Despite recent literature demonstrating the clinical efficacy of immersive virtual reality (VR) for pain reduction in pediatric and adult research settings, the neurobiological mechanisms underlying VR's action remain enigmatic. This study aims to further understand the neurobiological mechanisms of how VR may reduce perceived pain intensity, increase pain tolerance, and produce analgesia in healthy adolescents. This study will employ functional Magnetic Resonance Imaging (fMRI) technology to explore how functional activity in the brain relates to observed pain attenuation effects in healthy adolescents age 14-17. In particular, the study proposes to record whole-brain blood oxygen level-dependent (BOLD) signals during concurrent VR immersion and experimentally induced thermal pain. This modified event-related design will not only capture hemodynamic responses induced by the noxious stimuli, but will also allow for the measurement of how VR immersion may dynamically modulate these responses over the time course of the experiment. With region of interest analysis, temporal dynamics of the effects of VR immersion to BOLD signal changes in functional areas of the brain can be linked to the pain-related responses. Specifically, the proposed study aims to 1) investigate the effects of immersive VR on neural activity in brain regions associated with pain perception, pain tolerance, and analgesia in adolescents, and 2) discover how key cortical regions in the brain interact to produce analgesia. Improved understanding of the responsible neural mechanisms underlying VR may lend support to the use of this novel nonpharmacological method of pain attenuation. In addition, findings may illuminate complex interactions in the brain that work to produce analgesia. These findings could benefit many populations, including children with chronic pain conditions. Integrating fMRI and the use of virtual reality during experimentally induced pain will provide new information/knowledge into the efficacy of VR for pain attenuation, as well as illuminate underlying neurobiological mechanisms.
| Li, Angela; Montaño, Zorash; Chen, Vincent J et al. (2011) Virtual reality and pain management: current trends and future directions. Pain Manag 1:147-157 |
