic pain for ICD-11: chronic primary pain","volume":"160","author":"Nicholas","year":"2019","journal-title":"Pain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2629","DOI":"10.1097\/j.pain.0000000000002324","article-title":"Chronic nociplastic pain affecting the musculoskeletal system: clinical criteria and grading system","volume":"162","author":"Kosek","year":"2021","journal-title":"Pain"},{"key":"B5","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. 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