Abstract :
[en] 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.