Amygdala-centered mechanisms of pain amplification and chronification in fibromyalgia and migraine: Narrative review

This review aimed to examine the role of the amygdala as a central hub in the pathophysiology of chronic pain, with a specific focus on fibromyalgia and migraine. We synthesize evidence on how structural, functional, and neurochemical alterations within amygdala-centered circuits contribute to pain amplification, emotional dysregulation, and central sensitization, and discuss their implications for circuit-based therapeutic strategies. A comprehensive, theory-driven literature synthesis was conducted, integrating findings from neuroimaging, neuromodulation, molecular neuroscience, and clinical studies. We examined alterations in amygdala structure, function, and connectivity with cortical and brainstem regions…