Accepted for/Published in: JMIR XR and Spatial Computing (JMXR)
Date Submitted: Mar 21, 2023
Open Peer Review Period: Mar 21, 2023 - May 16, 2023
Date Accepted: Dec 26, 2023
(closed for review but you can still tweet)
Brain activation during virtual reality symptom provocation in obsessive-compulsive disorder: A proof-of-concept study
ABSTRACT
Background:
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions. We previously showed that a virtual reality (VR) game can be used to provoke and measure anxiety and compulsions in OCD patients. Here, we investigated whether this VR-game activates brain regions associated with symptom provocation.
Objective:
In this study we aim to investigate the neural regions that are activated in OCD patients when they are interactively confronted with a symptom provoking event and when they are performing compulsive actions in VR.
Methods:
In a proof-of-concept study, we investigated brain activation in response to the VR-game in nine OCD-patients and nine healthy controls. Participants played the VR-game while regional changes in blood oxygenation were measured using functional MRI. We investigated brain activation in relation to OCD related events and virtual compulsions in the VR-game. Due to low statistical power because of the sample size, we also reported results at trend significant level with a threshold of P < 0.1. Additionally, we investigated correlations between OCD severity and brain activation.
Results:
We found a trend for increased activation in the left amygdala (P = .07) at confrontation with OCD related events and for increased activation in the bilateral amygdala (P = .06, P = .09) and right insula (P = .09) when performing virtual compulsions in OCD patients compared to healthy controls, but this did not attain statistical significance. The amygdala and insula activation did not correlate with OCD severity.
Conclusions:
The findings of this proof-of-concept study indicate that VR elicits brain activation in line with previous provocation studies. Our findings need to be replicated in a study with a larger sample size. VR may be used as an innovative and unique method of interactive symptom provocation in future neuro imaging studies. Clinical Trial: Netherlands Trial Register NTR6420
Citation
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