This study explores how brain activity in the medial orbitofrontal cortex relates to widespread hyperalgesia—heightened sensitivity to pain across the body—in chronic pain conditions like chronic low back pain and chronic pancreatitis. Using high-density EEG and quantitative sensory testing from 85 participants, researchers found that patients with widespread hyperalgesia showed increased low-frequency (delta/theta) and decreased alpha oscillations in the medial orbitofrontal cortex during painful stimulation.

This EEG “biosignature” of central sensitization was consistent across both pain conditions and, when combined with sensory testing, improved prediction of treatment outcomes (especially response to endoscopic therapy in chronic pancreatitis). The findings suggest a shared central mechanism for nociplastic pain and highlight EEG as a potential tool for personalizing chronic pain treatments.