Exploratory findings with virtual reality for phantom limb pain

Cole, Jonathan; Crowle, Simon; Austwick, G.; Slater, David

doi:10.1016/j.neucli.2012.04.021

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…Studying the link between pain and the bodily self, it has also been reported that when upper‐limb amputees see their real arm/hand superimposed on the amputated arm/hand in a mirror, they may report relief from phantom pain (Maclachlan et al, 2006; Ramachandran and Rogers‐Ramachandran, 1996). Other studies reported a reduction of phantom pain for amputees by controlling a virtual limb in immersive virtual reality (Sato et al, 2010; Cole et al, 2009; Murray et al, 2007) or a decrease of the skin temperature in the real hand during the rubber hand illusion (Moseley et al, 2008a).…”

Section: Discussionmentioning

confidence: 99%

Seeing and identifying with a virtual body decreases pain perception

Hänsel

Lenggenhager

Känel

et al. 2011

European Journal of Pain

106

103

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a b s t r a c tPain and the conscious mind (or the self) are experienced in our body. Both are intimately linked to the subjective quality of conscious experience. Here, we used virtual reality technology and visuo-tactile conflicts in healthy subjects to test whether experimentally induced changes of bodily self-consciousness (self-location; self-identification) lead to changes in pain perception. We found that visuo-tactile stroking of a virtual body but not of a control object led to increased pressure pain thresholds and self-location. This increase was not modulated by the synchrony of stroking as predicted based on earlier work. This differed for self-identification where we found as predicted that synchrony of stroking increased self-identification with the virtual body (but not a control object), and positively correlated with an increase in pain thresholds. We discuss the functional mechanisms of self-identification, self-location, and the visual perception of human bodies with respect to pain perception.

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Section: Discussionmentioning

confidence: 99%

Seeing and identifying with a virtual body decreases pain perception

Hänsel

Lenggenhager

Känel

et al. 2011

European Journal of Pain

106

103

View full text Add to dashboard Cite

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“…Dr. Cole and his team developed a novel variation on the mirror box, in which motion data are captured directly from a patient's residual limb (rather than using the opposite remaining limb) and then transformed into goal‐directed, virtual action enacted by an avatar in a VR environment (Cole et al., ). As the residual limb is moved forward, so too does the VR anatomically intact arm or leg; if the subject stops, then so too does the avatar, to encourage agency.…”

Section: Presentationsmentioning

confidence: 99%

Virtual reality therapies for phantom limb pain

Perry

Mercier

Pettifer

et al. 2014

European Journal of Pain

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Postamputation pain: epidemiology, mechanisms, and treatment

Hsu¹,

Cohen²

2013

JPR

155

151

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Postamputation pain (PAP) is highly prevalent after limb amputation but remains an extremely challenging pain condition to treat. A large part of its intractability stems from the myriad pathophysiological mechanisms. A state-of-art understanding of the pathophysiologic basis underlying postamputation phenomena can be broadly categorized in terms of supraspinal, spinal, and peripheral mechanisms. Supraspinal mechanisms involve somatosensory cortical reorganization of the area representing the deafferentated limb and are predominant in phantom limb pain and phantom sensations. Spinal reorganization in the dorsal horn occurs after deafferentataion from a peripheral nerve injury. Peripherally, axonal nerve damage initiates inflammation, regenerative sprouting, and increased “ectopic” afferent input which is thought by many to be the predominant mechanism involved in residual limb pain or neuroma pain, but may also contribute to phantom phenomena. To optimize treatment outcomes, therapy should be individually tailored and mechanism based. Treatment modalities include injection therapy, pharmacotherapy, complementary and alternative therapy, surgical therapy, and interventions aimed at prevention. Unfortunately, there is a lack of high quality clinical trials to support most of these treatments. Most of the randomized controlled trials in PAP have evaluated medications, with a trend for short-term Efficacy noted for ketamine and opioids. Evidence for peripheral injection therapy with botulinum toxin and pulsed radiofrequency for residual limb pain is limited to very small trials and case series. Mirror therapy is a safe and cost-effective alternative treatment modality for PAP. Neuromodulation using implanted motor cortex stimulation has shown a trend toward effectiveness for refractory phantom limb pain, though the evidence is largely anecdotal. Studies that aim to prevent PA P using epidural and perineural catheters have yielded inconsistent results, though there may be some benefit for epidural prevention when the infusions are started more than 24 hours preoperatively and compared with nonoptimized alternatives. Further investigation into the mechanisms responsible for and the factors associated with the development of PAP is needed to provide an evidence-based foundation to guide current and future treatment approaches.

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Exploratory findings with virtual reality for phantom limb pain

Cited by 4 publications

References 3 publications

Seeing and identifying with a virtual body decreases pain perception

Seeing and identifying with a virtual body decreases pain perception

Virtual reality therapies for phantom limb pain

Postamputation pain: epidemiology, mechanisms, and treatment

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