Pilot study finds VR training benefit in depression

People with depression can sometimes have impaired memory, particularly for positive events, which can contribute to cognitive problems and impair their daily lives. Now, researchers in China say virtual reality-based training could help counteract that.

The team from Jinan and Guangdong Universities used a VR-based training programme designed to strengthen working memory – the retention of small packets of information in an accessible form – in a small, open-label study.

The trial included 22 patients with acute depression and 20 who had gone into remission, who all received 20 sessions with the VR working memory (VR-WM) programme, designed to train working memory, as well as other cognitive functions.

The training involved various game-like tasks on an HTC VIVE Pro headset, such as challenging the user to remember products to buy in a supermarket, recall the route to find a cherished item, and word-matching games, all of which get progressively harder over the course and train a number of memory and cognitive faculties.

Prior studies have suggested that as many as 78% of patients with MDD have evidence of cognitive impairment, including working memory deficits, which can affect social and work interactions and make symptoms worse.

Moreover, the deficits can continue in patients who have seen emotional improvements sufficient to be considered in remission, with almost half of recovered patients still complaining of problems.

At the moment, pen and paper, as well as computer-based training, is used to treat neuropsychological impairment in patients with major depressive disorder (MDD), but the researchers suggest the immersive nature of VR could make the training more effective.

While there was no direct testing of that hypothesis in the study, there were significant improvements from baseline in working memory, processing speed, visual learning, reasoning and problem-solving, as well as total cognition scores, with the benefits seen in both acute and recovered patients. In acute patients, there was also a significant improvement in verbal learning.

The researchers also attempted to explore the possible mechanisms behind the improvement and found that gains in memory and cognition tracked – at least partially – with improvements in depressive symptoms measured using the 24-item Hamilton Depression Rating Scale (24-HDRS) scale.

They acknowledge several limitations in the study, not least that it was small and did not include an active control group, but note that it is a pilot designed to investigate whether a larger study should be carried out.

The results “suggested that this VR-WM training can be a promising intervention in promoting the cognitive performance of depressed patients in the coming years,” the researchers write in a paper on the study published in the Journal of Affective Disorders.

“Since our findings revealed that acute MDD patients showed better treatment gain after VR-WM training, it’s suggested that MDD patients should receive cognitive training as soon as possible,” they add.