Virtual Reality News April 2008

• Hunter Hoffman and David Patterson's SnowWorld, which I've written about before, is currently being used at Loyola University Hospital in Maywood, IL for burn victims. More than just a distracting media presentation, SnowWorld is an immersive VR video game that relies on the user to complete problem-solving tasks in the game, reducing their pain levels as evidenced by self-reports and MRI scans

• In stroke rehabilitation, researchers in Israel are using VR to enhance both diagnosis and therapeutic treatment selection for patients. Currently, the team of computer scientists and health professionals have designed a system that can differentiate between types of injuries - traumatic brain injuries vs. cerebrovascular accidents. Next, they will program the computers to generate models of patient recovery in order to select the best treatment for each specific patient. While diagnosis is an area that doctors can already do without the help of technology, projecting treatment outcomes with consistent accuracy is not something doctors can currently do with high consistency and accuracy. The VR is also used in patient therapy to demonstrate healthy movements of limbs without physical movement. The patient sees their limbs on a screen performing movements without pain, which can activate mirror neurons, which are frontal lobe neurons that fire when performing a task or seeing it performed. By seeing a natural movement, not experiencing pain, and having the typical motion pathway activated in your brain, pain is reduced and the patient's motility increased.

• London researchers recently used a VR headset to study paranoia in the general population, as subjects were transported via a virtual London Underground on a 4-minute ride. About 1 in 3 participants experienced paranoid thoughts about one or more of the neutral passengers populating the subway. People who experienced day-to-day thoughts of paranoia were more likely to experience it in the virtual underground. The next steps are to design a protocol that allows diagnosis and therapeutic sessions utilizing the technology. Read more here.
  

Citation:

Freeman D, Pugh K, Antley A, Slater M, Bebbington P, Gittins M, Dunn G, Kuipers E, Fowler D and Garety P (2008) Virtual reality study of paranoid thinking in the general population.
British Journal of Psychiatry, 192, 258-263.

VR Grocery Shopping

Today, researchers from the University of Pittsburgh will present a poster on the correlation they found between conventional clinical measures of balance and measures of balance while subjects were immersed in a virtual grocery store environment. They will present their ideas on how VR environments can be used for therapeutic purposes for people with balance disorders. Specifically, a grocery store was chosen because of the need to simultaneously walk through different aisles while looking at various height levels of products.

Read the full abstract at NIH NIDCD Abstracts

Videos of PTSD Exposure Therapy

The Health Blog recently posted a thorough and clear explanation of how PTSD exposure therapy works, complete with video!

It also brings up an important problem that needs to be addressed before VR therapy becomes more prevalent. The article focuses on war veterans, and the studies have a high dropout rate exists because the realistic therapy is so difficult to endure. Maybe this is why (coupled with the fact it's relatively new) it's so hard to find hard numbers on VR. If you know of any, as always, please shoot me an e-mail or comment. Thanks!

Alzheimer's Study

An exciting article on the potential of DBS (deep brain stimulation) for Alzheimer's. This surgical implant procedure has traditionally been used to help Parkinson's patients regain some control and steadiness, but an accidental finding will spur new research on utilizing DBS to restore memories and brain function. It's early for sure, but it provides hope for an eventual treatment and/or cure for Alzheimer's.

More on Wii-hab

Please excuse that terrible pun, but here's another terrific article on the use of Nintendo Wii in rehabilitation, specifically for stroke victims. This study is headed by the Afferent Corporation, which develops devices that treat neurological dysfunction. A representative from the company, Bethany Therrien, states that playing the Wii stimulates a greater flow of sensory information to the brain, allowing the patient to reform old functional pathways.

VR Environments for Autistic People & Drug Addicts

I just learned about research at Duke University by Dr. Zachary Rosenthal that focuses on helping crack addicts effectively complete rehab. The Cognitive Behavioral Research and Treatment Program at Duke is the first instance I've heard in which virtual environments are used to simulate real-life scenarios specifically for drug users. The website states that randomized clinical trials are under way; it will be interesting to see the preliminary results.

MSN has a great profile of Brigadoon, a virtual island in Second Life that allows people with Asperger's to hone communication and socialization skills. At the Center for Brain Health at the University of Texas at Dallas, therapists are pushing the virtual environment one step farther and actually integrating them into therapy. The Chronicle of Higher Education ran an article (subscription required) applications of virtual reality for autistic people that quotes Dr. Rosenthal as well as the Director of the Center for Brain Health, Dr. Sandra Chapman. Since one hallmark of Asperger's is an inability to read facial expressions or detect nonverbal context clues, therapists work with patients to role play and analyze social situations. With the therapist's help, the patient can gain insight into how they handled specific situations and discuss appropriate actions and reactions.

Chapman asserts that the premise of such therapeutic interventions is that the brain can rewire pathways with intensive, experience-based practice. Virtual worlds offer a safe space for people to gain this invaluable practice, as well as a forum for patient, therapist, family members, and friends to interact. Chapman points out that the early, formative years, as the brain is developing, are a crucial time to help rewire neurological pathways. Center for Brain Health participants undergo a series of testing both pre- and post- treatment, including brain imaging and neurocognitive testing. It's an exciting time for autism research, and I can't wait to see some brain imaging or effect size numbers.

Further Reading:
http://www.utdallas.edu/news/2007/11/18-003.html

Rehab + Wii

As an undergraduate at Case, I heard anecdotal support for using the Nintendo Wii system to help nursing home patients get much-needed exercise and rehabilitation. CNN's Dr. Sanjay Gupta recently profiled another Ohio university, OSU, using the Wii system to complement therapy for paralyzed and injured patients. Check out the video here.

Most proponents of Wii-therapy are quick to say that it won't replace traditional therapy, but merely offers additional help for patients. Also, no one has quantified its effects yet; the evidence is merely anecdotal. I'm interested in research that provides a more systematic look at this exciting new research and a plan to integrate it more officially into therapies. Please shoot me an e-mail at elyse.moretti@gmail.com if you have any leads. Thanks!