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Can Hand Disownership in the Rubber Hand Illusion Reduce Pain?

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Information about Can Hand Disownership in the Rubber Hand Illusion Reduce Pain?
Health & Medicine

Published on March 5, 2014

Author: simonvanrysewyk

Source: slideshare.net

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Can Hand Disownership in the Rubber Hand Illusion Reduce Pain? Simon van Rysewyk Post-Doctoral Fellow Graduate Institute of Medical Humanities Taipei Medical University

Pain ‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’ (IASP) What does this pain definition imply? Are there other important features of pain? RHI Pain 2

Pain The multiple components of pain can separate: • Nociception is not pain – phantom pain, allodynia, SIA • Pain sensation is not always painful – frontal lobotomy, opiate analgesics The link between pain components is not always strong. RHI Pain 3

Types of Nociceptive Pain: Superficial Fast (‘first pain’) • sharp, pricking • acute • skin, muscles, peripheral nerves • Aδ III fibers • neospinothalamic RHI Pain 4

Types of Nociceptive Pain: Superficial Burning • burning, sore • acute, chronic • skin, muscles • C IV fibers • archispinothalamic, paleospinothalamic RHI Pain 5

Types of Nociceptive Pain: Deep Slow (‘second pain’) • dull, aching • chronic • viscera, joints, tendons • C IV fibers • paleospinothalamic RHI Pain 6

RHI Pain 7

Nociceptive Pain and the RHI RHI Pain 8

Can pain be felt in a rubber hand? Capelari et al. (2009) Aim: To study the interaction between vision, touch, proprioception, and pain. Hypothesis: Nociceptive pain will inhibit the RHI because illusory localization of noxious stimuli may lead to actual tissue damage. RHI Pain 9

Capelari et al. 2009 Conditions: synchronous, asynchronous (tactile ± nociceptive) Materials: paint brush, sharp pin Measures: VAS (0-10 cm, RHI magnitude), Drift, 2 questionnaires (Botvinick & Cohen (1998) RHI Pain 10

Capelari et al. 2009 Procedure: 4 min. stroking right index fingers both hands randomized conditions questionnaires were completed after the experiment. RHI Pain 11

Capelari et al. 2009 Main Results: 80% tactile RHI 77% tactile-nociceptive RHI Subject RHI sensation mostly in response to visible stimuli. RHI Pain 12

Mean VAS and SE per stimulus mode RHI Pain 13

Mean VAS and SE for drift per condition *p ˂ 0.001 RHI Pain 14

Capelari et al. (2009) Implications for Pain: Standard RHI does not inhibit nociceptive pain. RHI can alter pain-location. Pain localization involves similar mechanisms to those for innocuous touch. RHI Pain 15

Pain Reduction and RHI: Hypothesis RHI disrupts thermoregulation: ↓ in skin temperature (Moseley et al. 2008) RHI disrupts immunoregulation: ↑ reactivity to intradermal histamine (Barnsley et al. 2012) Hypothesis: Since tissue damage threatens homeostasis, RHI may reduce pain. RHI Pain 16

Mohan et al. 2013 Aim: To study if RHI can reduce pain. Hypothesis: RHI will have an analgesic effect on pain evoked by noxious stimuli given on the real right hand. RHI Pain 17

Mohan et al. 2013 Conditions: synchronous, asynchronous (tactile ± noxious or innocuous temperature) Materials: paint brush, heat probe Measures: VAS (0-10 cm), de-briefing questionnaire (Botvinick & Cohen, 1998) RHI Pain 18

Mohan et al. 2013 Procedure: RHI Pain 19

Mohan et al. 2013 Main Results: RHI Pain 20

Mean & SE for questionnaire RHI Pain 21

Mean & SE for pain ratings RHI Pain 22

Mohan et al. 2013 Implications for Pain: Standard RHI does not reduce nociceptive pain. Pain components can be independently manipulated. Pain localization involves similar mechanisms to those for innocuous touch. RHI Pain 23

Can Left-Hand RHI Reduce Pain? RHI Pain 24

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