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Pain is a subjective, multifaceted experience that varies substantially between and within chronic pain patients and is characterized by somatosensory, affective, and cognitive components. However, whether high day-to-day fluctuation amplitude (“hope for change”) or low amplitude/consistent pain experience (“know what to expect”) contributes to better or worse therapeutic outcomes is an ongoing debate. In this longitudinal MRI study involving an 8-week cognitive behavioral therapy (CBT) intervention in Fibromyalgia patients (N=61, all female, age (SD) = 41.27 (12.54) years), the impact of baseline daily reported pain fluctuations, i.e., standard deviation, on brain responses to nociceptive stimuli and clinical outcomes were investigated. Patients either received CBT or a duration-matched education-control (EDU). Preceding the intervention, patients underwent an evoked pressure pain paradigm during whole-brain …