Author Login

Correspondence to Author: Frot Maud, 

1. Central Integration of Pain, INSERM, U1028, Lyon Neuroscience Research Center, France 2. University Claude Bernard Lyon 1, France.

Abstract:  Contextual pain conditioning is the process of associating a specific painful experience to its emotional and environmental context. Although pain conditioning is suggested to play a key role in the development and maintenance of chronic pain, there is still paucity of studies and protocols specifically devoted to better understanding its underlying mechanisms. The present study offers an ecological experimental model of contextual aversive (painful and non-painful) conditioning using immersive virtual reality (iVR) technology. The protocol comprised both context and sensory stimuli, specifically: i) a three-roomed virtual apartment presented in iVR, ii) a painful aversive electro-stimulation (PA), and iii) non-painful aversive sounds (NPA). Acquisition and extinction phases consisted in participants completing ten rounds in the apartment, for which each room was associated to a specific stimulation delivery (PA, NPA or no stimulation for control). Sympathetic skin response (SSR), environment valence perception and stimulation evaluation were measured throughout the entire experiment to assess behavioral and physiological markers of aversive conditioning. Results confirmed that both aversive conditionings lead to a decrease in associated room valence compared to control, even more so for the PA associated room, which resettled after extinction. Together with a significantly greater SSR found during anticipation of pain in contrast to both aversive sounds and control, these outcomes may suggest that pain conditioning acquisition was stronger than non-painful aversive conditioning. Concluding modulation of aversive conditioning markers enabled to validate this protocol, which future application may be adjusted to allow studies in chronic pain patients.

Conclusion :  

Frot Maud. Contextual pain conditioning protocol design in Humans – a combination of behavioral and physiological measurements using immersive Virtual Reality. Journal of Pain 2024.