By Leigh Charvet, PhD, clinical neuropsychologist, as told by Alyson Powell Key
Charvet and Martin Malik co-presented the study “Virtual Reality as an Intervention for Chronic Pain in Multiple Sclerosis” at the 73rd Annual Meeting of the American Academy of Neurology April 17-22, 2021, where scientists discuss the latest research on MS and other diseases of the brain and nerves.
VR is evolving rapidly, both from a technological point of view and in terms of its use in all types of healthcare applications. It offers a 3D environment that immerses you psychologically, including all sensory experiences. It’s like a full 3D movie environment.
VR is now also widely used for medical education, allowing doctors to go into the heart, go through the brain, or see diseases. It is also used in rehabilitation to make exercise more enjoyable and to provide feedback that can aid in recovery.
We are very interested in the rehabilitation field and the use of VR for its sensory psychological benefits. It was first used in the research world for people with acute burns such as military veterans.
The basic idea is that the more immersed you are in VR, the less your brain can pay attention to other stimuli like pain signals. When the pain is overwhelming, you can immerse yourself in another world. That was the reason for our interest in using it for MS-related pain. Does VR enhance the mind’s ability to draw attention away from signals of pain or discomfort?
Most of our patients live with the burden of daily pain. So we took a specific vantage point to see if repeated VR sessions could allow the spirit to reduce the noise of pain signals and provide a way out over time both inside and outside the VR environment.
Eight patients were included in the study because they suffered from severe long-term pain associated with their MS. We designed the intervention as 8 separate days of 35 minute VR sessions. The larger study is used to compare different VR content. We categorized it as active where you’re sitting but moving your hands and actively navigating your environment, as opposed to passive where you’re watching an emotionally neutral or enjoyable video.
All participants were seated. For the “interactive” content, participants used hand controllers to move through a 3D virtual space. They navigated through virtual environments and performed simple activities like virtually catching or throwing a ball. For “passive” content, they viewed 3D space without interactive navigation or activity. Instead, they watched neutral and fun VR videos, such as tours through natural landscapes. Under both conditions, all participants completed a guided VR mindfulness experience, viewing a relaxing VR environment with peaceful breathing instructions.
We measured pain scores before and after each session. People at this point had a significant reduction in the pain they were experiencing. The second thing we found was that patients’ chronic pain ratings dropped back-to-back after repeated VR immersion. And everyone who completed the study reported enjoying the VR sessions.
VR technology is a fast-moving field, and now there’s VR for the home. It’s appealing because it’s not a drug and could be available upon request. The next step is to try home delivery and evolve it to accommodate larger sample sizes. We want to compare and refine the content to see what would be most helpful to the person. There is interest in offering VR as a treatment for patients with different medical conditions.
There is a lot of power in how we can use it; it just needs to be explored to maximize the benefits.