# Neural Mechanisms of Immersive Virtual Reality in Chronic Pain

> **NIH NIH R01** · UNIVERSITY OF MARYLAND BALTIMORE · 2022 · $638,324

## Abstract

Summary
The COVID-19 pandemic and its effect on the opioid crisis have created a pressing need for telemedicine and
consideration for use of non-pharmacological, low cost interventions as adjuvants in pain management arsenal.
We propose a project investigating neural mechanisms underlying pain reduction induced by immersive Virtual
Reality (VR). VR consists of immersion in artificial environments through the use of real-time rendering
technologies and latest generation devices. We have recently demonstrated that VR increases pain tolerance
limits and vagal activity with a parallel improvement in individual pain unpleasantness, mood, and situational
anxiety. To enhance the translatability of this project, we will directly dive into the neural mechanisms of VR in
chronic pain participants suffering from Temporomandibular Disorder(s) (TMD), a population with which the PI
and her collaborators have had fruitful results. The overarching goal is to investigate the pain modulation
mechanisms underlying VR-induced hypoalgesia by determining 1) the involvement of endogenous mu opioids,
2) the relationship between responsiveness to acute VR and long-term pain-related outcomes, and 3) the
changes in cortical excitability related to 3-week VR. We will use three main approaches: 1) a pharmacological
antagonist approach, 2) An ecological momentary assessment (EMA) for tracking dynamics of pain outcomes
over 6 months; and 3) a high-resolution electroencephalography to measure synchronization of peak alpha
frequency (PAF). We will disentangle the mechanisms of VR-induced hypoalgesia from placebo effects among
participants with distinct disabilities and grades of TMD. We expect that 1) VR, similar to placebo effects, will
reduce pain through the engagement of endogenous opioid systems, 2) VR-induced pain modulation capability
will result in better long-term pain outcomes, and 3) 3-week VR will favor a synchronization of PAF oscillations
paralleled by individual VR therapeutic benefits. This project will combine pharmacologic, the EMA, and
electroencephalographic techniques employed within TMD patients to maximize the translational value of the
resulting knowledge. The team has a history of successful collaboration and the expertise to generate innovative,
relevant, and timely findings. The successful completion of this research will generate mechanistic-based
evidence for the potential application of VR-based interventions which might empower TMD patients with new,
accessible, and affordable therapeutic solutions.

## Key facts

- **NIH application ID:** 10455010
- **Project number:** 5R01AT011347-02
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Luana Colloca
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $638,324
- **Award type:** 5
- **Project period:** 2021-08-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10455010

## Citation

> US National Institutes of Health, RePORTER application 10455010, Neural Mechanisms of Immersive Virtual Reality in Chronic Pain (5R01AT011347-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10455010. Licensed CC0.

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