PMID- 38466872
OWN - NLM
STAT- Publisher
LR  - 20240325
IS  - 1872-6623 (Electronic)
IS  - 0304-3959 (Linking)
DP  - 2024 Mar 8
TI  - The effects of virtual reality neuroscience-based therapy on clinical and 
      neuroimaging outcomes in patients with chronic back pain: a randomized clinical 
      trial.
LID - 10.1097/j.pain.0000000000003198 [doi]
AB  - Chronic pain remains poorly managed. The integration of immersive technologies 
      (ie, virtual reality [VR]) with neuroscience-based principles may provide 
      effective pain treatment by targeting cognitive and affective neural processes 
      that maintain pain and therefore potentially changing neurobiological circuits 
      associated with pain chronification and amplification. We tested the 
      effectiveness of a novel VR neuroscience-based therapy (VRNT) to improve 
      pain-related outcomes in n = 31 participants with chronic back pain, evaluated 
      against usual care (waitlist control; n = 30) in a 2-arm randomized clinical 
      trial (NCT04468074). We also conducted pre-treatment and post-treatment MRI to 
      test whether VRNT affects brain networks previously linked to chronic pain and 
      treatment effects. Compared with the control condition, VRNT led to significantly 
      reduced pain intensity (g = 0.63) and pain interference (g = 0.84) at 
      post-treatment vs pre-treatment, with effects persisting at 2-week follow-up. 
      These improvements were partially mediated by reduced kinesiophobia and pain 
      catastrophizing. Several secondary clinical outcomes were also improved by VRNT, 
      including disability, quality of life, sleep, and fatigue. In addition, VRNT was 
      associated with increases in dorsomedial prefrontal functional connectivity with 
      the superior somatomotor, anterior prefrontal and visual cortices, and decreased 
      white matter fractional anisotropy in the corpus callosum adjacent to the 
      anterior cingulate, relative to the control condition. Thus, VRNT showed 
      preliminary efficacy in significantly reducing pain and improving overall 
      functioning, possibly through changes in somatosensory and prefrontal brain 
      networks.
CI  - Copyright (c) 2024 International Association for the Study of Pain.
FAU - Ceko, Marta
AU  - Ceko M
AUID- ORCID: 0000-0001-8679-8145
AD  - Institute of Cognitive Science, University of Colorado, Boulder, CO, United 
      States.
FAU - Baeuerle, Tassilo
AU  - Baeuerle T
AD  - CognifiSense, Inc, Sunnyvale, CA, United States.
FAU - Webster, Lynn
AU  - Webster L
AD  - U.S. Center for Policy, Scientific Affairs, Dr. Vince Clinical Research, Salt 
      Lake City, UT, United States.
FAU - Wager, Tor D
AU  - Wager TD
AD  - Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, 
      United States.
FAU - Lumley, Mark A
AU  - Lumley MA
AD  - Department of Psychology, Wayne State University, Detroit, MI, United States.
LA  - eng
SI  - ClinicalTrials.gov/NCT04468074
PT  - Journal Article
DEP - 20240308
PL  - United States
TA  - Pain
JT  - Pain
JID - 7508686
SB  - IM
UOF - medRxiv. 2023 Jul 27;:. PMID: 37546872
EDAT- 2024/03/11 18:42
MHDA- 2024/03/11 18:42
CRDT- 2024/03/11 15:03
PHST- 2023/07/26 00:00 [received]
PHST- 2024/01/06 00:00 [accepted]
PHST- 2024/03/11 18:42 [medline]
PHST- 2024/03/11 18:42 [pubmed]
PHST- 2024/03/11 15:03 [entrez]
AID - 00006396-990000000-00549 [pii]
AID - 10.1097/j.pain.0000000000003198 [doi]
PST - aheadofprint
SO  - Pain. 2024 Mar 8. doi: 10.1097/j.pain.0000000000003198.