Pain perception can be drastically affected by external factors in the surrounding environment. Previous studies relying on subjective ratings of pain have shown that guided meditations supplemented by virtual reality (VR) can reduce the perception of pain more successfully than the audio alone. The research question for this study was: How does the efficacy of meditation as a means of pain mitigation differ with and without the application of VR? To answer this question, we used fNIRS to visualize changes in the dorsolateral prefrontal cortex (DLPFC), which has been shown to play a role in the larger pain matrix in the brain. To induce discomfort, we used a Cold Pressor Arm Wrap (CPAW), which is a variation of the more common Cold Pressor Task (CPT). This study was a within-subjects design where in each of the three conditions participants experienced CPAW. The three conditions were: (1) control (no VR & no audio), (2) audio (audio only), and (3) VR (audio + VR). We hypothesized that there would be a decrease in cortical activity in the DLPFC during CPAW when supplemented by VR meditation compared to audio-led meditation and no meditation, due to a decrease in perceived pain in the VR condition. Our results showed that VR meditation did significantly reduce perceived pain, according to the subjective pain ratings. Participants rated their discomfort the lowest in the VR condition, slightly higher in the audio condition, and highest for the control condition (in the absence of meditation). However, there were no significant differences in activity in the DLPFC between the conditions. The lack of any significant findings with the fNIRS data could be the result of many issues, including not having a large enough sample, physiological noise, improper localization of the pain ROIs, and not having a strong enough discomfort stimulus. The future directions for this study would seek to remedy these issues in order to obtain more informative fNIRS results. Overall, this study did show that VR meditation does effectively reduce pain perception and is therefore a promising tool for nonpharmacological pain management.

Introduction: The effect of a targeted pain management protocol consisting of sedation and local anesthesia on the stress response to treatment of dermatitis interdigitalis contagiosa (DINCO) was assessed in sheep placed in dorsal recumbency. Methods: Blood cortisol concentrations were measured once a day (Day -3 to 2) and additionally on day 0, six times during the claw treatment (stress model). Twelve healthy sheep (control group; HEALTHY) and 36 sheep with DINCO, randomly allocated to one of three treatment groups, underwent the stress model with or without pain control: the XYLA-IVRA sheep were sedated with 2% xylazine hydrochloride (XYLA) and received retrograde intravenous regional anesthesia (IVRA); the IVRA sheep underwent IVRA and received a placebo instead of sedation; the PLACEBO sheep received placebos for sedation and IVRA. The HEALTHY sheep underwent sham claw treatment and received placebos. Results and discussion: The cortisol concentrations were higher in sheep restrained in dorsal recumbency compared with the cortisol concentrations measured four hours later in standing sheep (HEALTHY 37.2 ± 3.3 ng/ml vs. 18.5 ± 3.3 ng/ml; DISEASED 34.0 ± 1.9 ng/ml vs. 17.6 ± 1.9 ng/ml; p < 0.001). The stress response of XYLA-IVRA (area under the curve; AUC = 34.9 ± 2.6 ng/ml) was reduced compared with the stress response of PLACEBO (AUC = 48.0 ± 2.6 ng/ml, p < 0.01) and HEALTHY sheep (AUC = 46.6 ± 2.5 ng/ml; p = 0.01). While cortisol concentration of XYLA-IVRA and HEALTHY sheep did not increase one day after the stress model (Day 1) compared with the day of the stress model (Day 0), both PLACEBO (47.4 ± 3.3 vs. 35.6 ± 3.1 ng/ml, p = 0.02) and IVRA sheep (39.1 ± 2.8 vs. 28.6 ± 3.1 ng/ml, p = 0.01) had higher cortisol concentrations. The results confirm that fixation in dorsal recumbency in a tilt squeeze chute was a major stressor in sheep. The differences in the cortisol concentration of the PLACEBO sheep versus the XYLA-IVRA sheep during and after the stress model illustrate the effect and necessity of pain management protocols in practice.