Children and adolescents affected by juvenile fibromyalgia show greater sensitivity to non-painful sensory stimuli, such as sounds and bright lights. This hypersensitivity is closely related to the severity of the disease and to the brain function of the young people affected, according to research by a team from the Faculty of Medicine and Health Sciences and the Institute of Neurosciences (UBneuro) at the University of Barcelona.
The findings provide new insights into the brain mechanisms underlying juvenile fibromyalgia, a chronic pain disorder that affects between 2% and 6% of children and adolescents. By combining detailed behavioural assessments with advanced brain imaging, the authors have defined patient subtypes that could explain why this disease is more disabling in some cases than in others.
The study opens up new avenues for improving diagnosis and developing more personalized therapeutic strategies to address a paediatric disease that is still difficult to characterize and manage.
Juvenile fibromyalgia: how does the brain respond during sensory stimulation?
Juvenile fibromyalgia is a complex and often misunderstood condition. It mainly affects adolescent girls, and symptoms can persist into adulthood and significantly impact daily life. Although pain is the most visible symptom, many patients also experience severe discomfort in response to everyday sensory stimuli. The neural mechanisms behind these manifestations and their clinical relevance in those affected are not yet well understood.
A study published by the team in the journal Pain reveals that adolescents with fibromyalgia show significantly greater sensitivity to visual, auditory, and tactile stimuli, as well as greater discomfort during multisensory stimulation.
The study did not detect any deficits in hearing or basic auditory attention processes, confirming that sensory hypersensitivity is not due to peripheral sensory impairment. Instead, brain imaging revealed that increased activation in brain regions involved in sensory integration and cognitive-emotional regulation - particularly the prefrontal areas - was closely associated with pain severity, functional disability, and overall symptom burden.
The study also reveals that altered brain processing of non-painful sensory stimuli plays a central role in the clinical expression of the disease from an early age, before the pain has become chronic over decades.
"Teenagers with fibromyalgia may perceive even everyday sounds as louder; this is not due to any hearing impairment, but rather to the amplification and coordination of sensory signals in the brain. This intensified neural processing helps explain why the condition can be so disabling, affecting pain levels and daily functioning from a very young age," says PhD student Laura Martín-Herrero, first author of the study.
