# Identifying neural pathophysiology in juvenile fibromyalgia

> **NIH NIH R01** · CINCINNATI CHILDRENS HOSP MED CTR · 2021 · $391,008

## Abstract

ABSTRACT
Juvenile-onset fibromyalgia (JFM) is a debilitating, chronic pain condition affecting adolescents, primarily
females, during a critical period for brain development, and that persists into adulthood for the majority of
patients. Due to the lack of definite physical or laboratory findings, JFM has been questioned as a clinical
entity, and sometimes regarded as merely an expression of anxiety or depression. This leads to poor
understanding, stigmatization, and appropriate disease management, underscoring the need for identifying
objective pathophysiology. We have previously used machine learning applied to fMRI data to yield
multivariate patterns of distributed brain activity that, together, can identify test subjects as adult FM patients
vs. healthy adults with high cross-validated accuracy (93%). However, extrapolating adult FM brain
abnormalities to JFM is problematic, given the many factors impacting the developing adolescent brain and the
clinical differences between adult and juvenile forms of the disease. The goal of this proposal is to identify
brain pathophysiology characteristic of JFM during tailored symptom provocation tasks. There is currently a
complete lack of research into the brain correlates of pain in children with widespread pain/JFM. This study will
lay the foundation for a line of research in understanding the neurophysiologic underpinnings of JFM,
discovering whether brain pathophysiology in JFM differs from adult FM, and assessing treatment effects on
specific markers of brain pathophysiology. This study is an R01 ancillary study to the NIH/NIAMS-funded trial
(R01 AR070474; Kashikar-Zuck), “Multi-site randomized clinical trial of Fibromyalgia Integrative Training for
Juvenile Fibromyalgia (FIT Teens)”. The exceptionally well characterized cohort of JFM patients from the
parent trial presents a unique opportunity to study JFM neural correlates. Our time-sensitive study will
transform the scientific output of the parent project by identifying neurophysiological correlates of pain,
psychological and physical symptoms in this large, representative, extensively-characterized sample of JFM
patients before and after treatment. We hypothesize that machine learning applied to fMRI data during tailored
symptom-provocation tasks will identify patterns of neural activity predictive of JFM status (vs. healthy), which
will correlate with JFM symptom dimensions (pain, non-painful sensory hypersensitivity, fatigue, and
depressive symptoms). This ancillary study will utilize the comprehensive psychological and physical
functioning profiles already being captured in the parent R01 trial to identify clinically meaningful neurologic
measures in JFM and explore the potential for these measures to change with treatment. This line of research
has the potential for a profound impact on understanding and identifying JFM pathophysiology and providing
neuro-physiologically informed treatment recommendations.

## Key facts

- **NIH application ID:** 10242702
- **Project number:** 5R01AR074795-03
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Robert C Coghill
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $391,008
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242702

## Citation

> US National Institutes of Health, RePORTER application 10242702, Identifying neural pathophysiology in juvenile fibromyalgia (5R01AR074795-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10242702. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*