Virtual Reality Therapeutics: part of the AI in Healthcare Series with Michael Ferro
Installment 6 in the AI in Healthcare Series with Michael Ferro, Jr
Written by Robin Farmanfarmaian
Virtual reality is enabled by the rapid advancement and convergence of multiple technologies — sensors, cameras, connectivity, computing power, computer storage, increased processing speeds — but the software itself is driven by artificial intelligence. VR doesn’t exist without AI.
There are VR software programs that have already cleared the FDA and are being used in the hospital. One example is AppliedVR — their EaseVRx VR treatment cleared the FDA in October 2020 for their use of VR in pain management, specifically focused on treatment-resistant fibromyalgia and chronic low back pain.
They are in over 250 hospitals to treat a range of conditions, including labor pains, post-surgery and patients in burn units. AppliedVR is also working on replacing opioids in pain management. What their treatment is actually doing is teaching the patient how to self-regulate their body, emotions, and cognitive responses to stress and pain. AppliedVR uses a method based on CBT — Cognitive Behavior Therapy —which is a gold standard in healthcare to treat pain, depression, and addiction.
Another great example is MindMaze, a Unicorn startup based in Europe. MindMaze has had CE Mark and FDA clearance for years for both their in-hospital VR and at-home VR hardware and software. Their stroke and brain injury rehabilitation software has successfully treated over 10,000+ patients in 20 countries. In 2020, they started distributing in the US at hospitals like John Hopkins.
A Unicorn Startup is a young company with a valuation of over $1B.
VR that uses the high end glasses such as MindMaze’s VR hardware has the ability to trick the brain into thinking something is real. When a part of the brain is injured — for example through a TBI (traumatic brain injury) or stroke — those damaged neurons no longer work. If those particular damaged neurons were involved with a specific body movement such as controlling the left arm, it can cause partial or full paralysis to that arm. Tricking the brain through the use of VR can help facilitate new neural connections and bypass those damaged neurons. That in turn can speed up and improve a patient’s recovery and outcomes.
MindMaze uses a technique that would normally require a mirror — called Mirror Box Therapy or Mirror Therapy. Before VR stroke recovery was an option, a stroke patient with partial paralysis of their [e.g. left arm] would go to a physical therapist. The physical therapist would hold up a mirror to trick the patient’s brain into thinking the healthy right arm was also a healthy left arm, while hiding the partially paralyzed left arm from the brain.
MindMaze has taken that same Mirror Box Therapy technique, but they are using the method inside a world of VR. VR makes the Mirror Therapy look significantly more realistic to the brain than just a normal mirror. The more realistic it looks, the easier it is to trick the brain. Imagine this scenario: a patient’s left arm is partially paralyzed. In the VR software, a mirror image of the healthy right arm is then layered over the left arm. When a patient moves their healthy right arm, inside of VR it looks like the patient is also moving their partially paralyzed left arm with the same range of motion, speed and strength. That is enough to trick the brain into thinking it’s real. That creates new neural connections in order to bypass the brain cells that were damaged during the stroke. This is an example of neuroplasticity — the brain has the ability to rewire itself through experience.
Instead of going to physical therapy a few times a week, which is difficult at any time and especially so during a pandemic, patients can now use at-home clinical grade VR for stroke or neuro tele-rehabilitation. Not only can the patient now do their physical therapy exercises daily without leaving home, they are able to do it in a way that makes it fun. Instead of boring, painful repetitions with a physical therapist one-on-one, patients play video games. One of the stroke software programs is of a patient flying a plane, but not as a pilot — as the actual plane. Not a bad way to get physical therapy done.
MindMaze has also worked on phantom pain. Phantom pain sometimes happens when a patient has had a limb amputated. The brain still thinks that limb exists, leaving the missing limb in constant pain. How do you treat pain in a part of the body that no longer exists? At that point it is a neuro problem, not a limb problem. Using that same Mirror Box Therapy technique, the software tricks the brain into thinking the amputated limb still exists, and that one session can shut down phantom pain, just by showing the brain it is still there.
Any type of medical condition that leverages neuroplasticity is a good candidate for virtual reality digital therapeutics. PTSD, mental health, dementia, pain, aging, ADHD, addiction, stroke, brain injury and phobias are all great use cases for immersive VR. Over the next 5–10 years, we will see more virtual reality therapeutics clear the FDA and enter healthcare.
Check out the previous 5 installments on the AI in Healthcare Series with Michael W Ferro and Robin Farmanfarmaian:
Remote Patient Monitoring
AI in Healthcare Introduction
Digital Therapeutics: DTx
Who Pays for AI in Healthcare?
AI Voice Technology in Healthcare
