Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama Prefecture, 700-8551, Japan.
Pain Med. 2010 Apr;11(4):622-9. doi: 10.1111/j.1526-4637.2010.00819.x. Epub 2010 Mar 1.
Chronic pain conditions such as phantom limb pain and complex regional pain syndrome are difficult to treat, and traditional pharmacological treatment and invasive neural block are not always effective. Plasticity in the central nervous system occurs in these conditions and may be associated with pain. Mirror visual feedback therapy aims to restore normal cortical organization and is applied in the treatment of chronic pain conditions. However, not all patients benefit from this treatment. Virtual reality technology is increasingly attracting attention for medical application, including as an analgesic modality. An advanced mirror visual feedback system with virtual reality technology may have increased analgesic efficacy and benefit a wider patient population. In this preliminary work, we developed a virtual reality mirror visual feedback system and applied it to the treatment of complex regional pain syndrome.
A small open-label case series. Five patients with complex regional pain syndrome received virtual reality mirror visual feedback therapy once a week for five to eight sessions on an outpatient basis. Patients were monitored for continued medication use and pain intensity.
Four of the five patients showed >50% reduction in pain intensity. Two of these patients ended their visits to our pain clinic after five sessions.
Our results indicate that virtual reality mirror visual feedback therapy is a promising alternative treatment for complex regional pain syndrome. Further studies are necessary before concluding that analgesia provided from virtual reality mirror visual feedback therapy is the result of reversing maladaptive changes in pain perception.
幻肢痛和复杂性区域疼痛综合征等慢性疼痛病症难以治疗，传统的药理学治疗和有创性神经阻滞并不总是有效。中枢神经系统在这些情况下会发生可塑性变化，可能与疼痛有关。镜像视觉反馈疗法旨在恢复正常的皮质组织，应用于慢性疼痛病症的治疗。然而，并非所有患者都从这种治疗中受益。虚拟现实技术越来越受到医疗应用的关注，包括作为一种镇痛方式。具有虚拟现实技术的先进镜像视觉反馈系统可能具有更高的镇痛效果，并使更多的患者受益。在这项初步工作中，我们开发了一种虚拟现实镜像视觉反馈系统，并将其应用于复杂性区域疼痛综合征的治疗。
小型开放标签病例系列。5 名复杂性区域疼痛综合征患者每周接受一次虚拟现实镜像视觉反馈治疗，共进行 5 至 8 次门诊治疗。监测患者持续用药和疼痛强度。
5 名患者中有 4 名疼痛强度降低超过 50%。其中 2 名患者在 5 次治疗后结束了我们疼痛诊所的就诊。
我们的结果表明，虚拟现实镜像视觉反馈疗法是复杂性区域疼痛综合征有前途的替代治疗方法。在得出虚拟现实镜像视觉反馈疗法提供的镇痛效果是逆转疼痛感知适应不良变化的结果之前，还需要进一步的研究。
