Tag: virtual reality

Virtual Reality Sessions can Lessen Cancer Pain, Trial Shows

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Hospitalised cancer patients who engaged in a 10-minute virtual reality (VR) session experienced significantly lessened pain in a trial published in CANCER, a peer-reviewed journal of the American Cancer Society. Participants still experienced sustained benefits a day later.

Most cancer patients experience pain, and treatment usually involves medications including opioids. VR sessions that immerse the user in new environments have been shown to be a noninvasive and nonpharmacologic way to lessen pain in different patient populations, but data are lacking in individuals with cancer. To investigate, Hunter Groninger, MD, of Georgetown University School of Medicine and MedStar Health and his colleagues randomized 128 adults with cancer with moderate or severe pain to a 10-minute immersive VR intervention involving calm, pleasant environments or to a 10-minute two-dimensional guided imagery experience on an iPad tablet.

The investigators found that both interventions lessened pain, but VR sessions had a greater impact. Based on patient-reported scores from 0 to 10, patients in the guided imagery group reported an average decrease of 0.7 in pain scores, whereas those in the VR group reported an average drop of 1.4. Twenty four hours after the assigned intervention, participants in the VR group reported sustained improvement in pain severity (1.7 points lower than baseline before the VR intervention) compared with participants in the guided imagery group (only 0.3 points lower than baseline before the active control intervention).

Participants assigned to the VR intervention also reported improvements related to pain “bothersomeness” (how much the pain bothered them, regardless of the severity of the pain) and general distress, and they expressed satisfaction with the intervention. 

“Results from this trial suggest that immersive VR may be a useful non-medication strategy to improve the cancer pain experience,” said Dr Groninger. “While this study was conducted among hospitalized patients, future studies should also evaluate VR pain therapies in outpatient settings and explore the impact of different VR content to improve different types of cancer-related pain in different patient populations. Perhaps one day, patients living with cancer pain will be prescribed a VR therapy to use at home to improve their pain experience, in addition to usual cancer pain management strategies like pain medications.”

Source: Wiley

Difficulty in Navigating could Predict Alzheimer’s Years Before Symptom Onset

People at risk of Alzheimer’s disease have impaired spatial navigation before they develop problems with other cognitive functions, including memory, finds a new study led by UCL researchers.

The research, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, used virtual reality to test the spatial navigation of 100 asymptomatic midlife adults, aged 43-66, from the PREVENT-Dementia prospective cohort study.

Participants had a hereditary or physiological risk of Alzheimer’s disease, due to either a gene (the APOE-ε4 allele) that puts them at risk of the condition, a family history of Alzheimer’s disease, or lifestyle risk factors such as low levels of physical activity. Crucially, these participants were around 25 years younger than their estimated age of dementia onset.

Led by Professor Dennis Chan, the study used a test designed by Dr Andrea Castegnaro and Professor Neil Burgess (all UCL Institute of Cognitive Neuroscience), in which participants were asked to navigate within a virtual environment while wearing VR headsets.

The researchers found that people at greater risk of developing Alzheimer’s disease, regardless of risk factor, were selectively impaired on the VR navigation task, without a corresponding impairment on other cognitive tests. The authors say their findings suggest that impairments in spatial navigation may begin to develop years, or even decades, before the onset of any other symptoms.

First author, Dr Coco Newton (UCL Institute of Cognitive Neuroscience), who carried out the work while at University of Cambridge said: “Our results indicated that this type of navigation behaviour change might represent the very earliest diagnostic signal in the Alzheimer’s disease continuum — when people move from being unimpaired to showing manifestation of the disease.”

The researchers also found that there was a strong gender difference in how participants performed, with the impairment being observed in men and not women.

Dr Newton added: “We are now taking these findings forward to develop a diagnostic clinical decision support tool for the NHS in the coming years, which is a completely new way of approaching diagnostics and will hopefully help people to get a more timely and accurate diagnosis.

“This is particularly important with the emergence of anti-amyloid treatments for Alzheimer’s, which are considered to be most effective in the earliest stages of the disease.

“It also highlights the need for further study of the differing vulnerability of men and women to Alzheimer’s disease and the importance of taking gender into account for both diagnosis and future treatment.”

Professor Chan said: “We are excited by these findings for two main reasons. First, they improve detection of the clinical onset of Alzheimer’s disease, critical for prompt application of treatments.

“Second, the VR navigation test is based on our knowledge of the spatial properties of cells in the brain’s temporal lobe, and the application of cellular neuroscience to clinical populations helps bridge the gap in understanding how disease at the neuronal level can result in the clinical manifestation of disease. This knowledge gap currently represents one of the biggest barriers to progress in Alzheimer’s research.”

Source: University College London

Medical Students Retain Knowledge Better from Virtual Reality Lessons

A trial published in the International Journal of Gynecology & Obstetrics lends support to the idea that 3D virtual reality lessons can improve medical students’ retention of knowledge and understanding of complex topics in obstetrics and gynaecology.

For the study, 21 students took part in a 15-minute virtual reality learning environment (VRLE) experience on the stages of foetal development, while 20 students received a PowerPoint tutorial on the same topic, serving as a control.

While the students’ level of knowledge increased after both learning experiences, it was only retained in the VRLE group at one-week follow up. Questionnaires completed by participants reflected a high degree of satisfaction with the VRLE tool compared with the traditional tutorial.

“Virtual reality learning tools hold potential to enhance student learning and are very well received by students,” said corresponding author Fionnuala McAuliffe, MD, of University College Dublin National Maternity Hospital, in Ireland.

Source: Wiley

Virtual Reality can Aid Addiction Recovery by Imagining the Future

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A pilot study published in the journal Discover Mental Health suggests that virtual reality simulation of imagined realities using realistic avatars of the participants can aid substance use disorder recovery by lowering the risk of relapse rates and increasing their future self-connectedness.

The Indiana University researchers have recently received over $4.9 million from the National Institutes of Health and launched an IU-affiliated startup company to test and further develop the technology.

Led by Brandon Oberlin, an assistant professor of psychiatry at the IU School of Medicine, IU researchers have built a virtual environment using “future-self avatars” to help people recover from substance use disorders. These avatars are life-sized, fully animated and nearly photorealistic. People can converse with their avatars, who speak in their same voice using personal details in alternate futures.

“VR technology is clinically effective and increasingly common for treating a variety of mental health conditions, such as phobias, post-traumatic stress disorder and post-operative pain, but has yet to find wide use in substance use disorders intervention or recovery,” A/Prof Oberlin said. “Capitalising on VR’s ability to deliver an immersive experience showing otherwise-impossible scenarios, we created a way for people to interact with different versions of their future selves in the context of substance use and recovery.”

“This experience enables people in recovery to have a personalised virtual experience, in alternate futures resulting from the choices they made,” Oberlin said. “We believe this could be a revolutionary intervention for early substance use disorders recovery, with perhaps even further-reaching mental health applications.”

The technology is particularly well-suited for people in early recovery, when relapse risk high, because the immersive experiences can help them choose long-term rewards over immediate gratification by deepening connections to their future selves, he said.

In the past five months, A/Prof Oberlin’s team was awarded numerous grants. These will be used to support clinical trials that test efficacy on relapse prevention, brain activation and other important elements related to substance use disorder treatment, A/Prof Oberlin said. For example, one study will deliver virtual reality experiences remotely via wireless headsets for participants to use at home, as remote delivery of mental health interventions addresses a pressing need for people unable or unwilling to engage in an in-person clinical setting.

Source: Indiana University

Clinical Trial of VR App Effective in Reducing Phobia Symptoms

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A New Zealand trial of a smartphone combining virtual reality (VR) with cognitive behavioural therapy (CBT) showed a 75% reduction in phobia symptoms after six weeks of the treatment programme. The results, published in the Australian and New Zealand Journal of Psychiatry, suggests an easily available treatment for the nearly one in 12 people who suffer common phobias such as that of heights or spiders.

The trial, led by Associate Professor Cameron Lacey, from the Department of Psychological Medicine, involved phobia patients using a smartphone app treatment programme called ‘oVRcome‘, which combines VR 360-degree video exposure therapy using headset alongside more traditional CBT. The company provides a simple headset into which users insert their own smartphone, turning it into a display.

“The improvements they reported suggests there’s great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias,” Associate Professor Lacey says.

“Participants demonstrated a strong acceptability of the app, highlighting its potential for delivering easily accessible, cost-effective treatment at scale, of particular use for those unable to access in-person exposure therapy to treat their phobias.”

A total of 129 people took part in the six-week randomised, controlled trial, over May–December 2021, with a 12-week follow-up. Participants needed to be aged between 18–64 years, have a fear of either flying, heights, needles, spiders and dogs. Weekly questionnaires were emailed to record their progress, with access made available to a psychologist for any adverse effects.

For all phobias, participants showed comparable improvements in the Severity Measures for Specific Phobia scale. The average severity score decreased from 28/40 (moderate to severe symptoms) to 7/40 (minimal symptoms) after six weeks. There were no participant withdrawals due to intervention-related adverse events.

“The oVRcome app involves what’s called ‘exposure therapy’, a form of CBT exposing participants to their specific phobias in short bursts, to build up their tolerance to the phobia in a clinically-approved and controlled way,” Assoc Professor Lacey explained.

“Some participants reported significant progress in overcoming their phobias after the trial period, with one feeling confident enough to now book an overseas family holiday, another lining up for a COVID vaccine and another reporting they now felt confident not only knowing there was a spider in the house but that they could possibly remove it themselves.”

The programme used standard CBT components including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and a relapse prevention model. Participants were able to select their own exposure levels to their particular phobia from a large library of VR videos.

“This means the levels of exposure therapy could be tailored to an individual’s needs which is a particular strength. The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience and a lack of motivation in people seeking out fears to expose themselves to. With this VR app treatment, triallists had increased control in exposure to their fears, as well as control over when and where exposure occurs,” said Assoc Professor Lacey.

The cost-effective availability of the app and headsets and the fact that multiple phobias were tested at once made this a novel trial, the researchers said. Most comparative VR studies to date have investigated high-end VR devices which are only available in research and limited clinical settings. One Dutch study examined a low-cost VR Dutch-language program using animated imagery that demonstrated improvement in fear-of-height symptoms, however this study only examined a single type of specific phobia.

Associate Professor Lacey says public demand to take part in the trial was unprecedented, demonstrating the increasing need and desire for phobia treatment in the community.

Source: University of Otago

Virtual Companion Helps Reduce Anxiety

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A study found that, when a companion is present virtually as an avatar, people respond with less anxiety to fear-inducing noises. This effect was found to be most pronounced in women.

Led by Professor Grit Hein, the study is published in the journal Translational Psychiatry and could have implications for the treatment and management of social anxiety.

“In a nutshell, we have shown that anxiety can also be reduced by the ‘presence’ of a virtual person, especially in socially anxious women. And women in general seem to benefit more from social presence,” Prof Hein said. She believes that this insight might have practical significance.

The study recruited 208 men and women, who were all exposed to fear-inducing sounds alternating with neutral ones – either alone or in the company of another person. Women had female companions, men had male companions. The researchers determined the level of the participants’ anxiety response through changes in skin conductance. Moreover, the participants had to rate the sounds on a scale.

But the series of experiments differed in one key aspect: One group had a real person at their side during the experiment whereas the second group completed the task in a virtual reality – accompanied by an avatar that was an image of the real companion.

“Earlier experiments have shown that the presence of a third party can significantly reduce fear responses. In such situations, social support thus has a stress-buffering effect,” said Prof Hein.

However, not all people are equally sociable: for some, the presence of others might actually trigger apprehension or anxiety. They fear that their companion might notice their anxious responses, such as trembling, flushing or sweating, causing them stress in the first place. Thus far it was unclear whether an avatar is also capable of triggering such a response.

The results of Prof Hein’s study have now provided clarity in this regard. They show that:

  • women respond much more strongly to fear-inducing sounds than men do.
  • the presence of another person reduces anxiety, especially in women. This is especially true for women without social anxiety disorder.
  • the presence of a virtual person also reduces the anxiety response in women – regardless of the level of social anxiety they experience. So a virtual agent may increase feelings of safety in women suffering from social anxiety disorder.
  • social anxiety does not have a comparable effect on men.

“Our findings provide new insights into the individual differences that influence the social modulation of the autonomic human anxiety responses,” the authors concluded in their study. The researchers’ next aim is to study long-term effects and replicate the findings in real life.

Future studies should systematically explore the effect of the gender of the present person, they suggested. This would also allow scientifically sound evidence to be provided as to how men respond when they have a woman at their side in fear-inducing situations and vice versa.

Source: News-Medical.Net

Researchers Test VR in Treatment of Chronic Pain

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A team of researchers at the University of East Anglia are starting a new project to see if virtual reality, combined with an innovative brain interface could help with the treatment of chronic pain.

Almost one in five South African adults are living with chronic pain, and the team will study whether new technology delivered via a VR headset could help ease their symptoms.

One very science-fiction-like aspect of the study the use of a ‘Brain-Computer Interface’ where participants will be taught to control elements of a VR game using only their thoughts. Previous studies have shown that VR therapy was effective in reducing chronic and acute pain in children and adults.  

Dr Jordan Tsigarides from UEA’s Norwich Medical School and a Rheumatology doctor at the Norfolk and Norwich University Hospital, said: “Virtual Reality is an emerging technology where the user gains a completely immersive, interactive and often transformative experience with the use of a head-mounted display.

“VR seems to flood the brain with a multitude of audiovisual signals, engaging the senses and diverting the brain’s attention from processing pain signals.”

“At present, there is evidence that VR can significantly decrease people’s acute pain. What we are looking to find out is whether this kind of technology can be used to help people suffering chronic pain as well.”

The team is working with industry partner, Orbital Innovations, and has developed an innovative VR program for patients with chronic pain conditions, such as fibromyalgia syndrome and chronic pain following a total knee replacement. It will be tested on patients recruited from the NNUH and Addenbrookes in partnership with rheumatology, orthopaedics and pain management departments.

Dr Tsigarides said: “The virtual worlds that we have created aim to transport patients to naturalistic, immersive environments whether its travelling down a cool snowy river or planting crops in a luscious warm forest. Through VR, we aim to engage patients through challenging and interactive games, with the objective of understanding more about how this technology can reboot the brain’s pain networks.

“We are working with neuroscientists at the UEA to look at the brain waves of people with chronic pain. This has the potential to allow us to see how this technology is working, as well as learn more about the brain function of people with these conditions.

“Moving things with your mind sounds like something straight from a sci-fi movie but with today’s technology, ‘Brain-Computer Interfaces’ are being used more and more in health research. We believe that this exciting new innovation when coupled with an immersive VR experience will ‘power up’ the pain relief seen with VR alone.

“Given that just under 28 million adults in the UK suffer from chronic pain, and that we are in the midst of an opioid epidemic, this treatment could be an important future intervention.”

Peter Brady, CEO of Orbital Innovations, said: “Orbital Innovations has been working towards the development of a virtual reality technology, which will offer a way of mitigating the effects of chronic pain. This innovative project collaboration with UEA, will be breaking new ground in fully exploring the exciting opportunities this technology will offer patients in the future.”

Source: University of East Anglia