A novel method for investigating the importance of visual feedback on somatosensation and bodily-self perception

A novel method for investigating the importance of visual feedback on somatosensation and... Scientific presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188PainData: A clinical pain registry in DenmarkH.B. Vægter a,b,∗ , M.T. Høybye c , S.K. Larsen d , O.B.Hansen e , C.B. Pedersen f , P.B.F. Jensen g , G.Handberg aaPain Research Group, Smertecenter Syd, OdenseUniversitetshospital, Denmarkb Klinisk Institut, Det SundhedsvidenskabeligeFakultet, Syddansk Universitet, Denmarkc Forskningsenheden, CPK, RegionshospitaletSilkeborg, Hospitalsenhed Midt, Denmarkd Tværfagligt Smertecenter Aalborg, AalborgUniversitetshospital, Denmarke Tværfagligt Smertecenter og Palliativt Team,Holbæk Sygehus, Denmarkf Smertecentret, Sjællands Universitetshospital, Køge,Denmarkg Tværfagligt Smertecenter, Næstved Sygehus,DenmarkE-mail address: henrik.bjarke.vaegter@rsyd.dk (H.B. Vægter).Aims: Chronic pain is a significant clinical problem with feweffective therapies. Objectives of this clinical registry are (1) toassist clinical decision-making, and (2) facilitate quality assurance and research projects to improve understanding and optimizetreatment of patients with chronic pain.Methods: PainData is an electronic software system developed for online data capture and clinical reporting, currentlyimplemented in public pain clinics in Odense, Silkeborg, Aalborg,Næstved, Køge and Holbæk. The system captures patient-specificinformation across several bio-psychosocial domains of pain beforethe first consultation at the pain clinic as well as immediatelyafter treatment, and 12 months after treatment. The registry alsoincludes information from clinicians (e.g. pain diagnosis, and standardized pain sensitivity testing). PainData is registered as a clinicaland research database with the Danish Data Protection Agency(16/39398, 14/44319).Results: Since February 1st 2015 more than 3000 patients havecompleted questionnaires in PainData. The current completion rateat baseline is >80% and at follow-up is close to 50%. Pain-related data(e.g. pain-distribution, psychological distress and use of analgesics)from the registry will be presented on the poster.Conclusions: The clinical pain registry contains data froma large cohort of consecutively referred chronic pain patientsattending public pain clinics for multidisciplinary assessment andtreatment. It contains detailed baseline and outcome data on abroad range of bio-psychosocial factors. The database has significant clinical relevance as it will contribute to an increasedunderstanding of chronic pain conditions as well as contribute tosubstantial knowledge on how various psychological factors influence the experience of pain and disability in patients with chronicpain. In addition, early prediction of treatment efficacy and futurestratification of patients with chronic pain has the potential to optimize treatment outcome. This will be of great interest to both theindividual patient and to society.http://dx.doi.org/10.1016/j.sjpain.2017.04.058185A novel method for investigating theimportance of visual feedback onsomatosensation and bodily-self perceptionMikkel Thøgersen a,∗ , John Hansen a , Herta Flor a,b ,Lars Arendt-Nielsen a , Laura Petrini a,caCenter for Neuroplasticity and Pain (CNAP), SMI,Department of Health Science and Technology,School of Medicine, Aalborg University, Aalborg E,Denmarkb Institute of Cognitive and Clinical Neuroscience,Central Institute of Mental Health, Mannheim,Germanyc Department of Communication & Psychology,Aalborg University, Aalborg E, DenmarkE-mail address: mt@hst.aau.dk (M. Thøgersen).Aims: Visual feedback is hypothesized to play an important rolein the phantom limb condition. In this study we attempt to create anillusory experimental model of phantom limb wherein this condition is simulated by removing the visual input from the upper limbin a group of intact participants. The aim of the study is to investigate the role of visual feedback on somatosensation, nociceptionand bodily-self perception.Methods: Using a novel mixed reality (MR) system, the visualfeedback of the left hand is removed in order to visually simulatea left hand amputation on 30 healthy participants (15 females).Using a within-subject design, three conditions are created: visualamputation condition (MR with no visual input); visual condition(MR with normal vision); and a baseline condition (no MR). Thermal detection and nociceptive thresholds using method of limitsare measured. Proprioception of the visually amputated hand isinvestigated by probing the felt hand position on a proximal-distalaxis from the body. Using a questionnaire the effects of the missingvisual feedback on bodily self is assessed.Results: There was a clear drift in proprioception of the left handin the proximal direction between the control and visual amputation condition (p < 0.001). A decrease in cold detection was alsosignificant between the control and visual amputation condition(p < 0.001). Finally, questions on perceptual experiences indicatedthat the observed proprioceptive retraction of the visually amputated hand was also felt by the participants.Conclusions: Missing visual feedback greatly influences theperception of the visually amputated arm underlining the importance of visual feedback. The observed proprioceptive retraction ofthe hand resembles the telescoping perceptions often reported byphantom limb patients. The novel method developed for this study,is a new tool to investigate the influence of visual feedback on therelationship of bodily-self and chronic pain.http://dx.doi.org/10.1016/j.sjpain.2017.04.059 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

A novel method for investigating the importance of visual feedback on somatosensation and bodily-self perception

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De Gruyter
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© 2017 Scandinavian Association for the Study of Pain
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1877-8860
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1877-8879
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10.1016/j.sjpain.2017.04.059
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Abstract

Scientific presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188PainData: A clinical pain registry in DenmarkH.B. Vægter a,b,∗ , M.T. Høybye c , S.K. Larsen d , O.B.Hansen e , C.B. Pedersen f , P.B.F. Jensen g , G.Handberg aaPain Research Group, Smertecenter Syd, OdenseUniversitetshospital, Denmarkb Klinisk Institut, Det SundhedsvidenskabeligeFakultet, Syddansk Universitet, Denmarkc Forskningsenheden, CPK, RegionshospitaletSilkeborg, Hospitalsenhed Midt, Denmarkd Tværfagligt Smertecenter Aalborg, AalborgUniversitetshospital, Denmarke Tværfagligt Smertecenter og Palliativt Team,Holbæk Sygehus, Denmarkf Smertecentret, Sjællands Universitetshospital, Køge,Denmarkg Tværfagligt Smertecenter, Næstved Sygehus,DenmarkE-mail address: henrik.bjarke.vaegter@rsyd.dk (H.B. Vægter).Aims: Chronic pain is a significant clinical problem with feweffective therapies. Objectives of this clinical registry are (1) toassist clinical decision-making, and (2) facilitate quality assurance and research projects to improve understanding and optimizetreatment of patients with chronic pain.Methods: PainData is an electronic software system developed for online data capture and clinical reporting, currentlyimplemented in public pain clinics in Odense, Silkeborg, Aalborg,Næstved, Køge and Holbæk. The system captures patient-specificinformation across several bio-psychosocial domains of pain beforethe first consultation at the pain clinic as well as immediatelyafter treatment, and 12 months after treatment. The registry alsoincludes information from clinicians (e.g. pain diagnosis, and standardized pain sensitivity testing). PainData is registered as a clinicaland research database with the Danish Data Protection Agency(16/39398, 14/44319).Results: Since February 1st 2015 more than 3000 patients havecompleted questionnaires in PainData. The current completion rateat baseline is >80% and at follow-up is close to 50%. Pain-related data(e.g. pain-distribution, psychological distress and use of analgesics)from the registry will be presented on the poster.Conclusions: The clinical pain registry contains data froma large cohort of consecutively referred chronic pain patientsattending public pain clinics for multidisciplinary assessment andtreatment. It contains detailed baseline and outcome data on abroad range of bio-psychosocial factors. The database has significant clinical relevance as it will contribute to an increasedunderstanding of chronic pain conditions as well as contribute tosubstantial knowledge on how various psychological factors influence the experience of pain and disability in patients with chronicpain. In addition, early prediction of treatment efficacy and futurestratification of patients with chronic pain has the potential to optimize treatment outcome. This will be of great interest to both theindividual patient and to society.http://dx.doi.org/10.1016/j.sjpain.2017.04.058185A novel method for investigating theimportance of visual feedback onsomatosensation and bodily-self perceptionMikkel Thøgersen a,∗ , John Hansen a , Herta Flor a,b ,Lars Arendt-Nielsen a , Laura Petrini a,caCenter for Neuroplasticity and Pain (CNAP), SMI,Department of Health Science and Technology,School of Medicine, Aalborg University, Aalborg E,Denmarkb Institute of Cognitive and Clinical Neuroscience,Central Institute of Mental Health, Mannheim,Germanyc Department of Communication & Psychology,Aalborg University, Aalborg E, DenmarkE-mail address: mt@hst.aau.dk (M. Thøgersen).Aims: Visual feedback is hypothesized to play an important rolein the phantom limb condition. In this study we attempt to create anillusory experimental model of phantom limb wherein this condition is simulated by removing the visual input from the upper limbin a group of intact participants. The aim of the study is to investigate the role of visual feedback on somatosensation, nociceptionand bodily-self perception.Methods: Using a novel mixed reality (MR) system, the visualfeedback of the left hand is removed in order to visually simulatea left hand amputation on 30 healthy participants (15 females).Using a within-subject design, three conditions are created: visualamputation condition (MR with no visual input); visual condition(MR with normal vision); and a baseline condition (no MR). Thermal detection and nociceptive thresholds using method of limitsare measured. Proprioception of the visually amputated hand isinvestigated by probing the felt hand position on a proximal-distalaxis from the body. Using a questionnaire the effects of the missingvisual feedback on bodily self is assessed.Results: There was a clear drift in proprioception of the left handin the proximal direction between the control and visual amputation condition (p < 0.001). A decrease in cold detection was alsosignificant between the control and visual amputation condition(p < 0.001). Finally, questions on perceptual experiences indicatedthat the observed proprioceptive retraction of the visually amputated hand was also felt by the participants.Conclusions: Missing visual feedback greatly influences theperception of the visually amputated arm underlining the importance of visual feedback. The observed proprioceptive retraction ofthe hand resembles the telescoping perceptions often reported byphantom limb patients. The novel method developed for this study,is a new tool to investigate the influence of visual feedback on therelationship of bodily-self and chronic pain.http://dx.doi.org/10.1016/j.sjpain.2017.04.059

Journal

Scandinavian Journal of Painde Gruyter

Published: Jul 1, 2017

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