Virtual Reality Effective on Spinal Cord Injury-Related Chronic Neuropathic Pain
Virtual reality is a possible noninvasive analgesic and neurorehabilitation tool for those with spinal cord injury.
The use of virtual reality (VR) and multisensory stimulation in patients with spinal cord injury (SCI) promotes mild relief from chronic neuropathic pain and represents a potentially helpful addition to SCI neurorehabilitation management, according to findings from 2 randomized studies published in Neurology.
In this review, investigators compared 20 patients with SCI and paraplegia vs 20 healthy controls who participated in VR. Researchers used synchronous or asynchronous visuotactile stimulation to each participant's back as well as to the patients' “virtual” legs that were observed in VR. Questionnaires were administered to assess the effect of this experience on leg ownership and subjective changes in neuropathic pain.
Investigators found that synchronous visuotactile stimulation caused a greater illusory ownership of the virtual legs in the SCI VR group (P =.037) as well as greater feelings of illusory touch (P =.008). Compared with healthy controls, patients with SCI reported weaker illusory leg ownership, which was independent of synchrony of stroking (interaction: P =.263). Full body illusion and virtual leg illusion also resulted in mild analgesic effects; however, pain relief only occurred in the lower back position and synchronous visuotactile stimulation in the virtual leg illusion.
The patient population in this review was small, which reduces the power of these findings. According to the investigators, studies featuring other SCI subgroups who have uniform clinical characteristics and disease etiology are needed to verify their results.
VR is a possible noninvasive analgesic and neurorehabilitation tool for those with SCI and potentially for those with “other acute and chronic pain conditions, such as complex regional pain syndrome, diabetic neuropathy, or multiple sclerosis.”
Pozeg P, Palluel E, Ronchi R, et al. Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury [published online October 6, 2017]. Neurology. doi: 10.1212/WNL.0000000000004585