TY - JOUR
T1 - Visually evoked pain and its extinction using virtual reality in a patient with complex regional pain syndrome type II
AU - Harvie, Daniel S.
AU - Stanton, Tasha R.
AU - Kennedy, Hannah
AU - Coppieters, Michel W.
N1 - Funding Information:
D.S.H. is supported by an Early Career Research Fellowship from the National Health and Medical Research Council of Australia (GNT1142929). TRS is supported by a Career Development Fellowship from the National Health and Medical Research Council of Australia (GNT1141735). Deidentified data are available from the authors upon reasonable request by email. The study was not preregistered. All authors contributed meaningfully to the manuscript.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - In this case report, we used virtual reality (VR) to explore pain evoked by only the appearance of being touched (rather than actually being touched) in a person with complex regional pain syndrome type II. Furthermore, we explored the degree to which this visually evoked pain could be extinguished by applying exposure principles in VR. In stage 1, we identified 4 specific scenarios where pain was triggered by visually simulated touch (without physical stimulation) and used these scenarios to quantify baseline sensitivity to visuotactile stimulation. In stage 2, the patient undertook a 12-week virtual exposure program, and the visual triggers were reassessed 3 weeks after the commencement and immediately upon completion of the program. At baseline, severe pain and a profound cold sensation were immediately and consistently evoked in concert with visually simulated touch. At 12-week follow-up, only one of the initially provocative visual stimuli triggered pain and only after 60 seconds of repeated stimulation. Unfortunately, the transfer of desensitisation from VR to the real world was limited. This case report describes the phenomena of visually evoked pain. Moreover, it describes the near complete extinguishing of visually evoked pain through virtual graded exposure. How improvements gained in VR might be better transferred to real-word improvements merits further investigation.
AB - In this case report, we used virtual reality (VR) to explore pain evoked by only the appearance of being touched (rather than actually being touched) in a person with complex regional pain syndrome type II. Furthermore, we explored the degree to which this visually evoked pain could be extinguished by applying exposure principles in VR. In stage 1, we identified 4 specific scenarios where pain was triggered by visually simulated touch (without physical stimulation) and used these scenarios to quantify baseline sensitivity to visuotactile stimulation. In stage 2, the patient undertook a 12-week virtual exposure program, and the visual triggers were reassessed 3 weeks after the commencement and immediately upon completion of the program. At baseline, severe pain and a profound cold sensation were immediately and consistently evoked in concert with visually simulated touch. At 12-week follow-up, only one of the initially provocative visual stimuli triggered pain and only after 60 seconds of repeated stimulation. Unfortunately, the transfer of desensitisation from VR to the real world was limited. This case report describes the phenomena of visually evoked pain. Moreover, it describes the near complete extinguishing of visually evoked pain through virtual graded exposure. How improvements gained in VR might be better transferred to real-word improvements merits further investigation.
KW - Case report
KW - Complex regional pain syndrome
KW - Multisensory integration
KW - Neuropathic pain
UR - http://www.scopus.com/inward/record.url?scp=85138453178&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000002605
DO - 10.1097/j.pain.0000000000002605
M3 - Article
C2 - 35297803
AN - SCOPUS:85138453178
SN - 0304-3959
VL - 163
SP - 1874
EP - 1878
JO - Pain
JF - Pain
IS - 10
ER -