Deng Xue, Jian Chuyao, Yang Qinglu, Jiang Naifu, Huang Zhaoyin, Zhao Shaofeng
Department of Rehabilitation Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.
Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen, China.
Front Neurosci. 2022 Nov 15;16:1033155. doi: 10.3389/fnins.2022.1033155. eCollection 2022.
Virtual reality has demonstrated its analgesic effectiveness. However, its optimal interactive mode for pain relief is yet unclear, with rare objective measurements that were performed to explore its neural mechanism.
This study primarily aimed at investigating the analgesic effect of different VR interactive modes functional near-infrared spectroscopy (fNIRS) and exploring its correlations with the subjectively reported VR experience through a self-rating questionnaire.
Fifteen healthy volunteers (Age: 21.93 ± 0.59 years, 11 female, 4 male) were enrolled in this prospective study. Three rounds of interactive mode, including active mode, motor imagery (MI) mode, and passive mode, were successively facilitated under consistent noxious electrical stimuli (electrical intensity: 23.67 ± 5.69 mA). Repeated-measures of analysis of variance (ANOVA) was performed to examine its pain relief status and cortical activation, with analysis after Bonferroni correction performed. Spearman's correlation test was conducted to explore the relationship between VR questionnaire (VRQ) items and cortical activation.
A larger analgesic effect on the active (-1.4(95%CI, -2.23 to -0.57), = 0.001) and MI modes (-0.667(95%CI, -1.165 to -0.168), = 0.012) was observed compared to the passive mode in the self-rating pain score, with no significant difference reported between the two modes (-0.733(95%CI, -1.631 to.165), = 0.131), associated with diverse activated cortical region of interest (ROI) in charge of motor and cognitive functions, including the left primary motor cortex (LM1), left dorsal-lateral prefrontal cortex (LDLPFC), left primary somatosensory cortex (LS1), left visual cortex at occipital lobe (LOL), and left premotor cortex (LPMC). On the other hand, significant correlations were found between VRQ items and different cortical ROIs (r = -0.629 to 0.722, < 0.05) as well as its corresponding channels (r = -0.599 to 0.788, < 0.05).
Our findings suggest that VR can be considered as an effective non-invasive approach for pain relief by modulating cortical pain processing. A better analgesic effect can be obtained by exciting and integrating cortical ROIs in charge of motor and cognitive functions. The interactive mode can be easily tailored to be in line with the client's characteristics, in spite of the diverse cortical activation status when an equivalent analgesic effect can be obtained.
虚拟现实已证明其镇痛效果。然而，其缓解疼痛的最佳交互模式尚不清楚，且很少有客观测量来探索其神经机制。
本研究主要旨在通过功能近红外光谱（fNIRS）研究不同虚拟现实交互模式的镇痛效果，并通过自评问卷探索其与主观报告的虚拟现实体验的相关性。
15名健康志愿者（年龄：21.93±0.59岁，11名女性，4名男性）参与了这项前瞻性研究。在一致的有害电刺激（电强度：23.67±5.69 mA）下，依次进行三轮交互模式，包括主动模式、运动想象（MI）模式和被动模式。进行重复测量方差分析（ANOVA）以检查其疼痛缓解状态和皮层激活情况，并在Bonferroni校正后进行分析。进行Spearman相关性检验以探索虚拟现实问卷（VRQ）项目与皮层激活之间的关系。
在自评疼痛评分中，与被动模式相比，主动模式（-1.4（95%CI，-2.23至-0.57），P = 0.001）和MI模式（-0.667（95%CI，-1.165至-0.168），P = 0.012）的镇痛效果更大，两种模式之间无显著差异（-0.733（95%CI，-1.631至0.1
