Human-Avatar Symbiosis for the Treatment of Auditory Verbal Hallucinations in Schizophrenia through Virtual/Augmented Reality and Brain-Computer Interfaces.

Antonio Fernández-Caballero,Elena Navarro,José M Latorre,Roberto Rodriguez-Jimenez,Patricia Fernández-Sotos,Jorge J Ricarte,Pascual González

doi:10.3389/fninf.2017.00064

Abstract

This perspective paper faces the future of alternative treatments that take advantage of a social and cognitive approach with regards to pharmacological therapy of auditory verbal hallucinations (AVH) in patients with schizophrenia. AVH are the perception of voices in the absence of auditory stimulation and represents a severe mental health symptom. Virtual/augmented reality (VR/AR) and brain computer interfaces (BCI) are technologies that are growing more and more in different medical and psychological applications. Our position is that their combined use in computer-based therapies offers still unforeseen possibilities for the treatment of physical and mental disabilities. This is why, the paper expects that researchers and clinicians undergo a pathway toward human-avatar symbiosis for AVH by taking full advantage of new technologies. This outlook supposes to address challenging issues in the understanding of non-pharmacological treatment of schizophrenia-related disorders and the exploitation of VR/AR and BCI to achieve a real human-avatar symbiosis.

Highlights

Nowadays, mental, neurological, and substance-use (MNS) disorders are one main problem in developed countries
Any perspective for the development of new treatments for auditory verbal hallucinations (AVH) should face two issues: creation of social environments similar to the real world where the patient is guided toward successful social situations, and, real-time monitoring of cerebral areas activated by the patient while living these situations to obtain information about the neurological effects of his/her decisions
The results of this study show that many patients were able to stand up to their AVH but not all patients may be able to face their persecutor during therapy (Leff et al, 2014)

Summary

INTRODUCTION

Mental, neurological, and substance-use (MNS) disorders are one main problem in developed countries. Schizophrenia belongs to the group of grand challenges in global mental health This mental disorder is characterized by abnormal social behavior and failure to recognize what is real. 25–30% of patients experience AVH that are unresponsive to antipsychotic medication (Shergill et al, 1998; Harrow et al, 2014) In this context, given the relative stagnation in the last decades of pharmacological alternatives focused on the dopaminergic system, proposals based on non-pharmacological strategies have acquired new value (Wykes et al, 2008). Cognitive-behavioral approaches centred on cognitive rehabilitation (both neurocognition and social cognition) are exhibiting significant growth, with many articles and metaanalyses showing their efficacy (McGurk et al, 2007) Another type of non-pharmacological approaches is based on cognitivebehavioral psychotherapy in so-called high-risk subjects, trying to prevent the development of psychotic disorder. Any perspective for the development of new treatments for AVH should face two issues: creation of social environments similar to the real world where the patient is guided toward successful social situations, and, real-time monitoring of cerebral areas activated by the patient while living these situations to obtain information about the neurological effects of his/her decisions

TOWARD HUMAN-AVATAR SYMBIOSIS FOR AUDITORY VERBAL HALLUCINATIONS

In Schizophrenia

In Brain-Computer Interfaces

Findings

DISCUSSION