Park Hyewon, Hwang Heekyung, Kim Minjung, Park Haein, Jeon Imhong, Shon Young-Min, Hong SungJun, Lee Deokjong
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Social Work Team, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
J Korean Med Sci. 2025 Aug 11;40(31):e185. doi: 10.3346/jkms.2025.40.e185.
Cognitive behavioral therapy (CBT) for panic disorder involves training to cope with anxiety and panic attacks effectively. Recently, CBT, when integrated with anxiety-inducing virtual reality (VR) scenarios, has been utilized to treat panic disorder. This study aimed to investigate the neurophysiological impacts of VR-enhanced CBT in the treatment of panic disorder.
Nineteen patients (6 men and 13 women; average age: 36.0 ± 11.7 years) diagnosed with panic disorder participated in four sessions of VR-based CBT. The VR program included educational elements focusing on abdominal breathing and muscle relaxation and training components that utilized relaxation techniques during exposure to a VR environment. Psychometric assessments and electroencephalogram (EEG) readings were collected before and after the CBT sessions. The EEG studies were performed under two conditions: a resting state and while engaging in a visual working memory task.
The Panic Disorder Severity Scale for panic symptoms improved following VR-based CBT. Although error rates in the Stroop test did not change before and after CBT, reaction times improved. Additionally, several EEG indicators exhibited differences pre- and post-CBT, with increased left frontal beta and parietal theta power observed during a visual working memory task.
This study indicated that VR-based CBT may alleviate panic symptoms and enhance cognitive functions, particularly executive control. Additionally, EEG results suggested that VR-based CBT could strengthen brain activity associated with working memory performance.
针对惊恐障碍的认知行为疗法(CBT)包括训练以有效应对焦虑和惊恐发作。最近,当CBT与诱发焦虑的虚拟现实(VR)场景相结合时,已被用于治疗惊恐障碍。本研究旨在调查VR增强型CBT在治疗惊恐障碍中的神经生理学影响。
19名被诊断为惊恐障碍的患者(6名男性和13名女性;平均年龄:36.0±11.7岁)参加了四节基于VR的CBT课程。VR程序包括专注于腹式呼吸和肌肉放松的教育元素,以及在接触VR环境期间利用放松技术的训练组件。在CBT课程前后收集心理测量评估和脑电图(EEG)读数。EEG研究在两种条件下进行:静息状态和进行视觉工作记忆任务时。
基于VR的CBT后,惊恐症状的惊恐障碍严重程度量表有所改善。虽然CBT前后Stroop测试中的错误率没有变化,但反应时间有所改善。此外,几个EEG指标在CBT前后表现出差异,在视觉工作记忆任务期间观察到左额叶β波和顶叶θ波功率增加。
本研究表明,基于VR的CBT可能减轻惊恐症状并增强认知功能,特别是执行控制。此外,EEG结果表明,基于VR的CBT可以增强与工作记忆表现相关的大脑活动。