000262484 001__ 262484
000262484 005__ 20190418064906.0
000262484 0247_ $$2doi$$a10.1212/WNL.0000000000005905
000262484 02470 $$2DOI$$a10.1212/WNL.0000000000005905
000262484 037__ $$aARTICLE
000262484 245__ $$aHeartbeat-enhanced immersive virtual reality to treat complex regional pain syndrome
000262484 260__ $$c2018
000262484 269__ $$a2018
000262484 336__ $$aJournal Articles
000262484 520__ $$aOBJECTIVES: To develop and test a new immersive digital technology for complex regional pain syndrome (CRPS) that combines principles from mirror therapy and immersive virtual reality and the latest research from multisensory body processing. METHODS: In this crossover double-blind study, 24 patients with CRPS and 24 age- and sex-matched healthy controls were immersed in a virtual environment and shown a virtual depiction of their affected limb that was flashing in synchrony (or in asynchrony in the control condition) with their own online detected heartbeat (heartbeat-enhanced virtual reality [HEVR]). The primary outcome measures for pain reduction were subjective pain ratings, force strength, and heart rate variability (HRV). RESULTS: HEVR reduced pain ratings, improved motor limb function, and modulated a physiologic pain marker (HRV). These significant improvements were reliable and highly selective, absent in control HEVR conditions, not observed in healthy controls, and obtained without the application of tactile stimulation (or movement) of the painful limb, using a readily available biological signal (the heartbeat) that is most often not consciously perceived (thus preventing placebo effects). CONCLUSIONS: Next to these specific and well-controlled analgesic effects, immersive HEVR allows the application of prolonged and repeated doses of digital therapy, enables the automatized integration with existing pain treatments, and avoids application of painful bodily cues while minimizing the active involvement of the patient and therapist. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that HEVR reduces pain and increases force strength in patients with CRPS.
000262484 700__ $$aSolcà, Marco
000262484 700__ $$aRonchi, Roberta
000262484 700__ $$aBello-Ruiz, Javier
000262484 700__ $$aSchmidlin, Thomas
000262484 700__ $$aHerbelin, Bruno
000262484 700__ $$aLuthi, François
000262484 700__ $$aKonzelmann, Michel
000262484 700__ $$aBeaulieu, Jean-Yves
000262484 700__ $$aDelaquaize, François
000262484 700__ $$aSchnider, Armin
000262484 700__ $$aGuggisberg, Adrian G.
000262484 700__ $$aSerino, Andrea
000262484 700__ $$aBlanke, Olaf
000262484 773__ $$j91$$k5$$qe479-e489$$tNeurology
000262484 8560_ $$fmyeong.song@epfl.ch
000262484 909CO $$ooai:infoscience.epfl.ch:262484$$particle$$pSV
000262484 909C0 $$0252325$$mmarco.solca@epfl.ch$$pLNCO$$xU11025$$zBlumer, Eliane
000262484 960__ $$amyeong.song@epfl.ch
000262484 961__ $$amanon.velasco@epfl.ch
000262484 973__ $$aEPFL$$rREVIEWED$$sPUBLISHED
000262484 980__ $$aARTICLE
000262484 981__ $$aoverwrite
000262484 999C0 $$0252517$$mbruno.herbelin@epfl.ch$$pCNP$$xU12599$$zBlumer, Eliane