How does the brain work? As science progresses to understand the intricacies of our body’s most complex organ, virtual reality could help to uncover some new mechanisms around brain plasticity and lead the way for innovative forms of treatment.
1. EMPATHY MACHINE
For a while, VR seemed like a technology reserved only for gamers – until, in a landmark TED Talk in 2015, Chris Milk pitched it as ‘the ultimate empathy machine’ and revealed its potential to be used in education, in advertising, in fundraising and in healthcare. In 2015, the Excedrin® Migraine campaign was one of the first to leverage the power of VR for disease awareness, by inviting friends and family of migraine sufferers to walk in the patient’s shoes and experience the debilitating effects of a migraine with a VR headset.
2. PAIN CONTROL
But this isn’t the only promise of virtual reality in healthcare. Pilots are flourishing all over the world to explore how VR can manipulate the brain to bypass pain signals, develop coping mechanisms, and improve mobility functions and body perception.
Some applications – such as pain control – are obvious, with VR being used to distract patients from their physical symptoms. SnowWorld was the first application designed to this effect (and was included in the Smithsonian Cooper Hewitt National Museum of Design Triennial in 2006). Targeting severely burned patients with the aim of relieving the pain of wound care, users are immersed into a cold and icy world. The VR game has been tested in various small studies in burn centres and specialised units with some patients reporting a similar level of pain relief with ‘VR analgesia’ as with opioids.
3. MENTAL HEALTH
Beyond pain management, the technology lends itself quite well for intervention in the mental health space by offering a virtual – i.e. safe – environment for patients to be exposed to their fears or triggers and develop new coping mechanisms. The first attempt to use the newly emerging VR technology for PTSD dates back to 1997 when researchers from Georgia Tech enrolled ten veterans into a small study – soon to be dubbed ‘Virtual Vietnam’. Having previously not responded to traditional PTSD therapies, all patients improved significantly within the first month of VR treatment. Virtual reality exposure therapies are now developed for phobias, addictions and PTSD.
As virtual reality operates by tricking the brain, it’s also shown significant potential in rehabilitation. At the University of Southern California, researchers from the Neural Plasticity and Neurorehabilitation Laboratory have started to investigate how VR could promote brain plasticity and recovery in patients recovering from stroke, with a brain-computer interface used to control an avatar. In another recent headline, it was announced in October 2018 that Accenture has developed a VR game designed to help amputees with phantom limb syndrome. The technology was tested in Sao Paulo, Brazil and demonstrated an increase in patient engagement and confidence to control their prosthetic limb and a decrease in phantom limb pain.
Pushing the exploration even further, the Duke University’s Walk Again Project aims to help patients with critical spinal cord injury to regain part of their sensations or mobility. What started the experiment was a simple observation: when paraplegic patients were asked to imagine they were walking, there was no modulation of brain signals. So, to stimulate their brains, the team designed a protocol combining brain-controlled exoskeletons and VR, helping restore the critical link between body and mind and ‘re-wire’ the brain. The first results were astonishing. In the small cohort of eight patients who participated in the study, all have regained some degree of motor control and sensation, with one patient even being able to move her legs again.
As science strives to better understand how our brains work, the potential for larger-scale studies and further application of VR to more health conditions is bound to increase. And with the democratisation of the cost of VR equipment, virtual reality programmes may well become a cost-efficient treatment option in the future.
Who’s ready for the emergence of digital therapeutics?