title: Virtual Reality Therapy for the Treatment of Alcohol Dependence: A Preliminary Investigation With Positron Emission Tomography/Computerized Tomography.
abstract: OBJECTIVE
  Virtual reality therapy (VRT) uses multimodal stimulation that includes visual, auditory, olfactory, and gustatory stimuli. The aim of this study was to assess the effectiveness of VRT in treating subjects with alcohol dependence (AD) by evaluating changes in brain metabolism.
  
  
  METHODS
  The VRT protocol consisted of three steps: relaxation, presentation of a high-risk situation, and presentation of an aversive situation. Twelve alcohol-dependent subjects underwent 10 sessions of VRT. The alcohol-dependent subjects were assessed with 18F-fluorodeoxyglucose positron emission tomography images before and after VRT, whereas the control group underwent imaging according to the same protocol only at baseline.
  
  
  RESULTS
  Compared with the healthy control group, AD subjects showed higher metabolism in the right lentiform nucleus and right temporal lobe (BA20) at baseline (P(FDR < .05) = .026). In addition, the metabolism in the left anterior cingulate was lower in subjects with AD (P(uncorr) = .001). After VRT, alcohol-dependent subjects showed decreased brain metabolism in the right lentiform nucleus (P(FDR < .05) = .026) and right temporal lobe (BA38, P(FDR < .05) = .032) relative to that at baseline.
  
  
  CONCLUSIONS
  Our results suggest a neurobiological imbalance, notably, a high sensitivity to stimuli, in the limbic system in subjects with AD. Furthermore, we determined that metabolism decreased in the basal ganglia after VRT, which may explain the limbic-regulated responses of reward and regulation. Therefore, we tentatively recommend VRT to treat AD through its regulating effect on limbic circuits.
authors.affiliation: Department of Psychiatry, Chung-Ang University Hospital, Seoul, South Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Son
authors.affiliation: Department of Psychiatry, Eun Hye Hospital, Incheon, South Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Chung-Ang University Hospital, Seoul, South Korea.
authors.forename: Ju Won
authors.initials: JW
authors.lastname: Seok
authors.affiliation: Department of Psychiatry, Chung-Ang University Hospital, Seoul, South Korea.
authors.forename: Baik Seok
authors.initials: BS
authors.lastname: Kee
authors.affiliation: Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea.
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chung-Ang University Hospital, Seoul, South Korea.
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Addiction Psychiatry, Seoul National Hospital, Seoul, South Korea.
authors.forename: Tae Kyung
authors.initials: TK
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Chung-Ang University Hospital, Seoul, South Korea.
authors.forename: Doug Hyun
authors.initials: DH
authors.lastname: Han
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006179:Gyrus Cinguli; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D013702:Temporal Lobe; D014057:Tomography, X-Ray Computed / Q000379:methods; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
chemical_list: D019788:Fluorodeoxyglucose F18