基于虚拟现实技术在甲基苯丙胺使用障碍患者的渴求评估中的应用

Craving assessment using virtual reality techniques in methamphetamine abuse patients

目的建立基于虚拟现实(VR)环境的渴求客观工具以评估甲基苯丙胺(MA)使用障碍患者的渴求,并探索相关神经机制。方法本研究创建VR中性环境和MA线索环境,并在VR头盔中呈现。试验共招募20例MA患者接受VR暴露,同步监测皮肤电导、脉搏和脑电图(EEG),并采集患者自我报告的渴求以及物质使用史。结果与中性线索暴露相比,MA相关虚拟环境暴露过程中,患者皮肤电导由(7.44±3.76)μS显著增加至(7.87±3.97)μS(t=2.594,P=0.018),背外侧前额叶、额极和眶额叶电流源密度分别降低0.41、0.51和0.49dBμV2/m2(P<0.05)。结论MA相关VR环境诱发患者生理状态和渴求相关大脑皮层活动改变,其机制可能与边缘奖赏环路和执行控制环路相关。

Objectives To develop a virtual reality( VR) tool to assess the cue-induced craving in methamphetamine( MA) patients and to explore the mechanism of cue-reactivity in autonomic nerves system and cortex. Methods MA cue enriched and neutral VR environment is created with a panoramic camera and displayed in the VR headset. A total of 20 MA patients were recruited. They received VR exposure while being monitored for skin conductance, pulse rate and electroencephalogram( EEG). Craving was assessed by a self-report measure and information about substance abuse history were collected. Results Patients' skin conductance significantly increased from( 7.44±3.76)μS to( 7.87±3.97)μS in MA cue enriched VR environment compared with neutral exposure( P=0.018). The activation of dorsolateral prefrontal, frontopolar and orbital frontal cortex significantly decreased by 0.41,0.51 and 0.49 dBμV2/m2, respectively( t=2.594, P< 0.05). Conclusions The findings in this pilot study have revealed the patients' psychophysical and cortex reaction to the MA cue enriched VR environment, which might be related to the mesocorticolimbic reward circuit and the executive control circuit.