A Neuro-Cognitive Trigger Model of Fibromyalgia Flare-Ups: The Role of Cognitive Load, Emotional Background Stress, and Neural Recovery

Fibromyalgia is a chronic pain condition characterized by widespread pain, fatigue, sleep disturbances, and cognitive complaints, with symptoms that commonly fluctuate over time and intensify during episodic flare-ups. While central sensitization is widely recognized as a core neurophysiological feature of fibromyalgia, existing models primarily emphasize baseline vulnerability and provide limited explanation for the dynamic mechanisms underlying symptom exacerbation.This paper proposes a neuro-cognitive trigger model that conceptualizes fibromyalgia flare-ups as emergent events arising from the interaction of sustained cognitive load, persistent emotional background stress, and insufficient neural recovery acting upon a neuro-sensitive baseline. Rather than advancing a causal etiology for fibromyalgia, the model focuses specifically on the conditions under which transient symptom exacerbations are more likely to occur, emphasizing temporally dynamic regulatory processes within the central nervous system.Grounded in established literature on central sensitization, cognitive load theory, stress neurobiology, and sleep-related recovery mechanisms, the proposed framework integrates these elements into a unified, trigger-based formulation. The model highlights recovery failure as an active modulatory factor in flare dynamics and explicitly distinguishes between baseline neuro-sensitivity and trigger-dependent symptom escalation.Importantly, the neuro-cognitive trigger model generates testable hypotheses suitable for prospective, within-subject research designs, including ecological momentary assessment and longitudinal symptom tracking. By offering a structured and operational conceptual framework for studying flare-up dynamics, this work aims to support future empirical investigation and contribute to a more precise understanding of fibromyalgia as a disorder of neural regulation rather than static pathology.