Hypermobility and chronic pain in adolescents: diverging functional and neural profiles without sensory differences.

Overview

1. Duke University School of Medicine, Durham, NC, United States
2. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
3. School of Medicine, University of Barcelona. Institute of Neuroscience, University of Barcelona. IDIBAPS, Hospital Clinic, Barcelona, Spain
4. Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
5. Stanford University, Palo Alto, CA, United States
6. Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, OH, United States
7. Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
8. Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, ON Canada

Abstract

Chronic pain (CP) affects approximately 20% of children, significantly impacting their physical, emotional, and social well-being. Hypermobility disorders (HDs) are prevalent in pediatric populations, including those with CP, and often contribute to impairments in psychological and physical functioning. This study examined differences in sensory, functional, and neural circuitry among CP in youth with and without comorbid HD (CP + HD). Contrary to our a priori hypothesis and previous literature suggesting that youth with CP + HD would exhibit greater suprathreshold pain sensitivity and lower pain thresholds, our findings revealed no significant differences in quantitative sensory testing measures between the 2 groups. This suggests that heightened pain sensitivity observed in CP + HD cannot be solely attributable to their hypermobility. However, the CP + HD cohort reported greater pain spread, increased fatigue, and poorer sleep quality, indicating that while they may not be more vulnerable to pain sensitization, they experience greater overall impairment in health and functioning. Furthermore, site-stratified analyses of multisensory task-evoked fMRI data revealed group differences in cerebellar activation and baseline cerebellar-supplementary motor cortex connectivity in youth with CP + HD, indicating altered neural strategies for sensory-motor integration. Notably, these significant fMRI findings were observed at 1 of the 2 study sites. Our results underscore the need for a nuanced understanding of the interplay between hypermobility, CP, and functional impairment to inform targeted interventions that address the multifaceted challenges faced by these patients.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

The paper links to its data, not to its authors' code: see the Data section.

Tracing map

A tracing map links a paper to the code its authors published: this paper has none, so it has no map.

Data

Datasets cited

• osf:cy5w8, at OSF; found in the acknowledgements

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 2, 28 September 2026

• Publisher: n/a → Lippincott Williams & Wilkins

Version 1, 28 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 18 authors, 6 keywords, 11 MeSH terms, 4 funders, 91 references.

Cite

This paper

Huft, K., Gaydos, E. F., White, J. N., Pascual-Diaz, S., Schubert-Hjalmarsson, E., Harrison, N., Moua, L., Hoeppli, M.-E., Biggs, E., Stinson, J. N., Aghaeepour, N., Angst, M. S., Gaudilliere, B., Coghill, R. C., Moayedi, M., López-Solá, M., King, C. D., & Simons, L. E. (2026). Hypermobility and chronic pain in adolescents: diverging functional and neural profiles without sensory differences. Pain, 167(8), e312-e324. https://doi.org/10.1097/j.pain.0000000000003999

Similar papers

The papers with a page that share the most with this one: the tools found in their code, their categories, datasets, cited references and authors, the rarest counting most.

[1] doi:10.1038/s41380-026-03641-0

Cerebral cortical alterations in adolescent early-onset psychosis: a surface-based morphometry mega-analysis.

Journal: Molecular psychiatry

In common: developmental, author Saül Pascual-Diaz

[2] doi:10.1016/j.ynirp.2026.100366 [code]

Lower resting-state functional connectivity between frontoparietal and sensory networks is associated with recent pain intensity in a community sample of youth.

Journal: Neuroimage. Reports

In common: pain, 3 references

[3] doi:10.1002/ejp.70331

Structural and Functional Neuroimaging Findings in Fibromyalgia: A Systematic Review.

Journal: European journal of pain (London, England)

In common: pain, 2 references

[4] doi:10.1016/j.isci.2026.116525

Longitudinal co-activation pattern analysis of menstrual cycle-related brain dynamics in primary dysmenorrhea.

Journal: iScience

In common: pain, 2 references

[5] doi:10.1162/imag.a.1191

Robust functional ultrasound imaging in the awake and behaving brain: A systematic framework for motion artifact removal.

Journal: Imaging neuroscience (Cambridge, Mass.)

In common: 3 references

[6] doi:10.1097/j.pain.0000000000003995 [code]

Cumulative impacts of early-life interpersonal adversity and persistent/recurrent pain in children: a longitudinal normative modelling study from the ABCD study cohort.

Journal: Pain

In common: pain, developmental, 1 reference

[7] doi:10.1371/journal.pbio.3003948 [code]

Neural encoding of pain is robust within but unstable between individuals.

Journal: PLoS biology

In common: pain, 1 reference

[8] doi:10.3390/ijms27135711

Role of Supraspinal Neuroinflammation in Chronic Pain After Experimental Spinal Cord Injury-A Systematic Review.

Journal: International journal of molecular sciences

In common: pain, 1 reference

[9] doi:10.1093/braincomms/fcag146 [code]

Convergent structural brain alterations in chronic pain: a multi-metric individual participant data meta-analysis.

Journal: Brain communications

In common: pain, 1 reference

[10] doi:10.1162/imag.a.1354 [code]

Development of a 24-channel 3T phased-array coil for fMRI in awake monkeys: Mitigating spatiotemporal artifacts in ferumoxytol-weighted functional connectivity estimation.

Journal: Imaging neuroscience (Cambridge, Mass.)

In common: 2 references

Contribute

The authors of this paper can claim it, correct its record and validate its tracing map, and the maintainers of its code (its owner, or a public member of its organization) correct what it says of their repository; anyone signed in can ask for its removal. Every request goes to OSCR's own machine, which answers it; your account page follows them.

Request its removal

To ask OSCR to remove this record, the copies of its authors' scripts or its tracing map, use the removal request page: signed in, you say who you are, what to remove and why, then review and confirm the request. Published rules decide every request (how).

Discussion: questions and error reports about this paper and its code, from signed-in readers and its authors. It opens with sign-in.

Reproductions: reports from readers who ran the authors' code: what they reproduced, with which environment, commit and data. It opens with sign-in.

Activity: what happens around this paper: new versions of its record, its map's validation, discussions and reproductions. It opens with sign-in.