Authors
Karpov O.E., Daminov V.D., Novak E.V., Slepnyova N.I.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Introduction: Aphasia, with the impairment of both verbal and non-verbal communication, and other symptoms of stroke causes emotional disorders. There is a range of conventional psychological interventions to improve that; however, they could have a limited value due to the loss of language.
Aim; This study estimates subjective and objective alternations in the emotional state of patients with aphasia after a relaxing session in virtual reality (VR).
Methods: In total, 40 patients during the first post-stroke year were randomized in the study and control group and successfully completed the sudy. The former underwent relaxation in VR for 20 minutes, whereas a conventional relaxation technique was used in the latter. Patients from both groups were tested with visual analogue scale (VAS) for their mood and electroencephalography (EEG) at the beginning, after a 5-minutes rest and after the intervention.
Results: Demographic parameters and VAS score for mood were comparable in both groups, and the latter improved altogether (p<0.042). The EEG analysis revealed a significant increase in the alpha-power (p = 0.003) and low beta-power (p = 0.004) for all patients with a slight dominance in the study group. The relative power of low alpha-rhythm (p = 0.031) grew while that of low and high beta-rhythm decreased. There was a significant rise of the low/high beta-rhythm ration (р = 0.005) in the study group in comparison to the control group.
Discussion: VR relaxation evokes changes in the brain activity comparable with those which have been described after other stress reduction interventions. Further research is required to understand long-term perspectives and the clinical effect.
Keywords: virtual reality, electroencephalography (EEG), depression, aphasia, stress.
References
1. Ashaie S, Hurwitz R, Cherney L. Depression and Subthreshold Depression in Stroke-Related Aphasia. Arch Phys Med Rehabil. 2019; 7:1294–1299.
2. Mitchell A, Sheth B, Gill J, Yadegarfar M, Stubbs B, Yadegarfar M, Meader N. Prevalence and predictors of post-stroke mood disorders: A meta-analysis and meta-regression of depression, anxiety and adjustment disorder. Gen Hosp Psychiatry. 2017; 47: 48–60.
3. Baker C, Worrall L, Rose M, Hudson K, Ryan B, O’Byrne L. A systematic review of rehabilitation interventions to prevent and treat depression in post-stroke aphasia. 2017: 1464–5165.
4. Russkikh OA, Chumakova UO, Smirnova EA, Perevochshikov PV, Syromiatnikova LI. The relationship of speech disorders with anxiety and depression in post-stroke patients and possibilities of neuropsychological rehabilitation. Chelovek. Iskusstvo. Vselennaya, 2018; 1: 267–271. (In Russ).
5. Camara E. Virtual reality: applications in medicine and psychiatry. Hawaii Med J. 1993; 52(12): 332–333.
6. Karpov OE, Daminov VD, Novak EV, Mychametova DA, Slepnyova NI. Virtual reality technologies in medical rehabilitation as an example of modern health informatization. Bulletin of Pirogov National Medical & Surgical Center. 2020; 15(1): 89–98. (In Russ).
7. Freeman D, Reeve S, Robinson A, Ethlers A, Clark D, Spanlang B, Slater M. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological Medicine. 2017; 47: 1–8.
8. Daminov VD, Gorochova IG, Daminov MV, Novak EV, Slepnyova NI. Primenenie sistemy tekhnologij virtual’noj real’nosti v klinicheskoj reabilitacii. M.: Maska; 2020 (In Russ).
9. Kontou E, Thomas S, Lincoln N. Psychometric properties of a revised version of the Visual Analog Mood Scales. 2012; 26(12): 1133–1140.
10. EuroQol Research Foundation. EQ-5D-5L User Guide. 2019. [URL] Accessed Dec 12, 2020.
11. Akulova AI, Gaydukova IZ, Rebrov AP. Validation of the EQ-5D-5L version in Rusia. Rheumatology Science and Practice. 2018; 56(3): 351–355. (In Russ.)
12. Newson J, Thiagarajan T. EEG Frequency Bands in Psychiatric Disorders: A Review of Resting State Studies. 2019; 12: 521.
13. Gaur S, Panjwani U, Kumar B. EEG Brain Wave Dynamics: A Systematic Review and Meta Analysis on Effect of Yoga on Mind Relaxation. J Biomed Res Environ Sci. 2020; 1(7): 353–362.