Virtual Reality-Delivered Mirror Visual Feedback and Exposure Therapy for FND..., 2019, Bullock et al

Andy

Retired committee member
Full title: Virtual Reality-Delivered Mirror Visual Feedback and Exposure Therapy for FND: A Midpoint Report of a Randomized Controlled Feasibility Study

Objective:
The aim was to provide preliminary feasibility, safety, and efficacy data for a personalized virtual reality-delivered mirror visual feedback (VR-MVF) and exposure therapy (VR-ET) intervention for functional neurological disorder (FND).

Methods:
Midpoint results of a single-blind, randomized controlled pilot are presented. Fourteen adults were randomly assigned to eight weekly 30-minute VR sessions—seven in the treatment arm and seven in the control arm. The treatment arm consisted of an immersive avatar-embodied VR-MVF treatment, plus optional weekly VR-ET starting at session 4 if participants had identifiable FND triggers. The control arm received equally immersive nonembodied sessions involving exploration of a virtual interactive space. Feasibility was measured by acceptability of randomization, completion rates, side effects, adverse events, and integrity of blinding procedures. Exploratory primary and secondary outcome measures were weekly symptom frequency and the Oxford Handicap Scale, respectively.

Results:
Two early dropouts occurred in the treatment arm, resulting in an 86% completion rate (N=12/14). No side effects or adverse events were reported. Blind assessment at study end indicated that two of the seven treatment arm and three of the seven control arm participants incorrectly guessed their assignment. Changes in mean symptom frequency and disability were reported, but data will not be statistically analyzed until study end.

Conclusions:
This study is the first to report on MVF and VR for treatment of FND. Results generated thus far support feasibility and justify continuation of the study and further investigation into the efficacy of VR interventions for FND.
Paywall, https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.19030071
Scihub, https://sci-hub.se/10.1176/appi.neuropsych.19030071
 
This is weird. It's a small trial with few data points, statistical analysis should be pretty straightforward. What's the point in publishing this besides being able to bring forward their personal preference about what they hope the results to be? You can't submit an unfinished paper in school where you just leave a note saying you'll finish it later. That's not how any of this works.
Amygdala sensitization and abnormal habituation have been documented in FND patients and with other anxiety disorders
Just call it anxiety disorder, then if it's what you're studying. That's fine. No need to use a fake category that pretends it's not what it is.
One person with known FND triggers was unable to find an appropriate simulated trigger on the YouTube VR-360 video channel. The trigger involved an interpersonal transaction of money—i.e., paying a plumber for services
That has nothing to do with neurology. Clearly actually studying anxiety, nothing at all to do with what people pretend FND is. This whole category is such a mess of deceit wrapped in false pretenses.
 
A friend's grandfather lost a leg in the. He had a mirror he used when he felt phantom pain that uncramped his lost leg. The family too it for granted :)
 
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