Virtually painless? Steps towards mechanism-driven use of immersive virtual reality for chronic pain

Virtual reality (VR) is an emerging digital therapeutic which has the potential to make a step change in the psychological management of chronic pain. Promising effects have been seen in both experimental and clinical pain states, however further mechanism-driven research is still required in order to help optimise therapeutic efficacy in chronic pain patients.

The aim of this project is to investigate the relationships between descending pain control and VR-induced effects on the development of secondary hyperalgesia in a human surrogate model of central sensitisation. Specifically, the objectives are:

1) Investigate the effects of VR exposure during the induction of central sensitisation on the subsequent development of secondary hyperalgesia.

2) Examine the relationship between conditioned pain modulation scores and VR-induced effects on secondary hyperalgesia.

3) Examine the relationship between the strength of functional connectivity between the medial prefrontal cortex and periaqueductal grey and VR-induced effects on secondary hyperalgesia.

This multimodal approach will help us to help better understand the top-down mechanisms associated with immersive VR therapy. Critically, this project will highlight the potential of psychophysical and neuroimaging techniques to be used as part of future phenotype stratified trials with VR in chronic pain patients with deficient descending pain control.

This project is funded by an Academy of Medical Sciences Springboard grant.