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MindLink: Usecase 1

Results. Visuotactile illusions decreased pain by an average of 7.8 points (95% CI [2.0–13.5]) which corresponds to a 25% reduction in pain, but the tactile only and visual only control conditions did not (Condition × Time interaction: p = 0.028). Visuotactile illusions did not differ from incongruent control conditions where the same visual manipulation occurred, but did differ when only the same tactile input was applied. Sustained illusions prolonged analgesia, but did not increase it. Repeated illusions increased the analgesic effect with an average pain decrease of 20 points (95% CI [6.9–33.1])–corresponding to a 40% pain reduction.
Discussion. Visuotactile illusions are analgesic in people with knee OA. Our results suggest that visual input plays a critical role in pain relief, but that analgesia requires multisensory input. That visual and tactile input is needed for analgesia, supports multisensory modulation processes as a possible explanatory mechanism. Further research exploring the neural underpinnings of these visuotactile illusions is needed. For potential clinical applications, future research using a greater dosage in larger samples is warranted.

Analgesic Efficacy and Pain Stickiness? Most analgesics have an NNT for 50% pain relief in chronic pain of between 3–10, and the superior effect of the primary drug over placebo is in the region of 30% [192]. In essence the majority of people treated with pharmacological interventions do not experience the desired effect [191].
It is, however, well known that pain relief has a binomial or U-shaped distribution, meaning that describing a sample by its mean score is to choose the experience of the least number of people [191]. It is better to think more carefully about who responds and why. One reason for the ineffectiveness may relate to how drugs, when used chronically, may enhance pain. While mechanisms are not fully understood, one example is chronic opioid use associated with increased DNA methylation and increased levels of clinical pain [69]. It should be noted however, that some of these data should be assessed in the context of duration of treatment; for example, for opioid effects on chronic pain, the longest randomized controlled trial (RCT) is only 16 weeks [45].


This project aims to validate a multisensory mixed reality (XR) medical device and treatment protocol integrating current multidisciplinary research for painful knee osteoarthritis and perceptual postural persistent dizziness.
The protocol uses a sensory-environmental approach to brain-computer interface in XR to target belief modulation by directing attention with altered environmental and bodily sensory perceptions.
Based on biopsychosocial treatment models, it will include elements from cognitive behavioural therapy, physical therapy and neuroscience education. Developing and testing an active inference model of chronic pain / where we could show the maladaptive (plasticity) belief-based generation of chronic pain / and then the adaptive (plasticity) AR world-building amelioration of the condition.

OPPORTUNITY: Personalized pain management without popping pills

The global chronic pain treatment market generated revenue of $80+ Billion in 2020, and it is expected to grow at a CAGR of 7% during 2020–2030.
Osteoarthritis is one of the most common chronic health conditions characterized by chronic pain and disability with reduced mobility.
The global osteoarthritis therapeutics market size was valued at $6+ Billion in 2020, and is estimated to exceed $15 Billion by 2030, growing at a CAGR of 8% from 2021 to 2030.
There is a well-established need for alternatives to pharmacology to treat functional neurological disorders and chronic pain, that share common neural mechanisms.

INNOVATION: Active inference and VR tech enabled pain management

The project applies theoretical frameworks from active inference and the attentional schema theory of consciousness into a therapeutic medical device.
Psychological flexibility (cognitive fusion and avoidance) and behaviourally reported measures of pain and dizziness will be used in addition to heart rate variability and eye tracking to evaluate state to trait transition.
The treatment includes an external attention (exteroceptive) stretch-shrink body illusion, an internal attention (interoceptive) illusion, and a visualisation movement task.
This XR medical device will collect biometric and behavioural data using off-the-shelf integration solutions, delivering real-time treatment efficacy results, integrating treatment and research, laying the pipeline for developing person-centred precision medicine.


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