{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:47:10Z","timestamp":1782798430441,"version":"3.54.5"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"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:p>\n                    Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) are complex multisystemic conditions frequently associated with chronic pain. Central Sensitization (CS)\u2014a state of neural amplification and hyperexcitability\u2014is hypothesized to be a unifying mechanism underlying the heterogeneous symptoms in chronic pain patients. Our aim was to investigate the association between central sensitization and multisystemic symptom burden in patients with hEDS\/HSD while identifying independent clinical predictors of CS. We prospectively enrolled 150 adults diagnosed with hEDS\/HSD at a specialized joint hypermobility clinic. Participants were evaluated using the Central Sensitization Inventory (CSI) and the SPIDER questionnaire. Clinical CS was defined as a CSI score &amp;gt; 40. Statistical analyses included univariate correlations and multivariable logistic regression. Centrally sensitized patients (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200976) were significantly younger and predominantly female compared to the non-CS group. While CSI scores correlated strongly with all eight SPIDER domains (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&amp;lt;\u20090.001), a multivariable logistic regression model (AUC 0.98) identified only three independent predictors of CS: fatigue (OR 1.089), pain (OR 1.067), and cardiac dysautonomia (OR 1.057). Central sensitization in hEDS\/HSD is independently associated with a triad of fatigue, pain, and cardiac dysautonomia. Clinical management should shift toward multidisciplinary strategies to effectively address the sensitized state in this population.\n                  <\/jats:p>","DOI":"10.3389\/fpain.2026.1799439","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:41:39Z","timestamp":1782798099000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Linking central sensitization to multisystemic manifestations in hypermobile Ehlers-Danlos syndrome"],"prefix":"10.3389","volume":"7","author":[{"given":"Ana Paula","family":"Montemayor Zaraz\u00faa","sequence":"first","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar Vidal","family":"Elizondo Solis","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Ayala Garc\u00eda","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Jes\u00fas","family":"Pacheco Estrella","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavio","family":"Ilizaliturri Guerra","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cecilia","family":"Arana Guajardo","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Pur\u00f3n Gonzalez","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Silva Luna","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Iv\u00e1n","family":"Lozano Plata","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Ramon","family":"Garc\u00eda Pompermayer","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Alberto","family":"Garza Elizondo","sequence":"additional","affiliation":[{"name":"Insituto de Medicina Interna, Centro M\u00e9dico Zambrano Hellion TecSalud","place":["San Pedro Garza Garc\u00eda, Nuevo Le\u00f3n, 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