Analgesic effects of interacting with a VR game and associated psychophysiological responses

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.