Virtual reality and transcranial electrical stimulation may help treat PTSD
A recent study suggests combining two therapies may help military veterans with post-traumatic stress disorder. In a Providence Veterans Affairs Medical Centre study, U.S. war veterans who received brain stimulation with a modest electrical current during virtual reality exposure sessions reported significantly less severe PTSD symptoms. The study appeared in JAMA Psychiatry on March 6.
Brown University Warren Alpert Medical School psychiatry and human behaviour professor Noah Philip wrote the paper regarding the study’s findings. Given the current PTSD treatment problems, he was happy with the result. Philip stated that scientists are using a different and innovative approach to treatment. He added that brain stimulation and psychotherapy are used to promote recovery. Philip, the Providence V.A. Centre for Neurorestoration and Neurotechnology’s mental health research head, praised these outcomes and predicted better ones.
According to studies, PTSD symptoms include intrusive thoughts and recollections, avoiding trauma-related stimuli, hyperarousal, and mood disturbances. For PTSD, medication and trauma-focused exposure therapy are frequent initial therapies. Philip claimed that treating PTSD among military veterans is particularly difficult. Exposure therapy requires reliving unpleasant events, which may be harsh on the stomach, and drugs have adverse effects. Up to 50% of patients stop traditional exposure therapy, while others never start.
Mascha van ‘t Wout-Frank, an associate professor of psychiatry and human behaviour (research) at Warren Alpert Medical School, and Philip, a psychiatric brain simulation researcher, collaborated on the study. Mascha studies how non-invasive brain stimulation affects “fear extinction,” or the understanding that dangerous things are safe and bearable.
According to a standard PTSD theory, the ventromedial prefrontal cortex and other brain regions cannot top-down control the amygdala, reducing exposure treatment’s effectiveness. Van ‘t Wout-Frank claims that impacted individuals have weaker safety learning and memory, which healthy brains support. He suggested adding transcranial direct current stimulation, which sends a constant, low-level, painless electrical current to a brain location, to trauma-focused exposure therapy. The non-invasive current may stimulate brain activity, aiding the ventromedial prefrontal cortex’s top-down control of safety learning. The research team used virtual reality and transcranial direct current stimulation to simulate real-world scenarios. Virtual reality simulates touch, visual, and olfactory sensations.
Based on a pilot investigation, the researchers undertook a more extensive, double-blind experiment with 54 American combat veterans with chronic PTSD to examine the combo treatment. Participants were randomly given transcranial direct current stimulation or a simulated electrical current experience with some sensation but no significant amount or duration. Transcranial direct current stimulation patients received six 25-minute warzone virtual reality sessions over two to three weeks. Low-energy (2 milliamps) sessions targeted the ventromedial prefrontal cortex.
Active transcranial direct current treatment effectively reduced PTSD symptom severity after one month. Even though all participants reduced their PTSD symptoms due to the V.R., unlike sham treatments, active transcranial direct current stimulation expedited their physiological and psychological adaptation to the virtual reality experiences in between sessions. Philip stated that one of the primary reasons people quit psychotherapy is because it’s hard to bring up prior trauma. This V.R. exposure is typically more straightforward to handle.
Electric stimulation and virtual reality treatment accelerated prolonged exposure therapy outcomes from 12 weeks to two weeks. Philip also saw that the treatment’s cumulative effects became greater. Philip also reported that patients improved following treatment, with the largest gains a month later. The research team thoroughly reviews the trial data to understand further how the treatment caused long-term brain alterations. Further research may examine the impact of repeated therapy, a larger sample size, and longer follow-ups.
