Abstract
Pain tolerance can be increased by the introduction of an active distraction, such as a computer game. This effect has been found to be moderated by game demand, i.e., increased game demand = higher pain tolerance. A study was performed to classify the level of game demand and the presence of pain using implicit measures from functional Near-InfraRed Spectroscopy (fNIRS) and heart rate features from an electrocardiogram (ECG). Twenty participants played a racing game that was configured to induce low (Easy) or high (Hard) levels of demand. Both Easy and Hard levels of game demand were played with or without the presence of experimental pain using the cold pressor test protocol. Eight channels of fNIRS data were recorded from a montage of frontal and central-parietal sites located on the midline. Features were generated from these data, a subset of which were selected for classification using the RELIEFF method. Classifiers for game demand (Easy vs. Hard) and pain (pain vs. no-pain) were developed using five methods: Support Vector Machine (SVM), k-Nearest Neighbour (kNN), Naive Bayes (NB) and Random Forest (RF). These models were validated using a ten fold cross-validation procedure. The SVM approach using features derived from fNIRS was the only method that classified game demand at higher than chance levels (accuracy = 0.66, F1 = 0.68). It was not possible to classify pain vs. no-pain at higher than chance level. The results demonstrate the viability of utilising fNIRS data to classify levels of game demand and the difficulty of classifying pain when another task is present.
Highlights
Awareness of pain and the ability to tolerate pain are influenced by selective attention (Torta et al, 2017)
The cold-pressor test (CPT) time is the total duration that participants kept their limb immersed in the cold water and this variable was used as a behavioural measure of pain tolerance
This model revealed a significant main effect [F(2, 16) = 9.91, p = 0.05, eta2 = 0.55], Bonferroni tests revealed that baseline CPT times (M = 22.5 s, sd = 9.75) were significantly lower than either of the two game demand conditions (p < 0.01), but there was no significant difference between Easy (M = 48.5 s, sd = 35.73) and Hard (M = 74.07 s, sd = 64.11) levels of game demand (p = 0.08)
Summary
Awareness of pain and the ability to tolerate pain are influenced by selective attention (Torta et al, 2017). The influence of attention on the experience of pain is explained by a neurocognitive model with supporting evidence from neuroimaging research (Legrain et al, 2009, 2012). This model of attention and pain can be exploited therapeutically by employing distraction to mitigate patients’ experience of pain (Koller and Goldman, 2012; Williams and Ishimine, 2016). The available evidence indicates that active forms of distraction are most effective (Wohlheiter and Dahlquist, 2013; Inan and Inal, 2019), presumably due to engagement of top-down attentional regulation that prioritises goal-related task stimuli over the bottom-up attentional processes triggered by the presence of pain (Legrain et al, 2009)
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