Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury

Abstract

Objective:To investigate changes in body ownership and chronic neuropathic pain in patients with spinal cord injury (SCI) using multisensory own body illusions and virtual reality (VR).Methods:Twenty patients with SCI with paraplegia and 20 healthy control participants (HC) participated in 2 factorial, randomized, repeated-measures design studies. In the virtual leg illusion (VLI), we applied asynchronous or synchronous visuotactile stimulation to the participant's back (either immediately above the lesion level or at the shoulder) and to the virtual legs as seen on a VR head-mounted display. We tested the effect of the VLI on the sense of leg ownership (questionnaires) and on perceived neuropathic pain (visual analogue scale pain ratings). We compared illusory leg ownership with illusory global body ownership (induced in the full body illusion [FBI]), by applying asynchronous or synchronous visuotactile stimulation to the participant's back and the back of a virtual body as seen on a head-mounted display.Results:Our data show that patients with SCI are less sensitive to multisensory stimulations inducing illusory leg ownership (as compared to HC) and that leg ownership decreased with time since SCI. In contrast, we found no differences between groups in global body ownership as tested in the FBI. VLI and FBI were both associated with mild analgesia that was only during the VLI specific for synchronous visuotactile stimulation and the lower back position.Conclusions:The present findings show that VR exposure using multisensory stimulation differently affected leg vs body ownership, and is associated with mild analgesia with potential for SCI neurorehabilitation protocols.

The Embodiment of Objects: Review, Analysis, and Future Directions

“…In another study, spinal cord injury patients received tactile back stimulation while viewing virtual legs being touched through an HMD (Pozeg et al, 2017). Studies have found that there is cortical reorganization after spinal cord injuries and the lower back is connected with the leg representations (Wrigley et al, 2009).…”

From multisensory integration in peripersonal space to bodily self‐consciousness: from statistical regularities to statistical inference

“…Overall, given the widespread availability of VR technologies and soaring neuroscientific evidence indicating how to design appropriate multisensory and sensorimotor environments (including the human body), we are already seeing a number of clinical trials using these approaches for the treatment of neurological conditions . As alluded to above, the next frontier is likely the psychiatric domain …”

Manipulating the Perceived Shape and Color of a Virtual Limb Can Modulate Pain Responses

“…Even though VR is a potential tool for modulating the pain threshold through virtual body illusions in healthy subjects [1,2,12,[17][18][19][20], this cannot be extrapolated to how these strategies are going to work in chronic pain patients. Indeed, there are some conflicting results about how bodily illusions can reduce chronic pain in clinical populations [21,22].…”