Fibromyalgia and the painful self: A meta-analysis of resting-state fMRI data

Fibromyalgia (FM) is a complex medical condition. The nested hierarchical model of self and its extension to the pain matrix could represent an integrated theoretical framework that might comprehensively captures FM clinical feautres. A multi-level meta-analysis was conducted. Resting-state functional connectivity (RS-FC) studies that compared patients with FM and healthy controls (HCs) were included. The association between RS-FC among self-related brain regions and pain intensity was also explored in the FM group. Eleven studies were eligible for meta-analytic procedures. Patients with FM, compared to HCs, were characterized by an increased RS-FC between the default mode network (DMN) and areas ascribed to interoceptive (e.g., insula) and exteroceptive (e.g., premotor, visual/auditory cortices) self layers. The clinical group also showed a reduced RS-FC among regions of the pain matrix (i.e., periaqueductal gray matter, somatosensory areas) involved in pain modulation. An increased R...