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See detailWhen less is more: Investigating factors influencing the distraction effect of virtual reality from pain
Barcatta, Katharina; Holl, Elisabeth UL; Battistutta, Layla UL et al

in Frontiers in Pain Research (2022), 2

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See detailPain Processing in Older Age – Evidence from Event-Related Potentials
Dierolf, Angelika UL; Rischer, Katharina Miriam UL; González-Rolán, Ana Maria et al

Scientific Conference (2021, June)

Aging is known to affect neurobiological and physiological aspects of pain perception and has been associated with reduced pain sensitivity and a deterioration of descending pain inhibitory mechanisms. To ... [more ▼]

Aging is known to affect neurobiological and physiological aspects of pain perception and has been associated with reduced pain sensitivity and a deterioration of descending pain inhibitory mechanisms. To investigate age differences in neural electrophysiological correlates of pain processing, we induced acute pain in healthy older (60 yrs+) and younger adults (18 to 35 yrs), using short transdermal electrical pulses administered to the inner forearm, with individually adjusted stimulation intensities. Participants received alternating blocks of painful and non-painful control stimulation and rated the intensity and unpleasantness of each stimulus on two visual analog scales. Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results indicate that younger and older participants rated painful stimuli more intensive and unpleasant compared to the control stimulation, with older adults showing a slight habituation over time. In younger adults, ERP amplitudes (N2, P2 P3) of painful stimulation were enhanced compared to non- painful stimulation. In contrast, older participants showed generally reduced ERPs, no difference between pain and non-painful stimulation and by tendency longer latencies for painful stimulation. This suggests that nociceptive neural processing is altered in aging, while the reported pain perception is unaffected. Given that aging is also associated with a decline of cognitive functions and PFC volume and activity changes, this could have implications for the efficacy of cognitive pain modulation. Altogether, our results highlight the need for a deeper understanding of the mechanisms underlying pain processing in older adults, and how these age-related changes affect (cognitive) pain treatments in this population. [less ▲]

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See detailDistraction from Pain: An fMRI Study on the Role of Age-related Changes in Executive Functions
Rischer, Katharina Miriam UL; González-Roldán, Ana M.; Montoya, Pedro et al

Scientific Conference (2021, June)

Even though aging is associated with increased and prolonged episodes of pain, little is known about potential age-related changes in the "top-down" modulation of pain, such as cognitive distraction from ... [more ▼]

Even though aging is associated with increased and prolonged episodes of pain, little is known about potential age-related changes in the "top-down" modulation of pain, such as cognitive distraction from pain. The hypoalgesic effect of distraction results from a competition for attentional and executive resources mediated by the prefrontal cortex (PFC). Given that age-related grey matter atrophy is particularly prominent in the PFC, older adults may benefit less from distraction to reduce pain than young adults. The aim of this study was to investigate the influence of aging on task-related hypoalgesia and its neural mechanisms, with a focus on the role of executive functions in distraction from pain. 64 participants (32 young adults: 26.69 ± 4.14 years; 32 older adults: 68.28 ± 7.00 years) first completed a battery of neuropsychological tests. In a second session, we administered a pain distraction paradigm while functional brain images were acquired. In this paradigm, participants completed a low (0-back) and a high (2-back) load condition of a working memory task while receiving either innocuous or painful heat stimuli to their lower arm. To control for age-related differences in sensitivity to pain and perceived task difficulty, stimulus intensity and task speed were individually calibrated. Both age groups showed significantly reduced activity in a network of regions involved in pain processing when performing the high compared to the low load distraction task; however, young adults showed a larger neural distraction effect in several of these regions, including the insula, caudate and midcingulate cortex. Moreover, in older adults, better executive functions – in particular inhibitory control abilities – were associated with a larger neural distraction effect in the insula, thalamus and primary somatosensory cortex, and with more activation in several prefrontal cortex regions during the high load task. These findings clearly demonstrate that the top-down control of pain is altered by age and could explain the higher vulnerability of older adults to developing chronic pain. Moreover, our findings suggest that the assessment of executive functions may be a useful tool for predicting the efficacy of cognitive pain modulation strategies in older adults. [less ▲]

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See detailCognitive distraction from pain: An fMRI study on the role of age and executive functions
Rischer, Katharina Miriam UL; Dierolf, Angelika UL; González-Roldán, Ana M. et al

Scientific Conference (2021, June)

Completing a cognitive task has been shown to be a powerful strategy to reduce concurrent pain. This reduction in pain is assumed to result from a competition between the painful stimulus and the ... [more ▼]

Completing a cognitive task has been shown to be a powerful strategy to reduce concurrent pain. This reduction in pain is assumed to result from a competition between the painful stimulus and the distractive task for attentional and executive resources mediated by the prefrontal cortex (PFC), a region that is particularly affected by age-related grey matter atrophy. In the present study, we investigated the role of age-related changes in gray matter volume and executive functions in modulating the efficacy of distraction from pain. In a first session, young and older adults completed a battery of neuropsychological tests. In a second session, we acquired functional brain images while participants completed a working memory task with two levels of cognitive load (low vs. high load) and concurrently received individually adjusted heat stimuli (innocuous vs. painful) to their lower arm. While we found no age-related differences in the distraction effect size on the behavioural level, young adults showed a larger neural distraction effect in several regions involved in pain processing, including the insula, caudate and midcingulate cortex. Interestingly, older adults with better executive functions, particularly, better inhibitory control abilities, showed a larger neural distraction effect in the insula, thalamus and primary somatosensory cortex, and more activation in frontal clusters during the high load task. Taken together, these findings suggest that age alters the neural mechanisms underlying cognitive distraction from pain, and that the magnitude of these changes may be dependent on the preservation of executive functions. [less ▲]

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See detailAnalgesic effects of interacting with a VR game and associated psychophysiological responses
Holl, Elisabeth UL; Rischer, Katharina Miriam UL

Scientific Conference (2021, June)

Introduction: Virtual reality (VR) has been shown to be an effective tool for pain distraction by redirecting attention away from painful stimuli. Although VR therapy has been successfully implemented in ... [more ▼]

Introduction: Virtual reality (VR) has been shown to be an effective tool for pain distraction by redirecting attention away from painful stimuli. Although VR therapy has been successfully implemented in clinical settings, little is known about the underlying factors that modulate analgesic responses, such as cognitive load, executive functions and VR or gaming experience. Methods: A final sample of N = 90 healthy participants played the VR game Subnautica in a high and a low cognitive load condition. In the low load condition, participants explored the VR along a predefined route. In the high load condition, participants had to additionally memorize eight digits presented along the route. Pain heat thresholds as well as psychophysiological measures (ECG, EDA) were recorded during a non-interactive resting state period prior to playing as well as during the two VR sessions. Furthermore, participants completed questionnaires (e.g., pain attitude) and executive functioning tasks (e.g., go/nogo task). Results: Pain thresholds did not differ for high versus low demand. However, participants achieved higher threshold for the interactive playing sessions compared to the resting state period. Psychophysiological markers (e.g., HRV) indicate lower sympathetic activity during the resting state compared to the playing session (resting state < low load < high load). Moreover, pain catastrophizing and fear of pain were significant predictors of pain thresholds. Discussion: Results shed light on the role of inter-individual differences and psychophysiological markers of VR-based pain sensitivity and indicate factors that facilitate/impair distraction effects. This may have important implication for the use of VR-therapy. [less ▲]

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See detailVirtual reality gaming for pain distraction - Investigation of attentional and psychophysiological effects
Holl, Elisabeth UL; Rischer, Katharina Miriam UL; Battistutta, Layla UL et al

Scientific Conference (2021, May)

Virtual reality has been shown to be a powerful method to divert attention away from pain (Malloy & Milling, 2010) and has been used successfully to temporally relieve patients from pain in clinical ... [more ▼]

Virtual reality has been shown to be a powerful method to divert attention away from pain (Malloy & Milling, 2010) and has been used successfully to temporally relieve patients from pain in clinical settings. However, little is known about the underlying attentional processes involved in pain processing in virtual reality. Therefore, as one of the first studies, this project investigates the role of especially cognitive factors influencing distraction from pain. N = 90 healthy participants played the video game Subnautica in two virtual reality conditions (high vs. low cognitive load). To assess the distraction effect, pain thresholds and psychophysiological measures were assessed during play. Additionally, executive functions and self-reported measures on, e.g., presence, simulation sickness and pain-related subjects were assessed. Results suggest that interactive virtual reality games are a potential tool to alter pain processing, regardless of the level of cognitive load. [less ▲]

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See detailInvestigating the role of individual differences in the hypoalgesic response to a virtual reality game: An exploratory analysis
Rischer, Katharina Miriam UL; Barcatta, Katharina; Battistutta, Layla UL et al

Scientific Conference (2021, March)

Introduction: Virtual reality (VR) has been shown to be a powerful method of redirecting attention away from pain and is increasingly used in clinical settings as a therapeutic tool for pain treatment ... [more ▼]

Introduction: Virtual reality (VR) has been shown to be a powerful method of redirecting attention away from pain and is increasingly used in clinical settings as a therapeutic tool for pain treatment. Yet, little is known about the underlying factors that modulate the size of the hypoalgesic response to a VR game, such as cognitive load and inter-individual differences in self-reported pain-related cognitions, emotion regulation habits, gaming skills, and executive functions. Methods: 90 healthy participants played two versions of the VR game 'Subnautica', differing in cognitive load (low load vs. high load). In the low load condition, participants navigated along a predefined route. In the high load condition, participants additionally memorized a series of single digits presented along the route. Pain heat thresholds as well as psychophysiological measures (ECG, EDA) were recorded during a passive control condition (in VR) prior to, as well as during, the two interactive sessions. In addition, participants completed several psychological questionnaires and different executive functioning tasks prior to the VR sessions. Results: Pain thresholds were significantly higher in the two interactive VR sessions when compared to the passive control condition, whereas the cognitive load of the game had no effect on pain thresholds. Individual differences in pain-related cognitions, prepotent response inhibition abilities and the level of emotional awareness reported by female participants, but not the level of gaming skills, influenced the size of the hypoalgesic effect. Discussion: In line with a growing body of studies, we observed a robust hypoalgesic response to playing a VR game, highlighting once more the potential of VR as a tool for pain reduction. Importantly, the hypoalgesic effect was not dependent on the participants’ level of gaming skills or the cognitive load of the game, suggesting that the sensory properties of the VR game were sufficient to change the processing of pain. [less ▲]

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See detailDistraction from pain: The role of selective attention and pain catastrophizing
Rischer, Katharina Miriam UL; Gonzalez-Roldan, Ana Maria; Montoya, Pedro et al

in European Journal of Pain (2020), 24(10), 1880-1891

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See detailMemory suppression and its deficiency in psychological disorders: A focused meta-analysis
Stramaccia, Davide F.; Meyer, Ann-Kristin; Rischer, Katharina Miriam UL et al

in Journal of Experimental Psychology. General (2020)

It is still debated whether suppressing the retrieval of unwanted memories causes forgetting and whether this constitutes a beneficial mechanism. To shed light on these 2 questions, we scrutinize the ... [more ▼]

It is still debated whether suppressing the retrieval of unwanted memories causes forgetting and whether this constitutes a beneficial mechanism. To shed light on these 2 questions, we scrutinize the evidence for such suppression-induced forgetting (SIF) and examine whether it is deficient in psychological disorders characterized by intrusive thoughts. Specifically, we performed a focused meta-analysis of studies that have used the think/no-think procedure to test SIF in individuals either affected by psychological disorders or exhibiting high scores on related traits. Overall, across 96 effects from 25 studies, we found that avoiding retrieval leads to significant forgetting in healthy individuals, with a small to moderate effect size (0.28, 95% CI [0.14, 0.43]). Importantly, this effect was indeed larger than for more anxious (−0.21, 95% CI [−0.41, −0.02]) or depressed individuals (0.05, 95% CI [−0.19, 0.29])—though estimates for the healthy may be inflated by publication bias. In contrast, individuals with a stronger repressive coping style showed greater SIF (0.42, 95% CI [0.32, 0.52]). Furthermore, moderator analyses revealed that SIF varied with the exact suppression mechanism that participants were instructed to engage. For healthy individuals, the effect sizes were considerably larger when instructions induced specific mechanisms of direct retrieval suppression or thought substitution than when they were unspecific. These results suggest that intact suppression-induced forgetting is a hallmark of psychological well-being, and that inducing more specific suppression mechanisms fosters voluntary forgetting. [less ▲]

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See detailIn context: emotional intent and temporal immediacy of contextual descriptions modulate affective ERP components to facial expressions
Rischer, Katharina Miriam UL; Savallampi, Mattias; Akwaththage, Anushka et al

in Social Cognitive and Affective Neuroscience (2020)

In this study, we explored how contextual information about threat dynamics affected the electrophysiological correlates of face perception. Forty-six healthy native Swedish speakers read verbal ... [more ▼]

In this study, we explored how contextual information about threat dynamics affected the electrophysiological correlates of face perception. Forty-six healthy native Swedish speakers read verbal descriptions signaling an immediate vs delayed intent to escalate or deescalate an interpersonal conflict. Each verbal description was followed by a face with an angry or neutral expression, for which participants rated valence and arousal. Affective ratings confirmed that the emotional intent expressed in the descriptions modulated emotional reactivity to the facial stimuli in the expected direction. The electrophysiological data showed that compared to neutral faces, angry faces resulted in enhanced early and late event-related potentials (VPP, P300 and LPP). Additionally, emotional intent and temporal immediacy modulated the VPP and P300 similarly across angry and neutral faces, suggesting that they influence early face perception independently of facial affect. By contrast, the LPP amplitude to faces revealed an interaction between facial expression and emotional intent. Deescalating descriptions eliminated the LPP differences between angry and neutral faces. Together, our results suggest that information about a person’s intentions modulates the processing of facial expressions. [less ▲]

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See detailPlay the Pain Away: Pain Regulation and Attention in Virtual Reality
Holl, Elisabeth UL; Rischer, Katharina Miriam UL; Battistutta, Layla UL et al

Scientific Conference (2020, May)

Virtual reality (VR) has been shown to be a powerful method to divert attention away from pain (Malloy & Milling, 2010). In an ongoing study (data collection will be finished in late December 2019 ... [more ▼]

Virtual reality (VR) has been shown to be a powerful method to divert attention away from pain (Malloy & Milling, 2010). In an ongoing study (data collection will be finished in late December 2019) healthy participants play the VR game Subnautica in two conditions (high vs. low cognitive load). Pain thresholds and psychophysiological measures are assessed during play to measure the distraction effect. Additionally, pain management will be compared to individual executive functions and attention investigated before playing. [less ▲]

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See detailInvestigating the role of individual differences in the analgesic response to a virtual reality game: An exploratory analysis (accepted submission, but symposium was cancelled due to COVID-19)
Rischer, Katharina Miriam UL; Barcatta, Katharina UL; Battistutta, Layla UL et al

Scientific Conference (2020, March)

Virtual reality (VR) has been shown to be a powerful method of redirecting attention away from pain and is increasingly used in clinical settings as a therapeutic tool for pain treatment. Yet, little is ... [more ▼]

Virtual reality (VR) has been shown to be a powerful method of redirecting attention away from pain and is increasingly used in clinical settings as a therapeutic tool for pain treatment. Yet, little is known about the underlying factors that modulate the size of the analgesic response to a VR game, such as task difficulty and inter-individual differences in pain attitude, emotion regulation habits, executive functions and virtual reality experience. Methods: 101 healthy participants played two versions of the VR game Subnautica, differing in cognitive load (low load vs. high load). In the low load condition, participants navigated along a predefined route. In the high load condition, participants additionally memorized a series of single digits presented along the route. Pain heat thresholds as well as psychophysiological measures (ECG, EDA) were recorded during a resting state period prior to, as well as during, the two VR playing sessions. In addition, participants completed several psychological questionnaires and different executive functioning tasks (Corsi block tapping task, flanker task, go/nogo task) prior to the VR sessions. Results: Preliminary results of a subgroup (N = 66) of the total sample revealed that pain thresholds were significantly higher for the VR playing sessions when compared to the resting state period, with a trend of a higher threshold for the high load condition. Moreover, pain catastrophizing and fear of pain were significant predictors of pain threshold measurements. The complete results will be presented at the symposium. Discussion: Results could shed light on the role of inter-individual differences on the efficacy of VR-based distraction from pain, and potentially elucidate factors that render an individual more likely to benefit from VR as a pain-relieving tool. This may have important consequences for the use of VR as a therapeutic treatment for pain patients. [less ▲]

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See detailPlacebo Analgesie im Alter
Dierolf, Angelika UL; Rischer, Katharina Miriam UL; van der Meulen, Marian UL

Scientific Conference (2020, January)

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See detailThe destruction of distraction? Neural mechanisms of reduced task-related analgesia with aging.
Rischer, Katharina Miriam UL; Dierolf, Angelika UL; Gonzalez-Roldan, Ana Maria et al

Poster (2019, September 06)

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See detailThe role of executive functions in task-related analgesia
Rischer, Katharina Miriam UL; Gigl, Sandra; Dierolf, Angelika UL et al

Poster (2019, March)

Introduction: Recent research suggests that weaker executive functions may be linked to a higher risk of pain chronicity. However, little is known about how executive functions affect the modulation of ... [more ▼]

Introduction: Recent research suggests that weaker executive functions may be linked to a higher risk of pain chronicity. However, little is known about how executive functions affect the modulation of acute pain. The present study aimed to investigate the impact of inhibitory control on the success of cognitive distraction from pain. Methods: Participants completed a battery of cognitive tasks (Go/NoGo, Color Stroop, Eriksen Flanker), assessing their cognitive inhibition and selective attention abilities. Additionally, self-report measures of pain catastrophizing and fear of pain were administered. In a pain distraction paradigm, participants completed either a cognitively demanding working memory task (2-back task) or a visually matched easy control task (target response task) while receiving warm or painful thermal stimuli to their left forearm. Nociceptive stimulus intensity was individually calibrated for each participant. Moreover, to maintain a similar level of task difficulty across participants, task speed was continuously adapted based on the participant's performance in the previous trials. Following each trial, participants rated the perceived intensity and unpleasantness of the thermal stimuli on visual analogue scales. Results: As expected, preliminary results indicate that the 2-back task, but not the target response task, successfully distracted participants from thermal pain, manifesting in significantly lower intensity and unpleasantness ratings. Importantly, the magnitude of the distraction effect was negatively associated with the Flanker effect. Discussion: In line with previous research, engaging in a cognitively demanding task led to significantly lower pain intensity and unpleasantness ratings when compared to an easy control task. Moreover, results indicate that better interference control abilities may predict greater task-related analgesia. Taken together, the results of the present study suggest that it is crucial to assess executive functions to develop a better understanding of the mechanisms behind cognitive distraction from pain. [less ▲]

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See detailA meta-analysis of suppression-induced forgetting in neurotypical and clinical populations
Stramaccia, Davide F.; Fawcett, Jonathan M.; Rischer, Katharina Miriam UL et al

Scientific Conference (2018, May)

Detailed reference viewed: 100 (6 UL)