Systematic Review and Meta-Analysis: Multimodal Abnormalities of Brain Structure and Function in Chronic Neck Pain.

BACKGROUND: Previous neuroimaging studies of patients with chronic neck pain (CNP) have revealed abnormal functional activity and structure of brain regions. However, these results often exhibit variability. Therefore, we have integrated existing research findings using a multimodal meta-analysis to obtain consistent and reliable results on brain functional activity and structural changes in CNP patients. METHODS: Studies of the amplitude of low frequency fluctuations, regional homogeneity, or voxel-based morphometry that investigated the differences in brain function and structure between CNP patients and healthy controls were searched for in seven Chinese and English databases up to November 12, 2025. Meta-analysis of the relevant neuroimaging data from the eligible literature was performed using anisotropic effect size signed differential mapping. RESULTS: This meta-analysis included a total of 36 datasets from 33 articles. The analytic results of resting-state functional magnetic resonance imaging indicate that the CNP patients exhibited abnormal functional activity in the right superior frontal gyrus (SFG), left median cingulate gyrus, right calcarine fissure cortex, right middle temporal gyrus (MTG), and left inferior parietal gyrus. Further, CNP patients exhibit abnormal gray matter volume (GMV) of the left paracentral lobule, right superior temporal gyrus (STG), right middle frontal gyrus (MFG), bilateral SFG, right cerebellum, right cuneus cortex, and left MTG. Additionally, the meta-regression analysis revealed that age is associated with increased functional activity in the right MTG, while disease duration is associated with decreased functional activity in the left median cingulate gyrus, as well as increased GMV in both the right MFG and STG. CONCLUSIONS: CNP patients exhibit widespread neuroimaging abnormalities, mainly involving pain perception, advanced cognition, and emotion regulation. These results may offer additional ideas for understanding the central mechanisms of CNP and the exploration of potential targets for CNP treatment.The PROSPERO Registration:CRD420251018254, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251018254.