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The Effect of Immersive Virtual Reality on Anterograde Amnesia and Subjective Pain During Procedures: A
Hunter G Hoffman1,2, Herta Flor3, Brett R Stacey4
1From the Virtual Reality Research Center, Human Photonics Lab, Department of Mechanical Engineering.
Background:
Immersive virtual reality (VR) distraction reduces procedural pain. The current study explores whether immersive VR also reduces how much people can remember about a painful experience: anterograde amnesia for pain.
Methods:
A within-subject, crossover design was used. Sixteen healthy adult volunteers participated. Each participant received 5 thermal stimuli (some hot, some cold) during no-VR and 5 stimuli during immersive VR distraction (treatment order randomized). They were instructed to memorize the order of hot and cold stimuli for a later memory test. After a brief delay after each stimulus set, participants completed a memory recall test for the order of stimuli (the primary measure) and also provided ratings of pain, distraction, anxiety, and nausea using standardized graphic rating scales (GRS; 0-10).
Results:
Within-subject Wilcoxon signed-rank tests revealed that immersive VR significantly reduced how accurately participants could recall the hot/cold order of thermal stimuli, mean accuracy: 96% correct (standard deviation [SD] = 8.06) in no-VR, versus 59% (SD = 25.79) in VR, Z = 3.09, P = .002, r = 0.77. On a rating scale from 0 to 10, immersive VR was significantly more distracting (mean = 7.60, very distracting, SD =1.72) compared to the control condition (mean = 2.07, mildly distracting, SD = 2.16, Z = 3.42, P < .001, r = 0.86), and on GRS mean pain perception ratings, participants reported significantly lower pain intensity during VR, mean = 4.03 (SD = 1.61) during VR, versus no-VR = 6.30 (SD = 1.81), Z = 3.47, P < .001, r = 0.87.
Conclusions:
Results of this study provide preliminary evidence that immersive VR reduces memory for a painful experience. Conscious/episodic memory formation and storage of memories about specific experiences requires attentional resources. VR distraction pain intervention significantly disrupts memory for painful stimuli, leading to what we term "VR amnesia." Our study provides preliminary laboratory evidence that immersive VR during pain induces anterograde amnesia for pain, disrupting the formation of memory for painful events. Further studies exploring the mechanism of how VR reduces memory for painful events are needed. These results suggest the utility of future studies in clinical pain contexts. If VR can reduce the formation of adverse memories associated with painful clinical procedures, VR may serve as an effective nonpharmacological adjunct to reduce postoperative distress and medications and may reduce risk of developing chronic pain.
