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Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses
Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651739/ https://www.ncbi.nlm.nih.gov/pubmed/38028428 http://dx.doi.org/10.3389/fpain.2023.1237090 |
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author | Terzulli, Claire Chauvin, Chloé Champagnol Di-Liberti, Cédric Faisan, Sylvain Goffin, Laurent Gianesini, Coralie Graff, Denis Dufour, André Laroche, Edouard Salvat, Eric Poisbeau, Pierrick |
author_facet | Terzulli, Claire Chauvin, Chloé Champagnol Di-Liberti, Cédric Faisan, Sylvain Goffin, Laurent Gianesini, Coralie Graff, Denis Dufour, André Laroche, Edouard Salvat, Eric Poisbeau, Pierrick |
author_sort | Terzulli, Claire |
collection | PubMed |
description | Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is facilitated by immersive environment and particularly efficient even for low hypnotizable patients. The aim of this study is to assess the efficacy of a VRH script on experimentally induced cold pain perception (intensity and unpleasantness) and physiological expression. 41 healthy volunteers had been recruited in this within-subjects study. They received 9 stimulations of 20 s (3 non-nociceptive cold; 3 low nociceptive cold and 3 highly nociceptive cold) during a VRH session of 20 min (VRH condition) or without VRH (noVRH condition). Physiological monitoring during the cold pain stimulation protocol consisted of recording heart rate, heart rate variability and respiratory frequency. Maximum cold pain intensity perception, measured through the visual analog scale (VAS) on 10, was of 3.66 ± 1.84 (VAS score/10) in noVRH condition and 2.46 ± 1.54 in VRH (Wilcoxon, p < 0.0001). Considering pain unpleasantness perception, 3.68 ± 2.06 in noVRH and 2.21 ± 1.63 in VRH (Wilcoxon, p < 0.0001). Hypnotizability negatively correlated with the decrease in VAS intensity from noVRH to VRH (Spearman r = −0.45; p = 0.0038). In our sample, we found that 31/41 volunteers (75.6%) displayed a reduction of more than 10% of their VAS pain intensity and unpleasantness scores. Trait anxiety was the best predictor of the VRH responders, as well as heart rate variability. In addition, respiratory rate was diminished under VRH in every subgroup. VRH is an effective tool to reduced pain intensity and unpleasantness in a vast majority of healthy subjects. We further indicate in this study that heart rate variability parameter RMSSD (root mean square of successive differences) is a good predictor of this effect, as well as anxiety as a personality trait (but not state anxiety). Further studies are expected to determine more precisely to whom it will be the most useful to offer tailored, non-pharmacological pain management solutions to patients. |
format | Online Article Text |
id | pubmed-10651739 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-106517392023-11-02 Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses Terzulli, Claire Chauvin, Chloé Champagnol Di-Liberti, Cédric Faisan, Sylvain Goffin, Laurent Gianesini, Coralie Graff, Denis Dufour, André Laroche, Edouard Salvat, Eric Poisbeau, Pierrick Front Pain Res (Lausanne) Pain Research Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is facilitated by immersive environment and particularly efficient even for low hypnotizable patients. The aim of this study is to assess the efficacy of a VRH script on experimentally induced cold pain perception (intensity and unpleasantness) and physiological expression. 41 healthy volunteers had been recruited in this within-subjects study. They received 9 stimulations of 20 s (3 non-nociceptive cold; 3 low nociceptive cold and 3 highly nociceptive cold) during a VRH session of 20 min (VRH condition) or without VRH (noVRH condition). Physiological monitoring during the cold pain stimulation protocol consisted of recording heart rate, heart rate variability and respiratory frequency. Maximum cold pain intensity perception, measured through the visual analog scale (VAS) on 10, was of 3.66 ± 1.84 (VAS score/10) in noVRH condition and 2.46 ± 1.54 in VRH (Wilcoxon, p < 0.0001). Considering pain unpleasantness perception, 3.68 ± 2.06 in noVRH and 2.21 ± 1.63 in VRH (Wilcoxon, p < 0.0001). Hypnotizability negatively correlated with the decrease in VAS intensity from noVRH to VRH (Spearman r = −0.45; p = 0.0038). In our sample, we found that 31/41 volunteers (75.6%) displayed a reduction of more than 10% of their VAS pain intensity and unpleasantness scores. Trait anxiety was the best predictor of the VRH responders, as well as heart rate variability. In addition, respiratory rate was diminished under VRH in every subgroup. VRH is an effective tool to reduced pain intensity and unpleasantness in a vast majority of healthy subjects. We further indicate in this study that heart rate variability parameter RMSSD (root mean square of successive differences) is a good predictor of this effect, as well as anxiety as a personality trait (but not state anxiety). Further studies are expected to determine more precisely to whom it will be the most useful to offer tailored, non-pharmacological pain management solutions to patients. Frontiers Media S.A. 2023-11-02 /pmc/articles/PMC10651739/ /pubmed/38028428 http://dx.doi.org/10.3389/fpain.2023.1237090 Text en © 2023 Terzulli, Chauvin, Champagnol Di-Liberti, Faisan, Goffin, Gianesini, Graff, Dufour, Laroche, Salvat and Poisbeau. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pain Research Terzulli, Claire Chauvin, Chloé Champagnol Di-Liberti, Cédric Faisan, Sylvain Goffin, Laurent Gianesini, Coralie Graff, Denis Dufour, André Laroche, Edouard Salvat, Eric Poisbeau, Pierrick Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
title | Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
title_full | Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
title_fullStr | Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
title_full_unstemmed | Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
title_short | Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
title_sort | virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses |
topic | Pain Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651739/ https://www.ncbi.nlm.nih.gov/pubmed/38028428 http://dx.doi.org/10.3389/fpain.2023.1237090 |
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