1
|
Moreau S, Thérond A, Cerda IH, Studer K, Pan A, Tharpe J, Crowther JE, Abd-Elsayed A, Gilligan C, Tolba R, Ashina S, Schatman ME, Kaye AD, Yong RJ, Robinson CL. Virtual Reality in Acute and Chronic Pain Medicine: An Updated Review. Curr Pain Headache Rep 2024:10.1007/s11916-024-01246-2. [PMID: 38587725 DOI: 10.1007/s11916-024-01246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE OF REVIEW This review critically analyzes the recent literature on virtual reality's (VR) use in acute and chronic pain management, offering insights into its efficacy, applications, and limitations. RECENT FINDINGS Recent studies, including meta-analyses and randomized controlled trials, have demonstrated VR's effectiveness in reducing pain intensity in various acute pain scenarios, such as procedural/acute pain and in chronic pain conditions. The role of factors such as immersion and presence in enhancing VR's efficacy has been emphasized. Further benefits have been identified in the use of VR for assessment as well as symptom gathering through conversational avatars. However, studies are limited, and strong conclusions will require further investigation. VR is emerging as a promising non-pharmacological intervention in pain management for acute and chronic pain. However, its long-term efficacy, particularly in chronic pain management, remains an area requiring further research. Key findings highlight that VR programs vary in efficacy depending on the specificity of the origin of pain.
Collapse
Affiliation(s)
- Sacha Moreau
- Massachusetts Institute of Technology, Boston, MA, USA
| | - Alexandra Thérond
- Department of Psychology, Université du Québec a Montréal, 100 Sherbrooke St W, Montréal, QC, H2X 3P2, Canada.
| | - Ivo H Cerda
- Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kachina Studer
- Department of Earth and Planetary Science, Harvard University, Cambridge, MA, USA
- Department Mechanical Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| | - Alicia Pan
- Northeastern University, Boston, MA, USA
| | - Jacob Tharpe
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, MA, USA
| | - Jason E Crowther
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, MA, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | | | - Reda Tolba
- Pain Management Department in the Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Sait Ashina
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | | | - Christopher L Robinson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| |
Collapse
|
2
|
Fauchon C, Bastuji H, Peyron R, Garcia-Larrea L. Fractal Similarity of Pain Brain Networks. ADVANCES IN NEUROBIOLOGY 2024; 36:639-657. [PMID: 38468056 DOI: 10.1007/978-3-031-47606-8_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The conscious perception of pain is the result of dynamic interactions of neural activities from local brain regions to distributed brain networks. Mapping out the networks of functional connections between brain regions that form and disperse when an experimental participant received nociceptive stimulations allow to characterize the pattern of network connections related to the pain experience.Although the pattern of intra- and inter-areal connections across the brain are incredibly complex, they appear also largely scale free, with "fractal" connectivity properties reproducing at short and long-time scales. Our results combining intracranial recordings and functional imaging in humans during pain indicate striking similarities in the activity and topological representation of networks at different orders of temporality, with reproduction of patterns of activation from the millisecond to the multisecond range. The connectivity analyzed using graph theory on fMRI data was organized in four sets of brain regions matching those identified through iEEG (i.e., sensorimotor, default mode, central executive, and amygdalo-hippocampal).Here, we discuss similarities in brain network organization at different scales or "orders," in participants as they feel pain. Description of this fractal-like organization may provide clues about how our brain regions work together to create the perception of pain and how pain becomes chronic when its organization is altered.
Collapse
Affiliation(s)
- Camille Fauchon
- Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France.
- Université Jean Monnet, Inserm, CRNL, NeuroPain, Saint-Etienne, France.
| | - Hélène Bastuji
- Université Claude Bernard Lyon 1, UJM, Inserm, CRNL, NeuroPain, Bron, France
| | - Roland Peyron
- Université Jean Monnet, Inserm, CRNL, NeuroPain, Saint-Etienne, France
- CHU, centre de la douleur, Saint-Etienne, France
| | - Luis Garcia-Larrea
- Université Claude Bernard Lyon 1, UJM, Inserm, CRNL, NeuroPain, Bron, France
| |
Collapse
|
3
|
De Miguel-Rubio A, Gallego-Aguayo I, De Miguel-Rubio MD, Arias-Avila M, Lucena-Anton D, Alba-Rueda A. Effectiveness of the Combined Use of a Brain-Machine Interface System and Virtual Reality as a Therapeutic Approach in Patients with Spinal Cord Injury: A Systematic Review. Healthcare (Basel) 2023; 11:3189. [PMID: 38132079 PMCID: PMC10742447 DOI: 10.3390/healthcare11243189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/30/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Spinal cord injury has a major impact on both the individual and society. This damage can cause permanent loss of sensorimotor functions, leading to structural and functional changes in somatotopic regions of the spinal cord. The combined use of a brain-machine interface and virtual reality offers a therapeutic alternative to be considered in the treatment of this pathology. This systematic review aimed to evaluate the effectiveness of the combined use of virtual reality and the brain-machine interface in the treatment of spinal cord injuries. A search was performed in PubMed, Web of Science, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and Medline, including articles published from the beginning of each database until January 2023. Articles were selected based on strict inclusion and exclusion criteria. The Cochrane Collaboration's tool was used to assess the risk of bias and the PEDro scale and SCIRE systems were used to evaluate the methodological quality of the studies. Eleven articles were selected from a total of eighty-two. Statistically significant changes were found in the upper limb, involving improvements in shoulder and upper arm mobility, and weaker muscles were strengthened. In conclusion, most of the articles analyzed used the electroencephalogram as a measurement instrument for the assessment of various parameters, and most studies have shown improvements. Nonetheless, further research is needed with a larger sample size and long-term follow-up to establish conclusive results regarding the effect size of these interventions.
Collapse
Affiliation(s)
- Amaranta De Miguel-Rubio
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, 14004 Cordoba, Spain; (I.G.-A.); (A.A.-R.)
| | - Ignacio Gallego-Aguayo
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, 14004 Cordoba, Spain; (I.G.-A.); (A.A.-R.)
| | | | - Mariana Arias-Avila
- Physical Therapy Department, Universidade Federal de São Carlos, São Paulo 13565-905, Brazil;
| | - David Lucena-Anton
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain;
| | - Alvaro Alba-Rueda
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, 14004 Cordoba, Spain; (I.G.-A.); (A.A.-R.)
| |
Collapse
|
4
|
Wu L, Tang H. The role of N6-methyladenosine modification in rodent models of neuropathic pain: from the mechanism to therapeutic potential. Biomed Pharmacother 2023; 166:115398. [PMID: 37647691 DOI: 10.1016/j.biopha.2023.115398] [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: 05/21/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
Neuropathic pain (NP) is a common chronic pain condition resulted from lesions or diseases of somatosensory nervous system, but the pathogenesis remains unclear. A growing body of evidence supports the relationship between pathogenesis and N6-methyladenosine (m6A) modifications of RNA. However, studies on the role of m6A modifications in NP are still at an early stage. Elucidating different etiologies is important for understanding the specific pathogenesis of NP. This article provides a comprehensive review on the role of m6A methylation modifications including methyltransferases ("writers"), demethylases ("erasers"), and m6A binding proteins ("readers") in NP models. Further analysis of the pathogenic mechanism relationship between m6A and NP provided novel theoretical and practical significance for clinical treatment of NP.
Collapse
Affiliation(s)
- Liping Wu
- Guangxi University of Traditional Chinese Medicine, Nanning, China; The First Clinical Medical College of Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Hongliang Tang
- Guangxi Traditional Chinese Medicine University Affiliated Fangchenggang Hospital.
| |
Collapse
|
5
|
Widerström-Noga E. Neuropathic Pain and Spinal Cord Injury: Management, Phenotypes, and Biomarkers. Drugs 2023:10.1007/s40265-023-01903-7. [PMID: 37326804 DOI: 10.1007/s40265-023-01903-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
Chronic neuropathic pain after a spinal cord injury (SCI) continues to be a complex condition that is difficult to manage due to multiple underlying pathophysiological mechanisms and the association with psychosocial factors. Determining the individual contribution of each of these factors is currently not a realistic goal; however, focusing on the primary mechanisms may be more feasible. One approach used to uncover underlying mechanisms includes phenotyping using pain symptoms and somatosensory function. However, this approach does not consider cognitive and psychosocial mechanisms that may also significantly contribute to the pain experience and impact treatment outcomes. Indeed, clinical experience supports that a combination of self-management, non-pharmacological, and pharmacological approaches is needed to optimally manage pain in this population. This article will provide a broad updated summary integrating the clinical aspects of SCI-related neuropathic pain, potential pain mechanisms, evidence-based treatment recommendations, neuropathic pain phenotypes and brain biomarkers, psychosocial factors, and progress regarding how defining neuropathic pain phenotypes and other surrogate measures in the neuropathic pain field may lead to targeted treatments for neuropathic pain after SCI.
Collapse
Affiliation(s)
- Eva Widerström-Noga
- The Miami Project to Cure Paralysis, University of Miami, 1611 NW 12th Avenue, Miami, FL, 33136, USA.
- Department of Neurological Surgery, University of Miami, 1095 NW 14th Terrace, Miami, FL, 33136, USA.
| |
Collapse
|
6
|
Saffari F, Kakaria S, Bigné E, Bruni LE, Zarei S, Ramsøy TZ. Motivation in the metaverse: A dual-process approach to consumer choices in a virtual reality supermarket. Front Neurosci 2023; 17:1062980. [PMID: 36875641 PMCID: PMC9978781 DOI: 10.3389/fnins.2023.1062980] [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: 10/06/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction Consumer decision-making processes involve a complex interrelation between perception, emotion, and cognition. Despite a vast and diverse literature, little effort has been invested in investigating the neural mechanism behind such processes. Methods In the present work, our interest was to investigate whether asymmetrical activation of the frontal lobe of the brain could help to characterize consumer's choices. To obtain stronger experimental control, we devised an experiment in a virtual reality retail store, while simultaneously recording participant brain responses using electroencephalogram (EEG). During the virtual store test, participants completed two tasks; first, to choose items from a predefined shopping list, a phase we termed as "planned purchase". Second, subjects were instructed that they could also choose products that were not on the list, which we labeled as "unplanned purchase." We assumed that the planned purchases were associated with a stronger cognitive engagement, and the second task was more reliant on immediate emotional responses. Results By analyzing the EEG data based on frontal asymmetry measures, we find that frontal asymmetry in the gamma band reflected the distinction between planned and unplanned decisions, where unplanned purchases were accompanied by stronger asymmetry deflections (relative frontal left activity was higher). In addition, frontal asymmetry in the alpha, beta, and gamma ranges illustrate clear differences between choices and no-choices periods during the shopping tasks. Discussion These results are discussed in light of the distinction between planned and unplanned purchase in consumer situations, how this is reflected in the relative cognitive and emotional brain responses, and more generally how this can influence research in the emerging area of virtual and augmented shopping.
Collapse
Affiliation(s)
- Farzad Saffari
- Neurons Inc., Høje-Taastrup Municipality, Denmark.,Augmented Cognition Lab, Aalborg University, Copenhagen, Denmark
| | - Shobhit Kakaria
- Faculty of Economics, University of Valencia, Valencia, Spain
| | - Enrique Bigné
- Faculty of Economics, University of Valencia, Valencia, Spain
| | - Luis E Bruni
- Augmented Cognition Lab, Aalborg University, Copenhagen, Denmark
| | - Sahar Zarei
- Neurons Inc., Høje-Taastrup Municipality, Denmark
| | | |
Collapse
|
7
|
Tran Y. EEG Signal Processing for Biomedical Applications. SENSORS (BASEL, SWITZERLAND) 2022; 22:9754. [PMID: 36560123 PMCID: PMC9787770 DOI: 10.3390/s22249754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Electroencephalography (EEG) signals are used widely in clinical and research settings [...].
Collapse
Affiliation(s)
- Yvonne Tran
- Department of Linguistics, Macquarie University Hearing, Macquarie University, Sydney, NSW 2109, Australia
| |
Collapse
|
8
|
Reece R, Bornioli A, Bray I, Newbutt N, Satenstein D, Alford C. Exposure to Green, Blue and Historic Environments and Mental Well-Being: A Comparison between Virtual Reality Head-Mounted Display and Flat Screen Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159457. [PMID: 35954820 PMCID: PMC9368727 DOI: 10.3390/ijerph19159457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
Improving the mental health of urban residents is a global public health priority. This study builds on existing work that demonstrates the ability of virtual exposure to restorative environments to improve population mental health. It compares the restorative effects of green, blue and historic environments delivered by both flat screen and immersive virtual reality technology, and triangulates data from psychological, physiological and qualitative sources. Results from the subjective measure analyses showed that exposures to all the experimental videos were associated with self-reported reduced anxiety and improved mood, although the historic environment was associated with a smaller reduction of anxiety (p < 0.01). These results were supported by the qualitative accounts. For two of the electroencephalography (EEG) frequency bands, higher levels of activity were observed for historic environments. In relation to the mode of delivery, the subjective measures did not suggest any effect, while for the EEG analyses there was evidence of a significant effect of technology across three out of four frequency bands. In conclusion, this study adds to the evidence that the benefits of restorative environments can be delivered through virtual exposure and suggests that virtual reality may provide greater levels of immersion than flat screen viewing.
Collapse
Affiliation(s)
- Rebecca Reece
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK;
- Correspondence:
| | - Anna Bornioli
- Erasmus Centre for Urban, Port and Transport Economics, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands;
| | - Isabelle Bray
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK;
| | - Nigel Newbutt
- College of Education, School of Teaching and Learning, Institute of Advanced Learning Technologies, University of Florida, Gainesville, FL 32611, USA;
| | - David Satenstein
- Department of Education and Childhood, Faculty of Arts, Creative Industries and Education, University of the West of England, Bristol BS16 1QY, UK;
| | - Chris Alford
- Psychological Sciences Research Group, University of the West of England, Bristol BS16 1QY, UK;
| |
Collapse
|
9
|
EEG-Based Empathic Safe Cobot. MACHINES 2022. [DOI: 10.3390/machines10080603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
An empathic collaborative robot (cobot) was realized through the transmission of fear from a human agent to a robot agent. Such empathy was induced through an electroencephalographic (EEG) sensor worn by the human agent, thus realizing an empathic safe brain-computer interface (BCI). The empathic safe cobot reacts to the fear and in turn transmits it to the human agent, forming a social circle of empathy and safety. A first randomized, controlled experiment involved two groups of 50 healthy subjects (100 total subjects) to measure the EEG signal in the presence or absence of a frightening event. The second randomized, controlled experiment on two groups of 50 different healthy subjects (100 total subjects) exposed the subjects to comfortable and uncomfortable movements of a collaborative robot (cobot) while the subjects’ EEG signal was acquired. The result was that a spike in the subject’s EEG signal was observed in the presence of uncomfortable movement. The questionnaires were distributed to the subjects, and confirmed the results of the EEG signal measurement. In a controlled laboratory setting, all experiments were found to be statistically significant. In the first experiment, the peak EEG signal measured just after the activating event was greater than the resting EEG signal (p < 10−3). In the second experiment, the peak EEG signal measured just after the uncomfortable movement of the cobot was greater than the EEG signal measured under conditions of comfortable movement of the cobot (p < 10−3). In conclusion, within the isolated and constrained experimental environment, the results were satisfactory.
Collapse
|