虚拟现实治疗对社交焦虑障碍患者前额叶皮质活动的影响：参与式和互动式虚拟现实治疗研究。
The Effects of Virtual Reality Treatment on Prefrontal Cortex Activity in Patients With Social Anxiety Disorder: Participatory and Interactive Virtual Reality Treatment Study.
机构信息
Department of Psychiatry, School of Medicine, Keimyung University, Daegu, Republic of Korea.
Department of Psychiatry, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
出版信息
J Med Internet Res. 2021 Dec 17;23(12):e31844. doi: 10.2196/31844.
BACKGROUND
Attempts to use virtual reality (VR) as a treatment for various psychiatric disorders have been made recently, and many researchers have identified the effects of VR in psychiatric disorders. Studies have reported that VR therapy is effective in social anxiety disorder (SAD). However, there is no prior study on the neural correlates of VR therapy in patients with SAD.
OBJECTIVE
The aim of this study is to find the neural correlates of VR therapy by evaluating the treatment effectiveness of VR in patients with SAD using portable functional near-infrared spectroscopy (fNIRS).
METHODS
Patients with SAD (n=28) were provided with 6 sessions of VR treatment that was developed for exposure to social situations with a recording system of each participant's self-introduction in VR. After each VR treatment session, the first-person view (video 1) and third-person view (video 2) clips of the participant's self-introduction were automatically generated. The functional activities of prefrontal regions were measured by fNIRS while watching videos 1 and 2 with a cognitive task, before and after whole VR treatment sessions, and after the first session of VR treatment. We compared the data of fNIRS between patients with SAD and healthy controls (HCs; n=27).
RESULTS
We found that reduction in activities of the right frontopolar prefrontal cortex (FPPFC) in HCs was greater than in the SAD group at baseline (t=-2.01, P=.049). Comparing the frontal cortex activation before and after VR treatment sessions in the SAD group showed significant differences in activities of the FPPFC (right: t=-2.93, P<.001; left: t=-2.25, P=.03) and the orbitofrontal cortex (OFC) (right: t=-2.10, P=.045; left: t=-2.21, P=.04) while watching video 2.
CONCLUSIONS
Activities of the FPPFC and OFC were associated with symptom reduction after VR treatment for SAD. Our study findings might provide a clue to understanding the mechanisms underlying VR treatment for SAD.
TRIAL REGISTRATION
Clinical Research Information Service (CRIS) KCT0003854; https://tinyurl.com/559jp2kp.
背景
最近，人们尝试将虚拟现实（VR）应用于各种精神疾病的治疗，许多研究人员已经确定了 VR 在精神疾病中的作用。研究报告称，VR 疗法对社交焦虑症（SAD）有效。然而，目前还没有关于 SAD 患者 VR 疗法的神经相关性的研究。
目的
本研究旨在通过使用便携式近红外光谱（fNIRS）评估 SAD 患者 VR 治疗的疗效，找到 VR 治疗的神经相关性。
方法
共纳入 28 例 SAD 患者，为其提供 6 次 VR 治疗，该治疗是为暴露于社交情境而开发的，并配备了每位参与者在 VR 中自我介绍的记录系统。在每次 VR 治疗后，系统会自动生成参与者自我介绍的第一人称视角（视频 1）和第三人称视角（视频 2）片段。在观看视频 1 和 2 时，参与者需进行认知任务，治疗前和整个 VR 治疗后以及第一次 VR 治疗后，使用 fNIRS 测量前额区域的功能活动。我们比较了 SAD 患者和健康对照组（HCs；n=27）的 fNIRS 数据。
结果
我们发现，在基线时，HCs 的右额极前额皮质（FPPFC）活动减少大于 SAD 组（t=-2.01，P=.049）。在 SAD 组中，比较 VR 治疗前后额叶皮质的激活情况，发现 FPPFC（右侧：t=-2.93，P<.001；左侧：t=-2.25，P=.03）和眶额皮质（OFC）（右侧：t=-2.10，P=.045；左侧：t=-2.21，P=.04）的活动有显著差异，同时观看视频 2。
结论
FPPFC 和 OFC 的活动与 SAD 患者接受 VR 治疗后的症状缓解有关。我们的研究结果可能为理解 SAD 的 VR 治疗机制提供线索。
试验注册
临床研究信息服务（CRIS）KCT0003854；https://tinyurl.com/559jp2kp。
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