Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;46(5):2041-2054.
doi: 10.1007/s10072-024-07967-x. Epub 2025 Jan 2.

Brain modulatory effects of rehabilitation interventions in fibromyalgia: a systematic review of magnetic resonance imaging studies

Nguyen Thanh Nhu  1   2 , Tran Thi Quynh Trang  1   3 , David Yen-Ting Chen  4   5 , Jiunn-Horng Kang  6   7   8   9
Affiliations

Brain modulatory effects of rehabilitation interventions in fibromyalgia: a systematic review of magnetic resonance imaging studies

Nguyen Thanh Nhu et al. Neurol Sci. 2025 May.

Abstract

Objectives: Fibromyalgia imposes a considerable burden of disability worldwide, and its therapies include rehabilitation interventions. However, the overall brain modulatory effects of rehabilitation interventions and their effects on clinical improvements in patients with fibromyalgia remain unclear. This systematic review of magnetic resonance imaging studies synthesised evidence for the brain modulatory effects of rehabilitation in patients with fibromyalgia.

Methods: We searched PubMed, EMBASE, and Web of Science databases from inception to August 2023 for English articles on rehabilitation-induced brain function changes in patients with fibromyalgia. Methodological evaluation was performed using the Physiotherapy Evidence Database checklist.

Results: We included 17 studies with 416 participants reporting the brain modulatory effects of several rehabilitation methods (i.e. exercises, brain stimulation, cognitive behavioural therapy, nerve stimulation, and neurofeedback). These studies received fair to good scores on the Physiotherapy Evidence Database scale. Rehabilitation-induced changes in brain function were correlated with the presentation of fibromyalgia. From the included studies, baseline brain functions could successfully predict posttreatment changes in disease symptoms. However, limited evidence is available for the effects of rehabilitation on brain structure.

Conclusion: Rehabilitation was found to modulate brain functions to alleviate fibromyalgia symptoms and improve patients' quality of life. This finding supports the hypothesis that brain modulation is one of the mechanisms underlying the rehabilitation-mediated mitigation of fibromyalgia. Our results suggest that brain function measured through functional magnetic resonance imaging can help predict the response of patients with fibromyalgia to rehabilitation programmes (PROSPERO registration number: CRD42023387612).

Keywords: Chronic pain; Fibromyalgia; Magnetic resonance imaging; Rehabilitation.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: Because this is a systematic review, ethics approval is not applicable. Competing interests: The authors declare no competing financial interests. Registration: Our systematic review was registered in PROSPERO (registration number: CRD42023387612) and was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Similar articles

See all similar articles

References

    1. Borchers AT, Gershwin ME (2015) Fibromyalgia: a critical and comprehensive review. Clin Rev Allergy Immunol 49(2):100–151 - PubMed - DOI
    1. Cagnie B et al (2014) Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. Semin Arthritis Rheum 44(1):68–75 - PubMed - DOI
    1. Gyorfi M, Rupp A, Abd-Elsayed A (2022) Fibromyalgia pathophysiology biomedicines 10(12)
    1. Jensen KB et al (2013) Overlapping structural and functional brain changes in patients with long-term exposure to fibromyalgia pain. Arthritis Rheum 65(12):3293–3303 - PubMed - PMC - DOI
    1. Sunol M et al (2024) Reduced cortico-cortical resting-state connectivity in sensory systems related to bodily pain in juvenile fibromyalgia. Arthritis Rheumatol 76(2):293–303 - PubMed - DOI

Publication types

LinkOut - more resources