Effects of Virtual Reality Therapy on Neuro-Cognitive and Behavioral Skills in Alcohol-Dependent Patients: A Quantitative Electroencephalography Imaging Investigation

Abstract

An immersive virtual reality based cognitive-behavioral therapy (VR-CBT) has been clinically used to improve the neuro-cognitive and behavioral skills in alcohol-dependent patients with destructive impulse-control disorders, but the therapeutic effects are unknown. The purpose of the investigation was to determine the effectiveness of an impulse-anger management VR-CBT program (IAM-VR-CBTP) on cortical activation, neuro-cognitive and behavioral skills as well as drinking, impulse-anger control, anxiety, and depression. A convenience sample of 11 patients diagnosed with DICD participated and underwent the IAM-VR-CBTP intervention, a 90-minute session, two times/week for 3 weeks. The intervention related physiological and neuro-psychiatric behavioral changes were measured with a quantitative electroencephalogram (QEEG) brain mapping and standardized neurocognitive and behavioral tests including the alcohol dependence scale, the obsessive compulsive drinking scale, the readiness to change questionnaire, the Barratt impulsiveness scale II, the Beck anxiety, the Beck depression inventory II, and the state trait anger expression inventory-2. The non-parametric Wilcoxon statistic was used at P < 0.05. There were no statistically significant differences between the pretest and the posttest scores induced by the IAM-VR-CBTP. QEEG data analyses showed that the post-QEEG maps were characterized by mildly diminished (z -score < – 1.5) relative powers in theta (Fz and Cz), fast alpha (Cz), and slow beta (Cz) bands after the IAM-VR-CBTP intervention. The results suggest that the IAM-VR-CBTP had promising effects on abnormal brain activity underlying compulsive drinking behaviors, motivation to change, and anger experience and unfair treatment by others and provide the first clinical evidence of IAM-VR-CBT on non-invasive neuromodulation and associated neuro-cognitive and behavioral outcomes in alcohol-dependent patients.