Towards a future VR-TENS multimodal platform to treat neuropathic pain

The complexity of the pathophysiology of neuropathic pain, imposes great challenges in the development of effective therapeutic approaches. This is even worse when taking into account the emotional and cognitive negative consequences of the experience of a long-term pain. Bioelectronic medicine, and in particular the stimulation of the peripheral nerves, recently has indicated several promising venues in this field. The general idea of this therapeutic approach is to cover referred painful areas through electrical stimulation that elicits more pleasant sensations. However, this can be a challenge when adopting a noninvasive approach (without implant close to nerve or spine), due to its low selectivity and reported naturalness. Here, we propose a novel multimodal noninvasive platform that aims at enhancing the naturalness of the noninvasive electrical stimulation. We combined Transcutaneous Electrical Nerve Stimulation (TENS) and Virtual Reality (VR) to allow the perceptual illusion of a more pleasant sensation thanks to a time-congruent visuo-tactile stimulation. Our results in four healthy subjects and one neuropathic patient show the feasibility of our platform in eliciting such sensations and potentially treating neuropathic symptoms.