Evidence map›Paper›PMID 41743617›Full record

ArticleLancet regional health. Americas2026

A critical role of affective content in the analgesic effect of virtual reality: a cross-sectional within-subject study.

Nandini Raghuraman, Roni Shafir, GianCarlo Colloca, Craig Kier, Barbara Brawn, Amitabh Varshney, Sarah Murthi, Yang Wang, Luana Colloca

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Nandini RaghuramanDepartment of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA.
Roni ShafirDepartment of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA.
GianCarlo CollocaTowson University, Information Technology Program, Towson, MD, USA.
Craig KierSchool of Music, University of Maryland College Park, MD, USA.
Barbara BrawnDepartment of Computer Science, Institute for Advanced Computer Studies, University of Maryland, College Park, MD, USA.
Amitabh VarshneyDepartment of Computer Science, University of Maryland, College Park, MD, USA.
Sarah MurthiDivision of Trauma and Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland, School of Medicine, Baltimore, MD, USA.
Yang WangDepartment of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA.
Luana CollocaDepartment of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA.

Funding

Neural correlates of hypoalgesia driven by observationR01AT010333 · NCCIH · UNIVERSITY OF MARYLAND BALTIMORE · PI COLLOCA, LUANA · 2019 to 2023
$3.7M
Neural Mechanisms of Immersive Virtual Reality in Chronic PainR01AT011347 · NCCIH · UNIVERSITY OF MARYLAND BALTIMORE · PI Luana Colloca · 2021 to 2026
$3.2M
NCCIH NIH HHS R01 AT010333NCCIH NIH HHS R01 AT011347
6 · The paper itself

Abstract

Background: The dual challenges of the opioid crisis and the global burden of chronic pain underscore the need for safe, non-pharmacological alternatives. Virtual reality (VR) is a promising digital therapeutic for pain, yet its mechanisms remain unclear. This study aimed to disentangle the roles of immersion and emotional engagement in VR-induced analgesia in individuals with temporomandibular disorders (TMD). Methods: In a counterbalanced within-subject design, 62 adults with TMD (21 males, 41 females; mean age 34.7 years [19-55]; 57 (91.9%) non-Hispanic or Latino, 30 (48.4%) White) were exposed to seven conditions: three immersive VR environments (ocean, opera, pink noise), matched non-immersive (2D) versions, and a 2-back working memory task. Heat pain tolerance was assessed using thermal stimulation. Participants rated pain intensity, pain unpleasantness, mood, anxiety, and enjoyment. Skin conductance response (SCR) indexed autonomic arousal. Multilevel mediation models tested the underlying psychological mechanisms. Findings: VR Ocean significantly increased heat pain tolerance (Cohen's d = 1.60), reduced pain intensity and unpleasantness, improved mood, and reduced situational anxiety relative to all other conditions (all p < 0.05). It was also rated as the most enjoyable experience (p < 0.01). Mediation analyses indicated mood (ab = -5.15) and enjoyment (ab = -6.12) significantly mediated VR Ocean's effect on pain intensity, whereas anxiety did not. No mediators explained changes in pain tolerance. SCR did not differ between VR and 2D conditions. Interpretation: VR-based analgesia relies not only on immersion but also on affectively rewarding contents. Digital therapeutics that enhance positive mood and enjoyment may be especially effective for chronic pain management. Funding: This study was supported by the National Institutes of Health and the University of Maryland.

Indexed as

Ambient soundAttentionCognitive engagementDistractionEmotional regulationSkin conductance

Identifiers

PMID41743617
PMCPMC12930066

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.