Tsamitros N, Gutwinski S, Beck A, Lange Mussons S, Sebold M, Schöneck R, Wolbers T, Bermpohl F, Heinz A, Lütt A
Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany.
Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany.
Sci Rep. 2024 Dec 18;14(1):30550. doi: 10.1038/s41598-024-81071-0.
New therapeutic approaches for alcohol dependence (AD) include virtual reality (VR)-based treatments offering scalable options for cue exposure (CE), a well-established strategy in cognitive behavioral therapy. This study aimed to evaluate the feasibility and tolerability of a new VR-CE paradigm. On an explorative basis, factors influencing the induction of craving were examined. This single-arm monocentric clinical study included n = 21 patients with AD in inpatient rehabilitation treatment, that completed one VR-CE session including confrontation with alcohol-associated stimuli. Measurements of subjective craving before, during and after exposure, affective states, VR side effects as cybersickness and the sense of presence in VR were conducted. Craving levels during and directly after VR-CE were significantly higher than before the intervention. Craving levels 20 min after VR-CE did not significantly differ compared to those before VR-CE. Patients described a pronounced sense of presence and only mild symptoms of cybersickness. Craving was significantly correlated with cybersickness. While positive affect decreased throughout the VR exposure, negative affect did not differ significantly in pre-post-comparisons. This study shows that craving induction through our VR-CE paradigm is feasible and well-tolerated by patients with AD in long-term rehabilitation. These results contribute to the development and future research of therapeutic VR-CE approaches.
酒精依赖（AD）的新治疗方法包括基于虚拟现实（VR）的治疗，为线索暴露（CE）提供可扩展的选择，这是认知行为疗法中一种成熟的策略。本研究旨在评估一种新的VR-CE范式的可行性和耐受性。在探索的基础上，研究了影响渴望诱发的因素。这项单臂单中心临床研究纳入了21名接受住院康复治疗的AD患者，他们完成了一次VR-CE治疗，包括面对与酒精相关的刺激。在暴露前、暴露期间和暴露后测量主观渴望、情感状态、VR副作用如晕动病以及在VR中的临场感。VR-CE期间和刚结束后渴望水平显著高于干预前。VR-CE后20分钟的渴望水平与VR-CE前相比无显著差异。患者描述有明显的临场感，只有轻微的晕动病症状。渴望与晕动病显著相关。在整个VR暴露过程中，积极情感下降，而消极情感在前后比较中无显著差异。本研究表明，通过我们的VR-CE范式诱发渴望对长期康复中的AD患者是可行的且耐受性良好。这些结果有助于治疗性VR-CE方法的开发和未来研究。
