Abnormal Visual Evoked Responses to Emotional Cues Correspond to Diagnosis and Disease Severity in Fibromyalgia

Noam Goldway*, Nathan M. Petro, Jacob Ablin, Andreas Keil, Eti Ben Simon, Yoav Zamir, Libat Weizman, Ayam Greental, Talma Hendler, Haggai Sharon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Chronic pain disorders are often associated with cognitive-emotional dysregulation. However, the relations between such dysregulation, underlying brain processes, and clinical symptom constellations, remain unclear. Here, we aimed to characterize the abnormalities in cognitive-emotional processing involved in fibromyalgia syndrome (FMS) and their relation to disease severity. Methods: Fifty-eight participants, 39 FMS patients (35F), and 19 healthy control subjects (16F) performed an EEG-based paradigm assessing attention allocation by extracting steady-state visually evoked potentials (ssVEP) in response to affective distractors presented during a cognitive task. Patients were also evaluated for pain severity, sleep quality, depression, and anxiety. Results: EEG ssVEP measurement indicated that, compared to healthy controls, FMS patients displayed impaired affective discrimination, and sustained attention to negative distractors. Moreover, patients displayed decreased task-related fronto-occipital EEG connectivity. Lack of adaptive attentional discrimination, measured via EEG, was predictive of pain severity, while impairments in fronto-occipital connectivity were predictive of impaired sleep. Conclusions: FMS patients display maladaptive affective attention modulation, which predicts disease symptoms. These findings support the centrality of cognitive-emotional dysregulation in the pathophysiology of chronic pain.

Original languageEnglish
Article number852133
JournalFrontiers in Behavioral Neuroscience
StatePublished - 4 May 2022


FundersFunder number
Kamin Program of the Israel Innovation Authority
Ministry of Science, Technology and Space3-11170


    • EEG
    • attention bias dynamics
    • chronic pain & fibromyalgia
    • emotion regulation
    • ssVEP (steady-state visual evoked potential)


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