Neural Mechanisms of Immersive Virtual Reality in Chronic Pain (VR TMD EEG)

NCT ID: NCT06214923

Last Updated: 2026-01-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-09

Study Completion Date

2026-11-30

Brief Summary

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This project examines, in chronic pain, the mechanisms of immersive virtual reality compared to the mechanisms of placebo hypoalgesia. The potential of developing new non-pharmacological premises for low-risk interventions for pain management is high.

Detailed Description

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Virtual reality (VR) has been seen as an intervention for alleviating clinical chronic (and acute) pain. An approach to pain management utilizing VR presents opportunities for reducing pain and suffering by using immersive, aesthetic, and multisensory stimulation. Investigator will analyze the behavioral and neural mechanisms of active VR against sham VR as two methods that investigate descending pain modulation. Thus, the central hypothesis is that those who respond to placebos will likely respond to active VR. If VR-induced analgesia depends upon the release of endogenous opioids.

In this project, the investigators will determine the effects of VR at the neural and clinical levels directly for TMD participants, inviting participants from an existing Colloca Lab-based cohort phenotyped for diagnosis, grade, and low/high impact pain profiles and prospective TMD participants in collaboration with Johns Hopkins University. These participants have agreed to be recontacted for further research.

In this study, based on our PAF study and modulation of autonomic measurements via VR, we will determine the role of acute and 3-week VR intervention to help restore PAF oscillations to normal. PAF and autonomic measurements will be collected in TMD participants characterized by low/high-impact pain. All participants will go through Active VR, Sham VR and NH phases (3-week each) where participants will be monitored for changes in cortical excitability via PAF oscillations and clinical benefit via EMA.

Conditions

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Pain Virtual Reality Placebo Temporomandibular Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This is a 2 (high- vs. low-impact pain) by 3 (3-week Active VR vs. 3-week Sham VR vs. 3-week NH) conditions mixed experimental design. TMD participants will be clinically phenotype into high-impact or low-impact pain groups according to Graded Chronic Pain Scale (GCPS). All participants will go through Active VR, Sham VR and NH phases (3-week each).

There will be 4 in-person visits where participants will be monitored for changes in cortical excitability via PAF oscillations and clinical benefit via Ecological Momentary Assessments (EMA) during the 3-week conditions.

Crossover Study Model was chosen because each participant will receive VR, Sham-VR, and No-VR in random order
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

SINGLE

Participants
Participants will be blinded to the VR and Sham-VR conditions

Study Groups

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Low impact TMD

Other: TMD Phenotype

TMD participants will be clinically phenotyped into two between-subject groups based on their score on the Graded Chronic Pain Scale (GCPS). This group will have a GCPS grade 0, 1, and 2a

Group Type OTHER

RelieVRx

Intervention Type DEVICE

Participants will use RelieVRx daily for 20min/day for 3 weeks

Sham-VR

Intervention Type DEVICE

Participants will use Sham-VR, consisting of video, images, and sound in a head-mounted display but lack the "sense of presence" and immersive features of Active-VR (for example, scene changes with head movement). Participants will use the Sham-VR daily for 20min/day for 3 weeks

No-VR (natural history control)

Intervention Type OTHER

Participants will continue regular/usual care without any VR devices (goggles or audiovisual input)

High impact TMD

Other: TMD Phenotype

TMD participants will be clinically phenotyped into two between-subject groups based on their score on the Graded Chronic Pain Scale (GCPS). This group will have a GCPS grade 2b, 3, and 4.

Group Type OTHER

RelieVRx

Intervention Type DEVICE

Participants will use RelieVRx daily for 20min/day for 3 weeks

Sham-VR

Intervention Type DEVICE

Participants will use Sham-VR, consisting of video, images, and sound in a head-mounted display but lack the "sense of presence" and immersive features of Active-VR (for example, scene changes with head movement). Participants will use the Sham-VR daily for 20min/day for 3 weeks

No-VR (natural history control)

Intervention Type OTHER

Participants will continue regular/usual care without any VR devices (goggles or audiovisual input)

Interventions

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RelieVRx

Participants will use RelieVRx daily for 20min/day for 3 weeks

Intervention Type DEVICE

Sham-VR

Participants will use Sham-VR, consisting of video, images, and sound in a head-mounted display but lack the "sense of presence" and immersive features of Active-VR (for example, scene changes with head movement). Participants will use the Sham-VR daily for 20min/day for 3 weeks

Intervention Type DEVICE

No-VR (natural history control)

Participants will continue regular/usual care without any VR devices (goggles or audiovisual input)

Intervention Type OTHER

Other Intervention Names

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Active-VR

Eligibility Criteria

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Inclusion Criteria

* Age (18-88 years)
* English speaker (written and spoken)
* Temporal Mandibular Disorder (TMD) for at least 3 months
* TMD Grade Chronic Pain Scale (GCPS) ≥ 0

Exclusion Criteria

* Present or past degenerative neuromuscular disease
* Cardiovascular, neurological diseases, pulmonary abnormalities, kidney disease, liver disease, history of cancer within past 3 years
* Cervical pain (e.g. stenosis, radiculopathy)
* Any personal (or family first degree) history of mania, schizophrenia, or other psychoses
* Severe psychiatric condition (e.g. schizophrenia, bipolar disorders, autism) leading to hospitalization within the last 3 years.
* Use of Antipsychotics (e.g., Risperdal, Ability and clozaril)Lifetime alcohol/drug dependence or alcohol/drug abuse in past 3 months
* Pregnancy or breast feeding
* Color-blindness
* Impaired or uncorrected hearing
* Non-dominant hand
* Any facial trauma that has occurred in the last 6 weeks
* History of a severe facial trauma in the last 2-3 months
* Conditions that would interfere with the VR mask placement (e.g. trauma, burn, infection)
* Known history of severe motion sickness
* Non-removable head cover, artificial hair, certain types of braids or dreadlocks
* History of fainting
* History of angioedema
* Failed drug test (testing for opiates, cocaine, methamphetamines, and amphetamines)
Minimum Eligible Age

18 Years

Maximum Eligible Age

88 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Maryland, Baltimore

OTHER

Sponsor Role lead

Responsible Party

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Luana Colloca

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Luana Colloca

Baltimore, Maryland, United States

Site Status RECRUITING

University of Maryland

Baltimore, Maryland, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Research Coordinator

Role: CONTACT

410-706-5975

Katia Matychak, MS

Role: CONTACT

410-706-5975

Facility Contacts

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Luana Colloca, MD,PhD,MS

Role: primary

301-364-8089

Luana Colloca, MD, PhD, MS

Role: primary

301-364-8089

Katia Matychak, MS

Role: backup

4107065975

References

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Honzel E, Murthi S, Brawn-Cinani B, Colloca G, Kier C, Varshney A, Colloca L. Virtual reality, music, and pain: developing the premise for an interdisciplinary approach to pain management. Pain. 2019 Sep;160(9):1909-1919. doi: 10.1097/j.pain.0000000000001539. No abstract available.

Reference Type BACKGROUND
PMID: 30817437 (View on PubMed)

Colloca L, Raghuraman N, Wang Y, Akintola T, Brawn-Cinani B, Colloca G, Kier C, Varshney A, Murthi S. Virtual reality: physiological and behavioral mechanisms to increase individual pain tolerance limits. Pain. 2020 Sep 1;161(9):2010-2021. doi: 10.1097/j.pain.0000000000001900.

Reference Type BACKGROUND
PMID: 32345915 (View on PubMed)

Amanzio M, Benedetti F. Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. J Neurosci. 1999 Jan 1;19(1):484-94. doi: 10.1523/JNEUROSCI.19-01-00484.1999.

Reference Type BACKGROUND
PMID: 9870976 (View on PubMed)

Colloca L. The Placebo Effect in Pain Therapies. Annu Rev Pharmacol Toxicol. 2019 Jan 6;59:191-211. doi: 10.1146/annurev-pharmtox-010818-021542. Epub 2018 Sep 14.

Reference Type BACKGROUND
PMID: 30216744 (View on PubMed)

Other Identifiers

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HP-00095888 (VR TMD EEG)

Identifier Type: -

Identifier Source: org_study_id

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