CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.
Br J Anaesth. 2023 Dec;131(6):1082-1092. doi: 10.1016/j.bja.2023.09.001. Epub 2023 Oct 3.
Virtual reality (VR) has been widely used as a non-pharmacological adjunct to pain management. However, there is no consensus on what type of VR content is the best for pain alleviation and by what means VR modulates pain perception. We used three experiments to explore the analgesic effect of VR scenes in healthy adult volunteers.
We first compared the effect of immersive VR on pain perception with active (i.e. non-immersive, two-dimensional video) and passive (i.e. no VR or audiovisual input) controls at both subjective perceptual (Experiment 1) and electrophysiological (electroencephalography) levels (Experiment 2), and then explored possible analgesic mechanisms responsible for VR scenes conveying different strategies (e.g. exploration or mindfulness; Experiment 3).
The multisensory experience of the VR environment lowered pain intensity and unpleasantness induced by contact heat stimuli when compared with two control conditions (P=0.001 and P<0.001, respectively). The reduced pain intensity rating correlated with decreased P2 amplitude (r=0.433, P<0.001) and increased pre-stimulus spontaneous gamma oscillations (r=-0.339, P=0.004) by 32-channel electroencephalography. A VR exploration scene induced a strong sense of immersion that was associated with increased pre-stimulus gamma oscillations (r=0.529, P<0.001), whereas a VR mindfulness meditation scene had a minor effect on immersive feelings but induced strong pre-stimulus alpha oscillations (r=-0.550, P<0.001), which led to a comparable analgesic effect.
Distinct neural mechanisms are responsible for VR-induced analgesia, deepening our understanding of the analgesic benefits of VR and its neural electrophysiological correlates. These findings support further development of digital healthcare.
虚拟现实（VR）已被广泛用作疼痛管理的非药物辅助手段。然而，对于哪种类型的 VR 内容最适合缓解疼痛以及 VR 通过何种方式调节疼痛感知，目前尚无共识。我们使用三个实验来探索 VR 场景对健康成年志愿者疼痛缓解的作用。
我们首先在主观感知（实验 1）和电生理（脑电图）水平上比较了沉浸式 VR 对疼痛感知的影响与主动（即非沉浸式、二维视频）和被动（即无 VR 或视听输入）对照的影响（实验 2），然后探索了负责传达不同策略（如探索或正念）的 VR 场景的可能镇痛机制（实验 3）。
与两种对照条件相比，VR 环境的多感觉体验降低了接触热刺激引起的疼痛强度和不适（分别为 P=0.001 和 P<0.001）。疼痛强度评分的降低与 P2 振幅的降低（r=0.433，P<0.001）和刺激前自发性伽马振荡的增加（r=-0.339，P=0.004）相关。32 通道脑电图显示，VR 探索场景引起强烈的沉浸感，与刺激前伽马振荡的增加相关（r=0.529，P<0.001），而 VR 正念冥想场景对沉浸感的影响较小，但引起强烈的刺激前阿尔法振荡（r=-0.550，P<0.001），从而产生相当的镇痛效果。
不同的神经机制负责 VR 诱导的镇痛作用，加深了我们对 VR 镇痛益处及其神经电生理相关性的理解。这些发现支持数字医疗保健的进一步发展。
