eMedicine Specialties > Clinical Procedures > Neurologic Procedures

Virtual Reality Biofeedback in Chronic Pain and Psychiatry: Multimedia

Author: Morris Steffin, MD, Chief Science Officer, Virtual Reality Neurotech Lab
Contributor Information and Disclosures

Updated: Jun 24, 2009

Multimedia

Real-time acquisition of orbital position data in...
(Enlarge Image)
Media file 1: Real-time acquisition of orbital position data including eyebrow region and palpebral fissure. These data allow charting of eye blinks and other relative position changes of the orbital region.
[ CLOSE WINDOW ]
Real-time acquisition of orbital position data in...

Real-time acquisition of orbital position data including eyebrow region and palpebral fissure. These data allow charting of eye blinks and other relative position changes of the orbital region.

Yawn detection by monitoring the upper and lower ...
(Enlarge Image)
Media file 2: Yawn detection by monitoring the upper and lower mouth regions. The algorithm operates essentially as in Image 1.
[ CLOSE WINDOW ]
Yawn detection by monitoring the upper and lower ...

Yawn detection by monitoring the upper and lower mouth regions. The algorithm operates essentially as in Image 1.

Real-time facial feature acquisition for the eyes...
(Enlarge Image)
Media file 3: Real-time facial feature acquisition for the eyes and mouth. Traces 1 and 3 show the position of the eye structures; traces 2 and 4 show the upper and lower mouth regions. The algorithm operates similar to that of Image 2. Click here to view video clip.
[ CLOSE WINDOW ]
Real-time facial feature acquisition for the eyes...

Real-time facial feature acquisition for the eyes and mouth. Traces 1 and 3 show the position of the eye structures; traces 2 and 4 show the upper and lower mouth regions. The algorithm operates similar to that of Image 2. Click here to view video clip.

Processing of ROI configuration data allows the c...
(Enlarge Image)
Media file 4: Processing of ROI configuration data allows the computer to interpret in real time whether the monitored movements are likely to represent physiologically significant activity. The movie clip demonstrates this process. Click here to play video clip.
[ CLOSE WINDOW ]
Processing of ROI configuration data allows the c...

Processing of ROI configuration data allows the computer to interpret in real time whether the monitored movements are likely to represent physiologically significant activity. The movie clip demonstrates this process. Click here to play video clip.

Experiential enhancement with virtual reality (VR...
(Enlarge Image)
Media file 5: Experiential enhancement with virtual reality (VR) biofeedback. Stimulation can be tailored to the patient's responses and monitored by patient input and physiological functions. Imagery similar to this can be combined with audio stimulation (eg, music and sea sounds) and stimulation of other modalities to engage neurophysiologic pain-suppression mechanisms.
[ CLOSE WINDOW ]
Experiential enhancement with virtual reality (VR...

Experiential enhancement with virtual reality (VR) biofeedback. Stimulation can be tailored to the patient's responses and monitored by patient input and physiological functions. Imagery similar to this can be combined with audio stimulation (eg, music and sea sounds) and stimulation of other modalities to engage neurophysiologic pain-suppression mechanisms.

Several types of stimuli, visual and auditory, ca...
(Enlarge Image)
Media file 6: Several types of stimuli, visual and auditory, can be optimized for individual patients and controlled by patient responses. For example, motion of the bird, the sea, and their intermixture can be modulated and correlated with the patient's response. Click here to play video clip.
[ CLOSE WINDOW ]
Several types of stimuli, visual and auditory, ca...

Several types of stimuli, visual and auditory, can be optimized for individual patients and controlled by patient responses. For example, motion of the bird, the sea, and their intermixture can be modulated and correlated with the patient's response. Click here to play video clip.

More on Virtual Reality Biofeedback in Chronic Pain and Psychiatry

References
[ CLOSE WINDOW ]

References

  1. Abuaisha BB, Costanzi JB, Boulton AJ. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract. Feb 1998;39(2):115-21. [Medline].

  2. Arena JG, Bruno GM, Hannah SL, Meador KJ. A comparison of frontal electromyographic biofeedback training, trapezius electromyographic biofeedback training, and progressive muscle relaxation therapy in the treatment of tension headache. Headache. Jul-Aug 1995;35(7):411-9. [Medline].

  3. Arendt-Nielsen L, Petersen-Felix S. Wind-up and neuroplasticity: is there a correlation to clinical pain?. Eur J Anaesthesiol Suppl. May 1995;10:1-7. [Medline].

  4. Bajuk S, Jelnikar T, Ortar M. Rehabilitation of patient with brachial plexus lesion and break in axillary artery: case study. J Hand Ther. Oct-Dec 1996;9(4):399-403. [Medline].

  5. Chudler EH, Dong WK. The role of the basal ganglia in nociception and pain. Pain. Jan 1995;60(1):3-38. [Medline].

  6. Coghill RC, Talbot JD, Evans AC, et al. Distributed processing of pain and vibration by the human brain. J Neurosci. Jul 1994;14(7):4095-108. [Medline].

  7. Cross SA. Pathophysiology of pain. Mayo Clin Proc. Apr 1994;69(4):375-83. [Medline].

  8. Derbyshire SW, Vogt BA, Jones AK. Pain and Stroop interference tasks activate separate processing modules in anterior cingulate cortex. Exp Brain Res. Jan 1998;118(1):52-60. [Medline].

  9. Disbrow E, Buonocore M, Antognini J, et al. Somatosensory cortex: a comparison of the response to noxious thermal, mechanical, and electrical stimuli using functional magnetic resonance imaging. Hum Brain Mapp. 1998;6(3):150-9. [Medline].

  10. Garrison DW, Foreman RD. Effects of transcutaneous electrical nerve stimulation (TENS) on spontaneous and noxiously evoked dorsal horn cell activity in cats with transected spinal cords. Neurosci Lett. Sep 27 1996;216(2):125-8. [Medline].

  11. Ham LP, Packard RC. A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with post-traumatic headache. Biofeedback Self Regul. Jun 1996;21(2):93-104. [Medline].

  12. Holroyd KA, France JL, Cordingley GE, et al. Enhancing the effectiveness of relaxation-thermal biofeedback training with propranolol hydrochloride. J Consult Clin Psychol. Apr 1995;63(2):327-30. [Medline].

  13. Kiernan BD, Dane JR, Phillips LH, et al. Hypnotic analgesia reduces R-III nociceptive reflex: further evidence concerning the multifactorial nature of hypnotic analgesia. Pain. Jan 1995;60(1):39-47. [Medline].

  14. Kropp P, Gerber WD, Keinath-Specht A, et al. Behavioral treatment in migraine. Cognitive-behavioral therapy and blood-volume-pulse biofeedback: a cross-over study with a two-year follow-up. Funct Neurol. Jan-Feb 1997;12(1):17-24. [Medline].

  15. Lamson RJ, Meisner M. Clinical application of virtual therapy to psyciatric disorders: theory, research, practice. In: KS Morgan, HM Hoffman, D Stredney, SJ Weghorst, et al, eds. Medicine Meets Virtual Reality 4. Amsterdam: IOS Press; 1996:723-724.

  16. Leone M, Grazzi L, D'Amico D, Moschiano F, Bussone G. A review of the treatment of primary headaches. Part I: Migraine. Ital J Neurol Sci. Dec 1995;16(9):577-86. [Medline].

  17. Markenson JA. Mechanisms of chronic pain. Am J Med. Jul 31 1996;101(1A):6S-18S. [Medline].

  18. McGrady A. Good news - bad press: applied psychophysiology in cardiovascular disorders. Biofeedback Self Regul. Dec 1996;21(4):335-46. [Medline].

  19. Miron D, Duncan GH, Bushnell MC. Effects of attention on the intensity and unpleasantness of thermal pain. Pain. Dec 1989;39(3):345-52. [Medline].

  20. Moret V, Forster A, Laverriere MC, et al. Mechanism of analgesia induced by hypnosis and acupuncture: is there a difference?. Pain. May 1991;45(2):135-40. [Medline].

  21. Moskowitz L. Psychological management of postsurgical pain and patient adherence. Hand Clin. Feb 1996;12(1):129-37. [Medline].

  22. Oshiro Y, Fuijita N, Tanaka H, et al. Functional mapping of pain-related activation with echo-planar MRI: significance of the SII-insular region. Neuroreport. Jul 13 1998;9(10):2285-9. [Medline].

  23. Oyama H, Ohsuga M, Tatsuno Y. Evaluation of the psycho-oncological effectiveness of the bedside wellness system. Cyberpsychol Behav. Feb 1999;2(1):81-84.

  24. Reid GJ, McGrath PJ. Psychological treatments for migraine. Biomed Pharmacother. 1996;50(2):58-63. [Medline].

  25. Riva G, Bacchetta M, Baruffi M. VREPAR 2: VR in eating disorders. Cyberpsychol Behav. Feb 1999;2(1):77-79.

  26. Rokicki LA, Holroyd KA, France CR, et al. Change mechanisms associated with combined relaxation/EMG biofeedback training for chronic tension headache. Appl Psychophysiol Biofeedback. Mar 1997;22(1):21-41. [Medline].

  27. Sarnoch H, Adler F, Scholz OB. Relevance of muscular sensitivity, muscular activity, and cognitive variables for pain reduction associated with EMG biofeedback in fibromyalgia. Percept Mot Skills. Jun 1997;84(3 Pt 1):1043-50. [Medline].

  28. Steffin M. Virtual Reality: Overview of its Applications to Neurology. Available at: http://www.emedicine.com/neuro/topic463.htm. eMedicine Journal [serial online]. 2006. [Full Text].

  29. Steffin M. Visual-Haptic Interfaces: Modification of Motor and Cognitive Performance. Available at: http://www.emedicine.com/neuro/topic464.htm. eMedicine Journal [serial online]. 2006. [Full Text].

  30. Steffin M. Bridging the gap between "real" reality and virtual reality: intelligent human-machine therapeutic interaction in patient videospace. Cyberpsychol Behav. 2000;3(3):447-463.

  31. Steffin M, Wahl K. Occam's approach to video critical behavior detection: a practical real time video in-vehicle alertness monitor. In: Westwood JM, Haluck RS, et al, eds. Medicine Meets Virtual Reality 12 Proceedings. Amsterdam: IOS Press;2004:370-375.

  32. Tolle TR, Kaufmann T, Siessmeier T, et al. Region-specific encoding of sensory and affective components of pain in the human brain: a positron emission tomography correlation analysis. Ann Neurol. Jan 1999;45(1):40-7. [Medline].

  33. Torebjork E. Human microneurography and intraneural microstimulation in the study of neuropathic pain. Muscle Nerve. Oct 1993;16(10):1063-5. [Medline].

  34. Treede RD. Peripheral acute pain mechanisms. Ann Med. Apr 1995;27(2):213-6. [Medline].

  35. VeHoffman H. Virtual reality: a new tool for interdisciplinary psychology research. Cyberpsychol Behav. 1998;1(2):195-200.

  36. Villanueva L, Le Bars D. The activation of bulbo-spinal controls by peripheral nociceptive inputs: diffuse noxious inhibitory controls. Biol Res. 1995;28(1):113-25. [Medline].

  37. Wauquier A, McGrady A, Aloe L, et al. Changes in cerebral blood flow velocity associated with biofeedback-assisted relaxation treatment of migraine headaches are specific for the middle cerebral artery. Headache. Jun 1995;35(6):358-62. [Medline].

  38. Wong AM, Lee MY, Chang WH, Tang FT. Clinical trial of a cervical traction modality with electromyographic biofeedback. Am J Phys Med Rehabil. Jan-Feb 1997;76(1):19-25. [Medline].

  39. Young LD, Bradley LA, Turner RA. Decreases in health care resource utilization in patients with rheumatoid arthritis following a cognitive behavioral intervention. Biofeedback Self Regul. Sep 1995;20(3):259-68. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

VR, psychiatric disorders, pain disorders, pain physiology, biofeedback in pain treatment, virtual reality applications in biofeedback, psychiatric applications of biofeedback

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Morris Steffin, MD, Chief Science Officer, Virtual Reality Neurotech Lab
Disclosure: Nothing to disclose.

Medical Editor

Marion Priscilla Short, MD, Assistant Professor, Departments of Neurology, Pediatrics, and Pathology, University of Chicago Hospitals and Clinics
Marion Priscilla Short, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuropathologists, American College of Medical Genetics, American Medical Association, and American Society of Human Genetics
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

James H Halsey, MD, Professor, Department of Neurology, University of Alabama Medical Center
James H Halsey, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neuroimaging, Medical Association of the State of Alabama, New York Academy of Sciences, Pan American Medical Association, Sigma Xi, Society for Neuroscience, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

RELATED EMEDICINE ARTICLES
Patient Education
 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.