Developing a virtual reality guided acupuncture imagery treatment for Chronic low back pain

Project Summary Low back pain (LBP) is one of the most common reasons for physician visits in the USA. A substantial number of chronic LBP (cLBP) patients do not adequately respond to current treatment options. Thus, the development of new treatments for cLBP is urgently needed. The use of imagery to treat illness, including chronic pain, is one of the oldest medical practices. Although still under investigation, literature suggests that the brain responds to imagined experience similarly to the way it responds to actual experience. Acupuncture is an ancient invasive therapeutic method and has been recommended for treating cLBP by the American College of Physicians. Previous studies have shown that both the experience of acupuncture needle stimulation and the visualization of acupuncture needle stimulation can provoke overlapping brain activation, which suggests that visualizing or imagining acupuncture may achieve therapeutic effects through a brain pathway similar to actual acupuncture treatment. Combining acupuncture and imagery, the PI (co-founder of Massachusetts Neuro Technology (MNT) and a research investigator at Massachusetts General Hospital (MGH)) and his team developed a new treatment modality, 2-dimensional (2D) video-guided acupuncture imagery treatment (2D-VGAIT). We found that 2D- VGAIT can 1) produce an analgesic effect in healthy subjects and 2) produce comparable symptom relief to real acupuncture after a 1-month (6 treatments) intervention in cLBP patients. Nevertheless, 2D-video is limited in its ability to simulate real experience. Recently, Virtual Reality (VR) has drawn the attention of researchers. Studies have shown that VR is a powerful tool for studying body representation and creating perceptual body- ownership transfer illusions. These unique properties of VR will advance 2D-VGAIT to the next level. Thus, the aim of this Phase I R41 (STTR) application is to develop a novel mind-body treatment modality / system (VR-guided acupuncture imagery treatment (VRGAIT)) that leverages the power of VR, imagery, and acupuncture to enhance the experiential simulation of video-guided acupuncture imagery and reduce chronic low back pain. Specifically, we will first develop a functional VRGAIT system / platform (prototype) (Aim 1). Next, we will perform a feasibility study that treats cLBP with the VRGAIT system (Aim 2). This application, if successful, will provide a cost-effective and easily accessible treatment option for cLBP and other chronic pain disorders, particularly for those who may have limited access to acupuncture treatment and medical care.