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A-1190 Virtual reality and cortical plasticity
Dominique Mouraux, Belgium
Friday, June 15, 2018 · 6:01 p.m. · 11m 40s
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information does not mean
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uh thank you mister chairman to introduce um he um it's a pleasure to speak apart
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and give me the opportunity to speak about the to reality and brain plastic sitting
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i'm a preview so uh speakers work speak about up a brain plus sixty and
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the reorganisation cortical organisation just to remember in hand rehabilitation we know that
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sometimes we can have sent to the re uh changes in and function like magician blindness
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uh then large cortical representation in some other sensory area
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but here we are more uh uh and often um present with
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due to different station basically amanda stays the clock amputation
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nerve lesion and a gently paying where we have cortical expansion
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of that just an area leads changing bring morphology
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and some motors suggested that there is a
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link between the amount of cortical reorganisation
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and a degree of pain it's a frequent in p. l. p.s
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your p. s. spinal cord injury and some uh current thing
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is it possible to train the brain us uh it has
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been suggest that restitution of normal call to come up
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might really for might improve a sensibility mortar execution all being and we
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have some examples in the church well like uh uh with whom
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bob the you will censor of a temporary honest is yeah uh
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demonstrates some modification by a function and and and the right
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and you see a just a below that the use of my electric put is this
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uh prevent cortical reorganisation and uh p. l. p.
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so today's to speak about pain and don't forget the three components of being a a there
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is a sensory problem but also as affective and
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cognitive uh it's three parts very important
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so okay and um our cracked is we use frequently uh me wrote therapy
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well i'm not with that and use a uh some uh modification but
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make an isn't beyond the mode of actions are really not clear
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uh some water speak about uh that x. one observation may be activated new on our own
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and uh there is a moderation of primary motor cortex mechanism increase of cortical and spinal
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motorists ability but also about um uh stimulate the it see lateral uh area
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so there is evidence but uh not yet compelling and there's something some limits of
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uh sometimes the patient done on just doesn't understand what it is to do and uh just look
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uh the healthy hand uh sometimes boring it's not very fun sometime
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uh that increase uh uh paying uh sometimes the positions
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very difficult for the uh the patient and as like being uh when we use uh this kind of to me
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that's the reason why it maybe it's very fun and very actually the virtual reality
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uh i have maybe a place in uh uh the part of the treatment
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when we speak about a view to reality to words appear it's
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immersion and presents if you have increased these two parameters
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you increase the quality of the vigil reality
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what was considered that virtual reality reality consists of a male t.
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sensory technology with three d. vision individual on the room and
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where the patient enter x. with game troop movement and visualisation
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which allow greater emotion and destruction and if you work negative a steam
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there is a lot that example or a like a gaming alike indication
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but now uh it's also attracting for medical uh application including
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a p. t. s. d. for yeah and uh also the energetic modalities act you would and i cracked
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first question is it effective in uh actually being a bad literature e. is a
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a presence not a lot but specially for burn patients and other children
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no no that's for sure sure that uh that can reduce pain n. x. city by distraction
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it's increase fun but not at all a that's also
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fascinated cares cares for numbers for a physical therapy
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that reduces timing being procedures mostly television times painkillers
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and fables the capitalisation of the injury
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there is a few hours to the about what happens in brain activation and it
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appears that there is a significant reduction in different part of uh the brink
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so i'll just from my thing in multiple treatment modalities fall on care
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dental playing burns his game playing and sit in pain experience pasta
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but is defective invalid uh in chronic pain uh you know
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and uh mm be up to cause social model of
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chronic pain it's uh uh at that uh_huh uh leads to a pain relative phase so it's more complex
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uh but everything's more complex in a chronic pain
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uh because of pharmacological treatment doesn't work sometimes
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uh in the z. from the roadblock are not always effective and now we are
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confronted with the uh incidence of a dependence toward the ones of option wheat
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so i'll they are uh i'm sure most of these about the impact of it a routine chronic pain
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if you see this uh study into doesn't sixteen why it's a forty patients
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with different a chronic pain and after using uh uh the system uh
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cool that's the name uh during five minutes there is or the a
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reduction in pain of forty three percent percent and thirty participants reported
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towards helping her rich it was found that was not the patients uh say
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there is a lot of imitation of this study they put is is is the athens and factors to
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get teary mechanism or and the feeling really easy because
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the pleasure of gain or experiencing pain relief
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another study i'm more interesting is the study uh published uh of
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this cat that now in a non set two thousand sixteen
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where the u. was fun to motor executions
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fascinated by machine learning and augmented reality
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if you observe the slide and the and the image there is a
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um the trigger um the m. g. on the the stem and
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when there's a trigger the on race and you have the possibly
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to observe and the same time uh he uh raised along
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if it's o. k. e. e. c. e. shift a of
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um to um sue use gaming and do exercise
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it's not the first to two of a study of what is gotten on but this one uh it's
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on more people twelve uh people with uh and tractor table paying and a fountain pen and also
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after twelve sessions a decrease in being also inactivity daily
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uh the life and also of the sleepy
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to sleep is better and uh the symptoms a decrease uh the frequency of the symptom decreased
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but what is interesting that the reduction in pain persists after one weekend
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six months uh um after the arrest of the the training
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so the put a sort of a political taste is is
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the uh an effect on reverse or cortical for reorganisation
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last the years we make also studio using a three d. augmented reality
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uh uh for a a unilateral upper extremity in the
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rat attic paying where we apply me routed happy
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uh with the system we duplicate the l. t. site
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and uh that a patient observe the uh
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i the ball a limbs all one names but it's only the l. decide that but yes
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to make some serious game way as to touch a a target with the
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a view troll hand and it's uh more than
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one complicated to succeed uh uh the task
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the results are uh interesting because after a five session there is all
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a rejection paying more than a forty six a person's um
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the time of a relieving being increase after each uh sessions but
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unfortunately the pain reappear progressive he after a week's the there
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is a studio over twenty two patients so uh with a lot
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of the c. or p. s. or p. l. p.
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some people traces maybe we distract us from pay maybe uh and
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a a a feature that the size than not happier to cause any
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damage and maybe that break the vicious cycle of pain temporally
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uh that leads to king is of your yeah and maybe an action on a central nervous system
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that's the reason why a three months ago we begin a news to d.
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uh with uh and a laboratory of northridge energy uh um to
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combine electro answer for the graffiti with a treaty augmented reality
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um but it's difficult trying to interpret and we must be very caution
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of by uh the results it's the beginning of this today
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it's a patient with a c. a. p. s. control and and much uh uh with uh
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uh at the participants ah what we can just say
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that after for a sessions four of five minutes
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well uh in a row we observe a decrease in being and uh the brain activity of uh
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totally change model eight uh with the operation of a theta waves
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also in the um or monitor and control and that's on a part of the
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brain but it's too early to a a controlled and the um anything
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so a lot too controlled uh certainly virtual reality
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uh can be effective effective as an action or activities up to even edges eek
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uh maybe some nice most suitable for attitude pain management in chronic pain
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uh we suppose nor physics change goes by of each real reality nevertheless it's
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it's time to standardise and ready five what equipment can because under
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as a feature pretty actually we are uh play stations against
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a very complex a system is multi sensory uh effect
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so it's time to make a randomised control a trial uh because we don't know also that
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time of a virtual reality defect at the long term and um we don't know that
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if it cassie and the understand always need to understand the mechanism
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so uh we have the technology but we just know how
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to use it thank you for your attention ha
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hi thank you very much unfortunately no time left we're running out of time
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i have to thank uh all speakers to my co chair i think we've opened a lot of interesting torso
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