title: Effects of virtual reality immersion and audiovisual distraction techniques for patients with pruritus.
abstract: BACKGROUND
  Virtual reality immersion (VRI), an advanced computer-generated technique, decreased subjective reports of pain in experimental and procedural medical therapies. Furthermore, VRI significantly reduced pain-related brain activity as measured by functional magnetic resonance imaging. Resemblance between anatomical and neuroendocrine pathways of pain and pruritus may prove VRI to be a suitable adjunct for basic and clinical studies of the complex aspects of pruritus.
  
  
  OBJECTIVE
  To compare effects of VRI with audiovisual distraction (AVD) techniques for attenuation of pruritus in patients with atopic dermatitis and psoriasis vulgaris.
  
  
  METHODS
  Twenty-four patients suffering from chronic pruritus - 16 due to atopic dermatitis and eight due to psoriasis vulgaris - were randomly assigned to play an interactive computer game using a special visor or a computer screen. Pruritus intensity was self-rated before, during and 10 min after exposure using a visual analogue scale ranging from 0 to 10. The interviewer rated observed scratching on a three-point scale during each distraction program.
  
  
  RESULTS
  Student's t tests were significant for reduction of pruritus intensity before and during VRI and AVD (P=0.0002 and P=0.01, respectively) and were significant only between ratings before and after VRI (P=0.017). Scratching was mostly absent or mild during both programs.
  
  
  CONCLUSIONS
  VRI and AVD techniques demonstrated the ability to diminish itching sensations temporarily. Further studies on the immediate and late effects of interactive computer distraction techniques to interrupt itching episodes will open potential paths for future pruritus research.
authors.affiliation: Department of Dermatology, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: Vera
authors.initials: V
authors.lastname: Leibovici
authors.forename: Florella
authors.initials: F
authors.lastname: Magora
authors.forename: Sarale
authors.initials: S
authors.lastname: Cohen
authors.forename: Arieh
authors.initials: A
authors.lastname: Ingber
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003196:Computer Graphics; D003876:Dermatitis, Atopic / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D011537:Pruritus / Q000523:psychology* / Q000628:therapy*; D011565:Psoriasis / Q000523:psychology / Q000628:therapy; D055815:Young Adult