Investigating Mechanisms Underlying Spinal Cord Stimulation Efficacy Using Virtual Reality and Full Body Illusion
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/7/2018 |
| Start Date: | October 2016 |
| End Date: | November 2019 |
| Contact: | Carson R Reider, PhD |
| Email: | carson.reider@osumc.edu |
| Phone: | 614-293-9274 |
The study hypothesis is that spinal cord stimulation (SCS) combined with virtual leg
illumination (provided through a wearable headset (OculusRift, OculusVR, Irvine, CA) and a
custom-designed virtual reality leg scenario) will lead to controlled analgesia induction,
boosting analgesic effects obtained with standard SCS treatments and will further be
associated with changes in the perception of the affected body part.
illumination (provided through a wearable headset (OculusRift, OculusVR, Irvine, CA) and a
custom-designed virtual reality leg scenario) will lead to controlled analgesia induction,
boosting analgesic effects obtained with standard SCS treatments and will further be
associated with changes in the perception of the affected body part.
Epidural spinal cord stimulation (SCS) is an approved treatment for truncal and extremity
neuropathic pain. The mechanisms underlying the efficacy of SCS are unknown. Recent advances
in cognitive neuroprosthetics using virtual reality allow for modulation of body perception
and bodily experience, which has also been shown to modulate pain perception. The present
research proposal plans to merge expertise in cognitive neuroprosthetics with neuromodulation
techniques in order to test the analgesic properties of the combination of epidural spinal
cord stimulation with a new system of multisensory stimulation based on virtual and enhanced
reality (i.e., neuro-visual stimulation). The investigators propose to study this hypothesis
prospectively in 25 patients with implanted SCS systems for the treatment of chronic
neuropathic pain. Primary outcomes will be pain reduction (based on subjective, functional
and physiological measures) and changes in body perception (based on subjective and objective
measures). The present study will generate a proof-of-concept for the application of
neuro-visual stimulation for the treatment of chronic pain and will form the basis for future
NIH funding application.
neuropathic pain. The mechanisms underlying the efficacy of SCS are unknown. Recent advances
in cognitive neuroprosthetics using virtual reality allow for modulation of body perception
and bodily experience, which has also been shown to modulate pain perception. The present
research proposal plans to merge expertise in cognitive neuroprosthetics with neuromodulation
techniques in order to test the analgesic properties of the combination of epidural spinal
cord stimulation with a new system of multisensory stimulation based on virtual and enhanced
reality (i.e., neuro-visual stimulation). The investigators propose to study this hypothesis
prospectively in 25 patients with implanted SCS systems for the treatment of chronic
neuropathic pain. Primary outcomes will be pain reduction (based on subjective, functional
and physiological measures) and changes in body perception (based on subjective and objective
measures). The present study will generate a proof-of-concept for the application of
neuro-visual stimulation for the treatment of chronic pain and will form the basis for future
NIH funding application.
Inclusion Criteria:
1. Age 18-and older at the time of enrollment
2. Patients carrying a diagnosis of CPRS type 125 or chronic refractory neuropathic leg
pain following FBS4
3. Patients who have implanted epidural SCS
4. The SCS implantation for at least three months prior to enrollment
5. Patients with efficacious SCS as defined by ≥ 50% pain improvement after switching SCS
from an OFF state to an ON state ('optimal' stimulation efficacy)
6. Patients willing and able to provide informed consent
Exclusion Criteria:
1. Patients who are unable to effectively or efficiently communicate for example patients
suffering from speech deficits (dysarthria, aphasia) or are non-English speaking.
2. Patients with history of prior cranial surgery, significant brain lesions for example
intracranial tumors, strokes etc.
3. Non efficacious response to SCS <50% pain improvement with optimal stimulation
parameters
4. Evidence of untreated psychiatric disorders or drugs/alcohol abuse.
5. History of seizures
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