vMed23: How Virtual Reality is Transforming Medicine

Virtual reality (VR) is not just for gaming and entertainment. As it turns out, extended reality (XR) technologies can help support human health and the wellbeing of patients who suffer from a variety of debilitating and chronic conditions, including irritable bowel syndrome (IBS), depression and cancer.

This new branch of medicine has begun to transform the healthcare industry and on March 30 and 31, nearly 400 people from around the world gathered at the Sofitel Hotel for Cedars-Sinai’s fifth Virtual Medicine Symposium to explore the intersection of medicine and these technologies and discuss what happens when medicine meets the metaverse.

The two-day event, led by Brennan Spiegel, MD, MSHS, director of Health Services Research at Cedars-Sinai and the Dorothy and George Gourrich Chair in Digital Health Ethics, featured 60 international speakers who discussed the present and future of medical extended reality (MXR).

“We are all here because we believe in the power of games—serious games,” Spiegel said. “We’re not talking about first-person shooter games. We’re talking about using humanistic technology to support people who are vulnerable—people who are suffering, who are in pain—and trying to figure out how we can carefully and responsibly interface these technologies within the biopsychosocial illness experience. We’re trying to understand the science behind how and why it works.”

And the science in this field has been expanding massively, noted Spiegel. There has been an exponential rise in the number of peer-reviewed papers that involve XR, VR and healthcare. In 2022 alone, there were over 3,000 studies published in the peer-reviewed literature, and there are now well over 19,000 studies that involve the use of VR in healthcare. 

The symposium highlighted a variety of research, such as using VR as a catalyst to teach the brain and the body to reduce pain without medication; using VRx for pain and anxiety; and using VR to address chronic abdominal pain, IBS and dyspepsia. The event even included a session from patients who received MXR therapeutics at Cedars-Sinai.

VR for Treating Abdominal Pain 

Brian Lacy, MD, PhD, from the Mayo Clinic took to the stage to discuss the brain-gut connection and how VR can help manage abdominal pain, bloating, IBS, dyspepsia and other conditions that often overlap with psychological comorbidities.

“For IBS, fortunately, there are now FDA-approved medications. And those medicines are pretty good at treating symptoms, but they’re really not good at treating the brain side of this gut-brain disorder,” Lacy said. “So, patients may say, ‘Yes, my constipation or diarrhea is better, but I still have pain.’ And that opens the door for VR and the possibility of using the technology to act on the brain and then break down that block to some of these signals to the GI tract.”

In early pilot studies that look at using VR to help manage pain in the gut, Lacy and his team are finding VR to be beneficial in treating these gastric disorders, but they say future trials are still needed to obtain meaningful data on the durability of VR treatment. 

“We’re very encouraged by the preliminary data we’ve seen so far, which shows patients have noticed significant improvement in overall global functional capacity scores after using VR. And we now are going to a larger, longer study to verify these results,” Lacy said.

VR to Treat People With Major Depressive Disorders and Depression

Margot Paul, PsyD, from Stanford University talked about how VR can be used to treat people with major depressive disorders or depression by integrating VR into an already existing protocol for depression called behavioral activation. 

Behavioral activation is a structured psychotherapeutic approach to grief that aims to increase one’s pleasure and mastery, which increases positive reinforcement and therefore improves one’s mood. This can be done by increasing engagement in activities that are adaptive, as they give people pleasure and make them feel accomplished.

“This is a very simple treatment that can be implemented by a variety of different providers, and it’s very effective,” said Paul. “Yet people with depression still aren’t receiving the care they need. There’s clearly a gap here and some barriers to care. One way to bridge this gap is by using VR.” 

When testing the feasibility of using VR to simulate pleasant activities, Paul found that VR could help address some of these barriers. People who engaged in things that gave them a sense of pleasure—but just in VR—elicited the same mood responses as if they were doing these activities in real life.

While this was only a feasibility trial, Paul is looking to do a similar study with a larger sample size.

VR for Relieving Anxiety During Cancer Treatments

Brian Minton, MHDS, and Scott Irwin, MD, PhD, of Cedars-Sinai described how they are using VR in infusion clinics to help ease anxiety in patients with cancer.

“Anxiety and pain both have adverse effects on quality of life and cancer care outcomes,” said Minton. “So, I wanted to see what VR might do to help ease anxiety levels during patients’ appointments and just see if they enjoyed the VR experience.”

In collaboration with the Cedars-Sinai Virtual Medicine Program, Minton offers patients a choice of computer-generated environment images, including the forest, outer space, the desert, underwater and a peaceful beach. The images can be paired with some relaxing music or, if patients wish, there is an option to incorporate a guided meditation or breathing exercise.

So far, the results look promising and show that patients’ anxiety did, in fact, decrease. Patients also expressed an overwhelmingly positive response of escapism and relaxation and the desire to use the VR technology again.

“A lot of these patients had never used VR before, and they weren’t familiar with it at all,” Minton said. “And they were just blown away.”

The Virtual Medicine Symposium is developed by the Cedars-Sinai Virtual Medicine Program with support from the Marc and Sheri Rapaport Fund for Digital Health Sciences and Precision Health and through a Catalyst Grant from the UCLA Clinical and Translational Science Institute. 

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