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Diallo S, Marchand S, Dumais A, Potvin S. The impact of an immersive digital therapeutic tool on experimental pain: a pilot randomized within-subject experiment with an active control condition. FRONTIERS IN PAIN RESEARCH 2024; 5:1366892. [PMID: 38903416 PMCID: PMC11187308 DOI: 10.3389/fpain.2024.1366892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Background Pain is a complex and multifaced sensory and emotional experience. Virtual reality (VR) has shown promise in reducing experimental pain and chronic pain. This study examines an immersive VR environment initially designed for endometriosis patients, which demonstrated short-term analgesic effects. The research aims to determine the impact of the VR environment on experimental pain intensity and unpleasantness both during and after VR exposure (3D with binaural beats), while using an active control condition (2D with no binaural beats). Additionally, a secondary objective of the study was to identify the psychological and psychophysical factors that predict the analgesic effects of the immersive digital therapeutic tool. Methods The study involved twenty-one healthy individuals and used a within-subject design, comparing a VR treatment with an active control condition. Continuous heat stimulation was applied to the left forearm with a Peltier thermode. Pain ratings were collected for immediate and short-term effects. Results In both the VR and Control conditions, there were no significant differences in pain intensity before, during, and after exposure. However, during VR exposure, there was a significant decrease in pain unpleasantness as compared to before exposure (p < 0.001), with a 27.2% pain reduction. In the Control condition, there were no significant differences in pain unpleasantness during and after exposure. Furthermore, no psychological and psychophysical factors predicted the analgesic effects. Discussion The study investigated how a VR environment affected experimentally induced pain in healthy volunteers. It showed that VR reduced pain unpleasantness during exposure but had no lasting impact. The VR environment mainly influenced the emotional aspect of pain, possibly due to its inclusion of binaural beats and natural stimuli. The study suggests that the VR environment should be tested in chronic pain population with high distress levels. Registration number clinicaltrialsgov NCT06130267.
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Affiliation(s)
- Sanoussy Diallo
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Serge Marchand
- Department of Surgery, Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Alexandre Dumais
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, QC, Canada
| | - Stéphane Potvin
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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Gungormus DB, Fernández-Martín M, Ortigosa-Luque ME, Pérez-Mármol JM. Effects of Nature-Based Multisensory Stimulation on Pain Mechanisms in Women with Fibromyalgia Syndrome: A Randomized Double-Blind Placebo-Controlled Trial. Pain Manag Nurs 2024; 25:46-55. [PMID: 37495473 DOI: 10.1016/j.pmn.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND The term "nature-based sensory stimuli" refers to the sensory information produced by biotic and abiotic agents from natural environments. The literature has reported the beneficial effects of these agents on various pain dimensions in non-clinical populations. AIMS To evaluate the potential analgesic effects of nature-based multisensory stimulation in women with fibromyalgia syndrome. METHODS A randomized, double-blind, placebo-controlled, parallel-group trial with a 1:1 allocation ratio was conducted. Forty-two women with fibromyalgia syndrome interacted with either different plant species with flowers, stones, and soil organic matter or their synthetic imitations for 30 minutes. Outcome measurements were performed before and after the intervention, including clinical pain intensity using the Numeric Rating Scale, cold pain thresholds using the Cold Pressor Test, mechanical hyperalgesia and wind-up using a monofilament, and pressure pain thresholds using a pressure algometer. RESULTS Analyses revealed group × time interactions for clinical pain intensity (F = 7.915, p = .008), cold-water immersion time (F = 7.271, p = .010), mechanical hyperalgesia (F = 4.701, p = .036), and pressure pain threshold (p ≤ .017). Between-group differences were found in clinical pain intensity (p = .012), cold pain thresholds (p = .002), and pressure pain thresholds (p < .05). The experimental group exhibited reduced clinical pain intensity (p = .001) and increased pressure pain thresholds (p ≤ .034). CONCLUSIONS Women with fibromyalgia syndrome may benefit from multisensory stimulation using biotic and abiotic agents from natural environments for 30 minutes. Interacting with flowering plants and soil components appears to induce analgesic effects.
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Affiliation(s)
- Dogukan Baran Gungormus
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Mónica Fernández-Martín
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.
| | | | - José Manuel Pérez-Mármol
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
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Otero M, Prieur-Coloma Y, El-Deredy W, Weinstein A. A High-Resolution LED Stimulator for Steady-State Visual Stimulation: Customizable, Affordable, and Open Source. SENSORS (BASEL, SWITZERLAND) 2024; 24:678. [PMID: 38276370 PMCID: PMC10819381 DOI: 10.3390/s24020678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Visually evoked steady-state potentials (SSVEPs) are neural responses elicited by visual stimuli oscillating at specific frequencies. In this study, we introduce a novel LED stimulator system explicitly designed for steady-state visual stimulation, offering precise control over visual stimulus parameters, including frequency resolution, luminance, and the ability to control the phase at the end of the stimulation. The LED stimulator provides a personalized, modular, and affordable option for experimental setups. Based on the Teensy 3.2 board, the stimulator utilizes direct digital synthesis and pulse width modulation techniques to control the LEDs. We validated its performance through four experiments: the first two measured LED light intensities directly, while the last two assessed the stimulator's impact on EEG recordings. The results demonstrate that the stimulator can deliver a stimulus suitable for generating SSVEPs with the desired frequency and phase resolution. As an open source resource, we provide comprehensive documentation, including all necessary codes and electrical diagrams, which facilitates the system's replication and adaptation for specific experimental requirements, enhancing its potential for widespread use in the field of neuroscience setups.
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Affiliation(s)
- Mónica Otero
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad San Sebastián, Santiago de Chile 8420000, Chile;
- Centro BASAL Ciencia & Vida, Universidad San Sebastián, Santiago de Chile 8580000, Chile
| | - Yunier Prieur-Coloma
- Brain Dynamics Laboratory, Universidad de Valparaíso, Valparaíso 2340000, Chile; (Y.P.-C.); (W.E.-D.)
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, Valparaíso 2340000, Chile
| | - Wael El-Deredy
- Brain Dynamics Laboratory, Universidad de Valparaíso, Valparaíso 2340000, Chile; (Y.P.-C.); (W.E.-D.)
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, Valparaíso 2340000, Chile
- Advanced Center for Electrical and Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso 2340000, Chile
| | - Alejandro Weinstein
- Escuela de Ingeniería Civil Biomédica, Facultad de Ingeniería, Universidad de Valparaíso, Valparaíso 2340000, Chile
- Advanced Center for Electrical and Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso 2340000, Chile
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Chang MC, Briand MM, Boudier-Revéret M, Yang S. Effectiveness of transcranial alternating current stimulation for controlling chronic pain: a systematic review. Front Neurol 2023; 14:1323520. [PMID: 38192572 PMCID: PMC10773732 DOI: 10.3389/fneur.2023.1323520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
Background Chronic pain is common, disruptive, and often treatment-resistant. Hence, researchers and clinicians seek alternative therapies for chronic pain. Transcranial alternating current stimulation (tACS) is an emerging neuromodulation technique that non-invasively modulates neural oscillations in the human brain. tACS induces pain relief by allowing the neural network to restore adequate synchronization. We reviewed studies on the effectiveness of tACS in controlling chronic pain. Methods The PubMed, SCOPUS, Embase, and Cochrane Library databases were systematically searched for relevant studies published until December 6, 2023. The key search phrase for identifying potentially relevant articles was [(Transcranial Alternating Current Stimulation OR tACS) AND pain]. The following inclusion criteria were applied for article selection: (1) studies involving patients with chronic pain; (2) tACS was applied for controlling pain; and (3) follow-up evaluations were performed to assess the degree of pain reduction after the application of tACS. Results We identified 2,330 potentially relevant articles. After reading the titles and abstracts and assessing eligibility based on the full-text articles, we included four articles in our review. Among the included studies, tACS was used for fibromyalgia in one study, low back pain (LBP) in two studies, and migraine in one study. In the study on fibromyalgia, it did not show a better pain-reducing effect of tACS compared with sham stimulation. Two studies on LBP showed conflicting results. In migraine, tACS showed a positive pain-reducing effect 24-48 h after its application. Conclusion There is insufficient research to draw a conclusive judgment on the effectiveness of tACS in controlling chronic pain. More studies across various chronic pain-related diseases are required for a definitive conclusion.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Marie-Michèle Briand
- Division of Trauma, Research Center, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montréal, QC, Canada
- Department of Physical Medicine and Rehabilitation, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l’Île-de-Montréal, Montréal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Mathieu Boudier-Revéret
- Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Department of Physical Medicine and Rehabilitation, University of Montreal Health Center, Montréal, QC, Canada
| | - Seoyon Yang
- Department of Rehabilitation Medicine, School of Medicine, Ewha Woman's University Seoul Hospital, Seoul, Republic of Korea
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Halpin SJ, Casson AJ, Tang NKY, Jones AKP, O'Connor RJ, Sivan M. A feasibility study of pre-sleep audio and visual alpha brain entrainment for people with chronic pain and sleep disturbance. FRONTIERS IN PAIN RESEARCH 2023; 4:1096084. [PMID: 36910250 PMCID: PMC9996154 DOI: 10.3389/fpain.2023.1096084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Chronic pain and sleep disturbance are bi-directionally related. Cortical electrical activity in the alpha frequency band can be enhanced with sensory stimulation via the phenomenon of entrainment, and may reduce pain perception. A smartphone based programme which delivers 10 Hz stimulation through flickering light or binaural beats was developed for use at night, pre-sleep, with the aim of improving night time pain and sleep and thereby subsequent pain and related daytime symptoms. The aim of this study was to assess the feasibility and give an indication of effect of this programme for individuals with chronic pain and sleep disturbance. Materials and methods In a non-controlled feasibility study participants used audio or visual alpha entrainment for 30 min pre-sleep each night for 4 weeks, following a 1 week baseline period. The study was pre-registered at ClinicalTrials.gov with the ID NCT04176861. Results 28 participants (79% female, mean age 45 years) completed the study with high levels of data completeness (86%) and intervention adherence (92%). Daily sleep diaries showed an increase compared to baseline in total sleep time of 29 min (p = 0.0033), reduction in sleep onset latency of 13 min (p = 0.0043), and increase in sleep efficiency of 4.7% (p = 0.0009). Daily 0-10 numerical rating scale of average pain at night improved by 0.5 points compared to baseline (p = 0.027). Standardised questionnaires showed significant within-participant improvements in sleep quality (change in median Global PSQI from 16 to 12.5), pain interference (change in median BPI Pain Interference from 7.5 to 6.8), fatigue (change in median MFI total score from 82.5 to 77), and depression and anxiety (change in median HADS depression score from 12 to 10.5 and anxiety from 13.5 to 11). Discussion Pre-sleep use of a smartphone programme for alpha entrainment by audio or visual stimulation was feasible for individuals with chronic pain and sleep disturbance. The effect on symptoms requires further exploration in controlled studies.
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Affiliation(s)
- Stephen J Halpin
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Alexander J Casson
- Department of Electrical and Electronic Engineering, University of Manchester, Manchester, United Kingdom
| | - Nicole K Y Tang
- Department of Psychology, University of Warwick, Warwick, United Kingdom
| | - Anthony K P Jones
- Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Rory J O'Connor
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Manoj Sivan
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.,Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
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Maddison R, Nazar H, Obara I, Vuong QC. The efficacy of sensory neural entrainment on acute and chronic pain: A systematic review and meta-analysis. Br J Pain 2022; 17:126-141. [PMID: 37057253 PMCID: PMC10088425 DOI: 10.1177/20494637221139472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Changes to the power of neural oscillations in cortical and sub-cortical structures can change pain perception. Rhythmic sensory stimulation is a non-invasive method that can increase power in specific frequencies of neural oscillations. If the stimulation frequency targets those frequencies related to pain perception, such as alpha or theta frequencies, there can be a reduction in perceived pain intensity. Thus, sensory neural entrainment may provide an alternative to pharmacological intervention for acute and chronic pain. This review aimed to identify and critically appraise the evidence on the effectiveness of sensory entrainment methods for pain perception. Methods We undertook a systematic search across Medline, Embase, PsycInfo, Web of Science and Scopus in November 2020 to identify studies investigating the efficacy of sensory entrainment on adults. We assessed studies for their quality using the PRISMA checklist. A random-effects model was used in a meta-analysis to measure the effect of entrainment on pain perception. Results Our systematic review yielded nine studies fitting the search criteria. Studies investigated the effect of visual and auditory entrainment on pain intensity rating, electrophysiological markers of pain and amount of analgesia needed during surgery. The meta-analysis suggests that alpha (8–13 Hz) sensory entrainment is effective for acute pain perception, whereas theta (4–7 Hz) entrainment is effective for chronic pain. Conclusions Although there is heterogeneity in the current evidence, our review highlights the potential use of sensory entrainment to affect acute and chronic pain. Further research is required regarding the timing, duration and frequency of the stimulation to determine the best application for maximum efficacy.
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Affiliation(s)
- Rhys Maddison
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
| | - Hamde Nazar
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
- Population and Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ilona Obara
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Quoc C Vuong
- Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
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Merlot B, Dispersyn G, Husson Z, Chanavaz-Lacheray I, Dennis T, Greco-Vuilloud J, Fougère M, Potvin S, Cotty-Eslous M, Roman H, Marchand S. Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial. J Med Internet Res 2022; 24:e39531. [PMID: 36129733 PMCID: PMC9536521 DOI: 10.2196/39531] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic pelvic pain is a common and disabling condition in women living with endometriosis. Pharmacological and surgical treatments are not always effective at controlling pain and present important restrictions. Digital therapeutics (DTx) are emerging as major nonpharmacological alternatives that aim to extend the analgesic therapeutic arsenal of patients. OBJECTIVE In this randomized controlled trial (RCT), we aimed to measure the immediate and 4-hour persisting effects of a single use 20-minute DTx (Endocare) on pain in women experiencing pelvic pain due to endometriosis. METHODS A total of 45 women with endometriosis participated in a randomized controlled study comparing the analgesic effect of a single use of a virtual reality digital treatment named Endocare (n=23, 51%) to a 2D digital control (n=22, 49%). Perceived pain and pain relief were measured before the treatment and 15, 30, 45, 60, and 240 minutes after the end of the treatment. RESULTS The clustered posttreatment pain was significantly reduced compared to the pretreatment for both Endocare and the control group (all P<.01). Endocare was significantly more effective than the control group (all P<.01). Endocare decreased the mean pain intensity from 6.0 (SD 1.31) before the treatment to 4.5 (SD 1.71) posttreatment, while the control only decreased it from 5.7 (SD 1.36) to 5.0 (SD 1.43). When comparing each posttreatment measures to the pretest, Endocare significantly reduced pain perception for all points in time up to 4 hours posttreatment. The differences did not reached significance for the control group. Moreover, Endocare was significantly superior to the control group 15, 30, and 45 minutes after the treatment (all P<.001). The mean perceived pain relief was significantly higher for Endocare at 28% (SD 2%) compared to the control, which was 15% (SD 1%) for all the posttreatment measurements (all P>.05). CONCLUSIONS Our study aimed to test the effects of a single use of a DTx treatment on reported pain at different time points in women diagnosed with endometriosis experiencing moderate-to-severe pelvic pain. Importantly, our results support that Endocare, a virtual reality immersive treatment, significantly reduce pain perception compared to a digital control in women living with endometriosis. Interestingly, we are the first to notice that the effect persisted up to 4 hours posttreatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04650516; https://tinyurl.com/2a2eu9wv.
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Affiliation(s)
- Benjamin Merlot
- Franco European Multidisciplinary Endometriosis Institute (IFEMEndo), Bordeaux, France
| | | | - Zoé Husson
- Franco European Multidisciplinary Endometriosis Institute (IFEMEndo), Bordeaux, France
| | | | - Thomas Dennis
- Franco European Multidisciplinary Endometriosis Institute (IFEMEndo), Bordeaux, France
| | | | | | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | | | - Horace Roman
- Franco European Multidisciplinary Endometriosis Institute (IFEMEndo), Bordeaux, France
| | - Serge Marchand
- Lucine, Bordeaux, France
- Faculté de Médecine et des Sciences de la Santé, Centre de Recherche Clinique du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
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Jacquet T, Poulin-Charronnat B, Bard P, Perra J, Lepers R. Physical Activity and Music to Counteract Mental Fatigue. Neuroscience 2021; 478:75-88. [PMID: 34601062 DOI: 10.1016/j.neuroscience.2021.09.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/26/2022]
Abstract
Mental fatigue impairs both cognitive and physical performance. Bioactive substances (e.g., caffeine) have been used to counteract mental fatigue but could have side effects. The present study aimed to test two non-bioactive strategies to counteract mental fatigue: physical activity and listening to music. The participants first performed an arm-pointing task, then carried out a 32-min cognitively demanding task to induce mental fatigue (TLDB task), followed by another arm-pointing task at the end of the experiment. Between the end of the cognitively demanding task and the last arm-pointing task, 20 min went during which participants performed either 15 min of physical activity, of listening to music or of discussion (control). The subjective feeling of mental fatigue was assessed before each arm-pointing task and after the cognitively demanding task. For "physical activity" and "listening to music" groups, EEG was recorded at rest after each evaluation of subjective feeling of mental fatigue and during the cognitively demanding task. An increase in alpha power during the cognitively demanding task evidenced the presence of mental fatigue, without recovery during the following 20-min period. In the control condition, the arm-pointing task performance was deteriorated 20-min after the cognitively demanding task, while it remained stable after both physical activity and listening to music. Furthermore, recovery on the subjective feeling of mental fatigue was similar for both groups. The present results suggested that practicing physical activity and listening to music could be efficient strategies to counteract the negative effects of mental fatigue on motor performances.
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Affiliation(s)
- Thomas Jacquet
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Pôle AAFE, 11 Esplanade Erasme, 21000 Dijon, France; CAPS, INSERM U1093, Université Bourgogne Franche-Comté, Faculty of Sport Sciences, BP 27877 UFR STAPS, 21000 Dijon, France.
| | - Bénédicte Poulin-Charronnat
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Pôle AAFE, 11 Esplanade Erasme, 21000 Dijon, France
| | - Patrick Bard
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Pôle AAFE, 11 Esplanade Erasme, 21000 Dijon, France
| | - Joris Perra
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Pôle AAFE, 11 Esplanade Erasme, 21000 Dijon, France
| | - Romuald Lepers
- CAPS, INSERM U1093, Université Bourgogne Franche-Comté, Faculty of Sport Sciences, BP 27877 UFR STAPS, 21000 Dijon, France
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Frohlich F, Riddle J, Ugen G, Lersch F. Brainwave entrainment for the treatment of chronic pain: comment on Br J Pain 2020; 14: 161-70. Br J Pain 2021; 15:369-370. [PMID: 34381615 DOI: 10.1177/2049463721994614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Alpha entrainment drives pain relief using visual stimulation in a sample of chronic pain patients: a proof-of-concept controlled study. Neuroreport 2021; 32:394-398. [PMID: 33661810 DOI: 10.1097/wnr.0000000000001606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
One-third of the population in the UK and worldwide struggle with chronic pain. Entraining brain alpha activity through noninvasive visual stimulation has been shown to reduce experimental pain in healthy volunteers. Neural oscillations entrainment offers a potential noninvasive and nonpharmacological intervention for patients with chronic pain, which can be delivered in the home setting and has the potential to reduce use of medications. However, evidence supporting its use in patients with chronic pain is lacking. This study explores whether (a) alpha entrainment increase alpha power in patients and (b) whether this increase in alpha correlates with analgesia. In total, 28 patients with chronic pain sat in a comfortable position and underwent 4-min visual stimulation using customised goggles at 10 Hz (alpha) and 7 Hz (control) frequency blocks in a randomised cross-over design. 64-channel electroencephalography and 11-point numeric rating scale pain intensity and pain unpleasantness scores were recorded before and after stimulation. Electroencephalography analysis revealed frontal alpha power was significantly higher when stimulating at 10 Hz when compared to 7 Hz. There was a significant positive correlation between increased frontal alpha and reduction in pain intensity (r = 0.33; P < 0.05) and pain unpleasantness (r = 0.40; P < 0.05) in the 10 Hz block. This study provides the first proof of concept that changes in alpha power resulting from entrainment correlate with an analgesic response in patients with chronic pain. Further studies are warranted to investigate dose-response parameters and equivalence to analgesia provided by medications.
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Jacquet T, Lepers R, Poulin-Charronnat B, Bard P, Pfister P, Pageaux B. Mental fatigue induced by prolonged motor imagery increases perception of effort and the activity of motor areas. Neuropsychologia 2020; 150:107701. [PMID: 33276035 DOI: 10.1016/j.neuropsychologia.2020.107701] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/04/2020] [Accepted: 11/29/2020] [Indexed: 01/26/2023]
Abstract
Recent literature suggests that when prolonged, motor imagery (MI) induces mental fatigue and negatively impacts subsequent physical exercise. The aim of this study was to confirm this possibility with neurophysiological and self-reported measures. Thirteen participants performed 200 imagined isometric knee extension contractions (Prolonged MI condition) or watched a documentary (Control condition), and then performed 150 actual isometric knee extensions. Electroencephalography was continuously recorded to obtain motor-related cortical potential amplitude at Cz electrode (MRCP, index of motor area activity) for each imagined and actual contraction. Electromyography of the vastus lateralis muscle as well as the perceived effort required to perform prolonged MI, watch the documentary, and perform the actual contractions were measured. During prolonged MI, mental fatigue level, the effort required to imagine the contractions and MRCP amplitude increased over time. The increase in the effort required to imagine the contractions was significantly correlated with the MRCP amplitude. During the physical exercise, a significant condition × time interaction revealed a greater increase over time in perceived effort in the prolonged MI condition compared to the control condition, as well as a specific alteration in EMG RMS of the vastus lateralis muscle. These alterations observed in the presence of mental fatigue during actual contractions, combined with those observed during prolonged MI, suggest that prolonged MI may impair the motor command required to perform imagined or actual contractions. While the observed effect of mental fatigue on MRCP amplitude was clear during MI, future studies should tailor the physical exercise to minimize the exercise-induced decrease in force production capacity and control for its confounding effects on MRCP amplitude in the presence of mental fatigue.
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Affiliation(s)
- Thomas Jacquet
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Dijon, 21000, France.
| | - Romuald Lepers
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences Du Sport, Dijon, F-21000, France
| | | | - Patrick Bard
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Dijon, 21000, France
| | - Philippe Pfister
- LEAD - CNRS UMR5022, Université Bourgogne Franche-Comté, Dijon, 21000, France
| | - Benjamin Pageaux
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences Du Sport, Dijon, F-21000, France; Ecole de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
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