Virtual reality for assessment of patients suffering chronic pain: a case study
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The study of body representation and ownership has been a very active research area in recent years. Synchronous multisensory stimulation has been used for the induction of the illusion of ownership over virtual body parts and even full bodies, and it has provided experimental paradigms for the understanding of the brain processing of body representation. However, the illusion of ownership of a virtual body has rarely been used for patient evaluation and diagnosis. Here we propose a method that exploits ownership of a virtual body in combination with a simple brain computer interface (BCI) and basic physiological measures to complement neurological assessment. A male patient presenting a fixed posture dystonia featuring a permanently closed left fist participated in this case study. The patient saw a virtual body that substituted his own after donning a head-mounted display and thereby entering the virtual reality. The left virtual hand had the same posture as his corresponding real hand. After inducing virtual hand ownership by correlated visuo-tactile stimulation and dynamic reflections in a virtual mirror, the virtual hand would open either automatically or through a cognitive task assessed through a BCI that required him to focus attention on the virtual hand. The results reveal that body ownership induced changes on electromyography and BCI performance in the patient that were different from those in five healthy controls. Overall, the case study shows that the induction of virtual body ownership combined with simple electrophysiological measures could be useful for the diagnosis of patients with neurological conditions.
KeywordsBody ownership Immersive virtual reality Pain Assessment
We would like to acknowledge Pere Sivecas for his help during the experiment. JLL work was funded by the “Fundació de la Marató de TV3” project 71531 to MS. MG-F was supported by the FI-DGR grant from the Catalan Government (CUR-Gencat) cofounded by the European Social Found (EC-ESF). This work was also funded by the “Fundació de la Marató de TV3” project 110930 to JV-S, and by European Union FP7 Integrated Project BEAMING (248620) to MS and MS-V. MS is also supported by an ERC grant TRAVERSE (#227985).
- Blanke O (2012) Multisensory brain mechanisms of bodily self-consciousness. Nat Rev Neurosci 13(8). doi:http://dx.doi.org/10.1038/nrn3292
- Brütsch K, Schuler T, Koenig A, Zimmerli L, Koeneke SM, Lünenburger L, Riener R, Jäncke L, Meyer-Heim A (2010) Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children. J Neuroeng Rehabil 7:15. doi: 10.1186/1743-0003-7-15 PubMedCrossRefGoogle Scholar
- González-Franco M, Pérez-Marcos D, Spanlang B, Slater M (2010) The contribution of real-time mirror reflections of motor actions on virtual body ownership in an immersive virtual environment. In: IEEE virtual reality conference, 2010. IEEE, pp 111–114Google Scholar
- Lin TA, John LR (2006) Quantifying mental relaxation with EEG for use in computer games. In: International conference on internet computing, 2006, pp 409–415Google Scholar
- Neuper C, Pfurtscheller G (2010) Neurofeedback training for BCI control. In: Brain-computer interfaces. The frontiers collection. Springer, Berlin, Heidelberg, pp 65–78. doi: 10.1007/978-3-642-02091-9
- Sato K, Fukumori S, Matsusaki T, Maruo T, Ishikawa S, Nishie H, Takata K, Mizuhara H, Mizobuchi S, Nakatsuka H, Matsumi M, Gofuku A, Yokoyama M, Morita K (2010) Nonimmersive virtual reality mirror visual feedback therapy and its application for the treatment of complex regional pain syndrome: an open-label pilot study. Pain Med 11(4):622–629. doi: 10.1111/j.1526-4637.2010.00819.x PubMedCrossRefGoogle Scholar
- Slater M, Perez-Marcos D, Ehrsson HH, Sanchez-Vives MV (2008) Towards a digital body: the virtual arm illusion. Front Hum Neurosci 2(6). doi: 10.3389/neuro.09.006.2008
- Taylor RM, Hudson TC, Seeger A, Weber H, Juliano J, Helser AT (2001) VRPN: a device-independent, network-transparent VR peripheral system. In: Proceedings of the ACM symposium on virtual reality software and technology, New York, NY, USA. ACM Press, pp 55–61. doi: 10.1145/505008.505019
- Tsakiris M, Hesse MD, Boy C, Haggard P, Fink GR (2007) Neural signatures of body ownership: a sensory network for bodily self-consciousness. Cereb Cortex (New York, NY: 1991) 17(10):2235–2244. doi: 10.1093/cercor/bhl131