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

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 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.

In context: emotional intent and temporal immediacy of contextual descriptions modulate affective ERP components to facial expressions

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 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.

Investigating 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)

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 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.

The role of executive functions in task-related analgesia

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 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.

When versus what: How time and valence of contextual descriptions modulate affective ERP components in response to facial expressions

Poster (2018, March)