By Leigh Charvet, PhD, clinical neuropsychologist, told to Alyson Powell Key
Charvet and Martin Malik co-presented the study “Virtual Reality as an Intervention for Chronic Pain in Multiple Sclerosis” at the 73rd Annual Meeting of the American Academy of Neurology, April 17-22, 2021, where scientists discuss the latest research on MS and other brain and nerve conditions.
Virtual reality is growing rapidly, both technologically and in its use in all kinds of healthcare applications. It provides a 3D environment in which you are psychologically immersed, including all sensory experiences. It’s like a full 3D movie environment.
Virtual reality is also being used a lot now for medical education, allowing doctors to go into the heart, scan the brain, or see diseases. It is also used in rehabilitation to make exercise more enjoyable and provide information that can aid recovery.
Treating MS pain with virtual reality
We are very interested in the rehabilitation space and the use of virtual reality for its sensory psychological benefits. It was first used in the research world for people with acute burns, such as veterans.
The basic idea is that the more you are immersed in virtual reality, the less your brain can pay attention to other stimuli like pain signals. When the pain is overwhelming, you can step into a different world. This was the basis of our interest in using it for MS pain. Does virtual reality enhance the mind’s ability to distract from signals of pain or discomfort?
Most of our patients live with the burden of pain on a daily basis. So we took a specific angle to see if repeated VR sessions can allow the mind to reduce pain signal noise and provide escape, both inside and outside the environment. VR, over time.
Eight patients were recruited into the study on the basis of long-term severe pain related to their MS. We designed the intervention into 8 separate days of 35-minute VR sessions. The larger study is designed to compare different VR content. We’ve categorized it as active, where you’re sitting but moving your hands and actively navigating the environment, as opposed to passive, where you’re watching an emotionally neutral or pleasurable video.
All participants were seated. For the “interactive” content, participants used joysticks to move around in a virtual 3D space. They navigated virtual environments and performed simple activities like virtually catching or throwing a ball. For the “passive” content, they visualized the 3D space without any navigation or interactive activity. Instead, they watched neutral, enjoyable VR videos such as tours through natural environments. In both conditions, all participants performed a guided VR mindfulness experience, viewing a relaxing VR environment with peaceful breathing prompts.
We measured pain ratings before and after each session. People had a significant reduction in the pain they felt at that time. The second thing we found was that patients’ chronic pain ratings dropped after repeated, consecutive immersion in virtual reality. And everyone who completed the study said they enjoyed the virtual reality sessions.
The future of virtual reality for pain management
VR technology is such a rapidly evolving space, and now there’s home VR. It’s attractive because it’s not a drug and can be available on demand. The next step is to try home delivery and expand it to reach larger samples. We want to compare and refine the content to identify what would be most useful for the person. There is interest in offering virtual reality as a treatment for patients suffering from different conditions.
There is a lot of power in how we can apply it; you just have to study it to optimize the benefits.