Brain Activation During Virtual Reality Symptom Provocation in Obsessive-Compulsive Disorder: Proof-of-Concept Study

Abstract

Background: Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions. We previously showed that a virtual reality (VR) game can be used to provoke and measure anxiety and compulsions in patients with OCD. Here, we investigated whether this VR game activates brain regions associated with symptom provocation. Objective: In this study, we aim to investigate the neural regions that are activated in patients with OCD when they are interactively confronted with a symptom-provoking event and when they are performing compulsive actions in VR. Methods: In a proof-of-concept study, we investigated brain activation in response to the VR game in 9 patients with OCD and 9 healthy controls. Participants played the VR game while regional changes in blood oxygenation were measured using functional magnetic resonance imaging. We investigated brain activation in relation to OCD-related events and virtual compulsions in the VR game. Due to low statistical power because of the sample size, we also reported results at trend significance level with a threshold of P