Brain Mechanisms of Juvenile Fibromyalgia

Juvenile-onset fibromyalgia (JFM) is a chronic, widespread pain condition that primarily
affects females. Previous work has shown increased sensitivity to painful and non-painful
sensory stimuli in adults with fibromyalgia, as well as brain processing abnormalities
associated with these stimuli. These abnormalities in adults are highly predictive of
fibromyalgia status (as opposed to healthy status) in adults. Although JFM has some similar
symptoms and features to fibromyalgia in adults, the neural mechanisms of JFM may be
partially different, given the moment of sharp brain development characterising JFM. fMRI
scans will be completed before and after different treatments for JFM (e.g. neuromuscular
training + cognitive behavioral therapy, graded aerobic exercise) to investigate the effects
of treatment on brain measures related to pain, fatigue and emotion processing.

Inclusion Criteria:

- Diagnosis of Juvenile Fibromyalgia (by a pediatric rheumatologist or pain physician
using 2010 American College of Rheumatology criteria)

- Right handed

- Functional Disability Index score ≥ 7, indicating at least mild disability

- Stable medication regimen for 3 weeks prior to MRI scan

Exclusion Criteria:

- Non-MRI compatible metal objects in the body (including braces, permanent upper
retainers)

- Comorbid rheumatic disease (e.g. juvenile arthritis, systemic lupus erythematosus)

- Major psychiatric diagnoses (e.g. bipolar disorder, obsessive compulsive disorder,
schizophrenia) or documented developmental delay

- Taking opioid pain medication