R01AT011347

Neural Mechanisms of Immersive Virtual Reality in Chronic Pain - Summary

The COVID-19 pandemic and its effect on the opioid crisis have created a pressing need for telemedicine and consideration for the use of non-pharmacological, low-cost interventions as adjuvants in pain management. We propose a project investigating the neural mechanisms underlying pain reduction induced by immersive virtual reality (VR). VR involves immersion in artificial environments through the use of real-time rendering technologies and the latest generation devices.

We have recently demonstrated that VR increases pain tolerance limits and vagal activity, while also improving individual pain unpleasantness, mood, and situational anxiety. To enhance the translatability of this project, we will directly dive into the neural mechanisms of VR in chronic pain participants suffering from temporomandibular disorder(s) (TMD), a population with which the PI and her collaborators have had fruitful results.

The overarching goal is to investigate the pain modulation mechanisms underlying VR-induced hypoalgesia by determining: 1) the involvement of endogenous mu opioids, 2) the relationship between responsiveness to acute VR and long-term pain-related outcomes, and 3) the changes in cortical excitability related to 3-week VR. We will use three main approaches: 1) a pharmacological antagonist approach, 2) an ecological momentary assessment (EMA) for tracking dynamics of pain outcomes over 6 months, and 3) high-resolution electroencephalography to measure synchronization of peak alpha frequency (PAF).

We will disentangle the mechanisms of VR-induced hypoalgesia from placebo effects among participants with distinct disabilities and grades of TMD. We expect that: 1) VR, similar to placebo effects, will reduce pain through the engagement of endogenous opioid systems, 2) VR-induced pain modulation capability will result in better long-term pain outcomes, and 3) 3-week VR will favor a synchronization of PAF oscillations paralleled by individual VR therapeutic benefits.

This project will combine pharmacologic, EMA, and electroencephalographic techniques employed within TMD patients to maximize the translational value of the resulting knowledge. The team has a history of successful collaboration and the expertise to generate innovative, relevant, and timely findings. The successful completion of this research will generate mechanistic-based evidence for the potential application of VR-based interventions, which might empower TMD patients with new, accessible, and affordable therapeutic solutions.

University Of Maryland, Baltimore

NOT APPLICABLE

93.213 - Research and Training in Complementary and Integrative Health

National Center for Complementary and Integrative Health (NCCIH) [HHS - NIH]

Baltimore, Maryland 21201 United States

Single Zip Code

Research Project Grant (Parent R01 Clinical Trial Required) (PA-20-183)

Amendment Since initial award the End Date has been extended from 05/31/26 to 05/31/27 and the total obligations have increased 365% from $686,074 to $3,191,176.