Table_1_When Less Is More: Investigating Factors Influencing the Distraction Effect of Virtual Reality From Pain.DOCX

Virtual reality (VR) is a powerful method of redirecting attention away from pain. Yet, little is known about which factors modulate the size of this distraction effect. The aim of this study was to investigate the role of cognitive load and inter-individual differences in the cognitive and affective domain on heat pain thresholds during a VR game. Ninety healthy participants (mean age ± SD: 23.46 ± 3.28; 50% identified as male and 50% as female) played a low and high load version of a VR game while heat pain thresholds and heart rate were recorded. The effects of cognitive load were assessed by computing the difference in pain thresholds between the high and low load condition for each participant. In addition, we computed the difference in heart rate variability (HRV) measures between both conditions to explore whether these would be correlated with the difference in heat pain thresholds. Prior to the VR session, participants completed questionnaires about their emotional distress, pain-related cognitions, and different executive functioning tasks. Contrary to our expectations, not all participants benefitted from a higher load in terms of distraction from pain. Logistic regression analysis revealed that participants who reported more emotional distress were more likely to exhibit higher pain thresholds in the low relative to the high load condition. Accordingly, these participants tended to show marginally higher HRV in the low compared to the high load condition. Our study demonstrates that the potential benefits of an increased cognitive load in VR on pain sensitivity depends on individual differences in affective state.

虚拟现实（Virtual Reality，VR）是一种能够有效将注意力从疼痛感受上转移开来的强效手段。然而，目前对于哪些因素能够调节该分心效应的强度尚不清楚。本研究旨在探究虚拟现实游戏过程中，认知负荷以及认知与情感领域的个体间差异对热痛阈值的影响作用。90名健康受试者（平均年龄±标准差：23.46±3.28；性别占比各为50%）分别游玩低认知负荷与高认知负荷版本的虚拟现实游戏，实验期间同步记录其热痛阈值与心率数据。通过计算每名受试者在高、低认知负荷条件下的痛阈值差值，来评估认知负荷的效应。此外，我们还计算了两种条件下的心率变异性（Heart Rate Variability，HRV）指标差值，以探究其是否与热痛阈值差值存在相关性。在虚拟现实实验环节前，受试者需完成关于情绪困扰、疼痛相关认知的问卷调查，以及多项执行功能任务。与我们的预期相悖的是，并非所有受试者都能从更高的认知负荷中获得疼痛分心的益处。逻辑回归分析结果显示，自我报告情绪困扰程度更高的受试者，在低认知负荷条件下的痛阈值相较于高认知负荷条件下更高的可能性更大。相应地，这类受试者在低认知负荷条件下的心率变异性指标也略高于高认知负荷条件下的水平。本研究表明，虚拟现实场景中提升认知负荷对疼痛敏感性的潜在益处，取决于受试者情感状态的个体差异。