TY  - JOUR
AU  - Terzulli, Claire
AU  - Melchior, Meggane
AU  - Goffin, Laurent
AU  - Faisan, Sylvain
AU  - Gianesini, Coralie
AU  - Graff, Denis
AU  - Dufour, André
AU  - Laroche, Edouard
AU  - Chauvin, Chloé
AU  - Poisbeau, Pierrick
PY  - 2022
DA  - 2022/7/29
TI  - Effect of Virtual Reality Hypnosis on Pain Threshold and Neurophysiological and Autonomic Biomarkers in Healthy Volunteers: Prospective Randomized Crossover Study
JO  - J Med Internet Res
SP  - e33255
VL  - 24
IS  - 7
KW  - virtual reality
KW  - hypnosis
KW  - pain
KW  - analgesia
KW  - autonomic changes
KW  - thermal pain
KW  - physiological
KW  - nervous system
KW  - heat pain
AB  - Background: Virtual reality hypnosis (VRH) is a promising tool to reduce pain. However, the benefits of VRH on pain perception and on the physiological expression of pain require further investigation. Objective: In this study, we characterized the effects of VRH on the heat pain threshold among adult healthy volunteers while monitoring several physiological and autonomic functions. Methods: Sixty healthy volunteers were prospectively included to receive nociceptive stimulations. The first set of thermal stimuli consisted of 20 stimulations at 60°C (duration 500 milliseconds) to trigger contact heat evoked potentials (CHEPs). The second set of thermal stimuli consisted of ramps (1°C/second) to determine the heat pain threshold of the participants. Electrocardiogram, skin conductance responses, respiration rate, as well as the analgesia nociception index were also recorded throughout the experiment. Results: Data from 58 participants were analyzed. There was a small but significant increase in pain threshold in VRH (50.19°C, SD 1.98°C) compared to that in the control condition (mean 49.45°C, SD 1.87; P<.001, Wilcoxon matched-pairs signed-rank test; Cohen d=0.38). No significant effect of VRH on CHEPs and heart rate variability parameters was observed (all P>0.5; n=22 and n=52, respectively). During VRH, participants exhibited a clear reduction in their autonomic sympathetic tone, as shown by the lower number of nonspecific skin conductance peak responses (P<.001, two-way analysis of variance; n=39) and by an increase in the analgesia nociception index (P<.001, paired t-test; n=40). Conclusions: The results obtained in this study support the idea that VRH administration is effective at increasing heat pain thresholds and impacts autonomic functions among healthy volunteers. As a nonpharmacological intervention, VRH has beneficial action on acute experimental heat pain. This beneficial action will need to be evaluated for the treatment of other types of pain, including chronic pain. 
SN  - 1438-8871
UR  - https://www.jmir.org/2022/7/e33255
UR  - https://doi.org/10.2196/33255
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35904872
DO  - 10.2196/33255
ID  - info:doi/10.2196/33255
ER  -