Targeting pain catastrophization in patients with fibromyalgia using virtual reality exposure therapy: a proof-of-concept study
Open accessAbstract
[Purpose] Pain catastrophizing is a key predictor of poor compliance to exercises among patients with fibromyalgia syndrome. Alteration of pain catastrophizing in this group is thus warranted. This study aimed to provide proof-of-concept of a novel virtual reality exposure therapy program as treatment for exercise-related pain catastrophizing in patients with fibromyalgia syndrome. [Subjects and Methods] An exploratory, case-controlled study was conducted (fibromyalgia syndrome group and matched control group). Functional magnetic resonance imaging was used to acquire neural correlates. The functional magnetic resonance imaging task consisted of two stimuli: active (exercise activity visuals) and passive (relaxing visuals). Structural images and blood-oxygenation-level-dependent contrasts were acquired for the conditions and compared within subjects/groups and between groups. Statistic images were thresholded using corrected clusters (determined by Z>2.3; level of significance: 0.05). [Results] Thirteen fibromyalgia syndrome subjects and nine healthy matched controls were included. The right inferior frontal gyrus, right middle frontal gyrus, right posterior cerebellum, left thalamus, and left supramarginal gyrus were activated in the fibromyalgia syndrome subjects. [Conclusion] The study results provide preliminary proof indicating that exposing patients with fibromyalgia syndrome to visuals of exercises elicits neurophysiological changes in functional brain areas associated with pain catastrophization and add to the current body of knowledge regarding the possibility of objectively identifying cognitive behavioral strategies like pain catastrophization.
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One study showed that exposing fibromyalgia patients to virtual-reality visual exercises elicited changes in brain areas associated with pain catastrophizing.
“Functional magnetic resonance imaging showed that exposing patients to visual exercises elicited changes in brain areas associated with pain catastrophizing [34].”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [34]
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- Authors
- Morris, L. D., Louw, Q. A., Grimmer, K. A., & Meintjes, E.
- Affiliations
- Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University: Tygerberg, South Africa
- Stellenbosch University (ZA)
- University of South Australia (AU)
- University of Cape Town (ZA)
- Venue
- Journal of Physical Therapy Science
- Publisher
- Society of Physical Therapy Science
- Published
- 2015
- Volume
- 27
- Issue
- 11
- Pages
- 3461-3467
- ISSN
- 0915-5287 (ISSN-L)
- 2187-5626
- PMC
- PMC4681926
- OpenAlex
- W2217468081
- Cited by
- 28
- References
- 36
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 7
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of Physical Therapy Science (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion, other-oa)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc-nd)
- World Physiotherapy Congress Archive
- Funders
- Universiteit Stellenbosch
- University of Cape Town
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- fibromyalgia, pain catastrophizing, virtual reality exposure therapy, exercise-induced pain, neural correlates, brain activation, inferior frontal gyrus, thalamus, cognitive-behavioral techniques, medication adherence
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