Allison Gandey

May 14, 2010

May 12, 2010 (Baltimore, Maryland) — Investigators are exploring the analgesic benefits of virtual reality. The computer-simulated environments immerse people in a 3-dimensional world of sights, sounds, and, in some cases, smells. No longer science fiction, virtual reality programming is becoming increasingly common and clinically useful.

Presenting here at the American Pain Society 29th Annual Scientific Meeting, investigators showed the immersive technology lessens the perception of pain by engaging the senses.

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Young patient receiving treatment while using a computer-simulated environment.

The neurobiological mechanisms are not fully understood, session moderator Jeffrey Gold, PhD, from the University of Southern California in Los Angeles, told Medscape Neurology. "Virtual reality produces a modulating effect that is endogenous, so the analgesic effect is not simply the result of distraction but may also affect how the brain responds to pain."

The potential for this is huge, said presenter Dave Thomas, PhD, from the National Institute on Drug Abuse in Bethesda, Maryland. "This won't cure all pain, but the number of patients is so significant that even if it helps some, this will have a big impact."

There are close to 3000 virtual reality articles listed in PubMed. Many dental offices are already applying the new technology.

Dr. Gold presented preliminary data from new magnetic resonance imaging (MRI) studies in 5 patients. The findings suggest that virtual reality increases activity in the superior frontal, orbitofrontal cortex, and right-hand motor areas.

Sean Mackey, MD, from Stanford University in California, presented another small study exploring the use of a brain training therapy measured by real-time functional MRI. Patients received high-tech training to control specific regions of the brain to see if this would alter their perception of pain.

His team studied 10 patients with chronic pain who underwent a wait list control period followed by brain training therapy. He reports a decrease in McGill Pain Questionnaire scores after real-time functional MRI but not during the wait list period of the study (38.2% ± 9.4%, P = .003, vs −35.6% ± 54.2%, P = .54).

David Patterson, PhD, from the University of Washington in Seattle, has worked with virtual reality in young burn patients. He showed his program called Snow World at the meeting. The computer-simulated environment is designed for children to help relieve pain.

Immersive technologies appear to moderate the perception of pain by engaging visual and other senses.

"This is a very new area of research," said Lynnda Dahlquist, PhD, who also works with children. "It is very exciting to be a part of and there is a lot to learn," she said.

Dr. Thomas pointed out that much has changed since he first approached the National Institutes of Health for funding years ago. "They thought I was a crazy person back then," he said.

The immersive technology is now being tested in a variety of areas. It is used in painful medical procedures and cancer pain, and it also helps desensitize people of phobias and anxieties. Virtual reality has helped war veterans with posttraumatic stress and people with arachnophobia.

The programs are also being tested in people with substance abuse and eating disorders to aid in body image modification.

Dr. Mackey reports research funding from Eli Lilly. Dr. Gold, Dr. Dahlquist, Dr. Patterson, and Dr. Thomas have disclosed no relevant financial relationships.

American Pain Society (APS) 29th Annual Scientific Meeting: Abstract 309. Presented May 6, 2010.


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