Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 2:16:974393.
doi: 10.3389/fnhum.2022.974393. eCollection 2022.

Altered effective connectivity in the emotional network induced by immersive virtual reality rehabilitation for post-stroke depression

Affiliations

Altered effective connectivity in the emotional network induced by immersive virtual reality rehabilitation for post-stroke depression

Jia-Jia Wu et al. Front Hum Neurosci. .

Abstract

Post-stroke depression (PSD) is a serious complication of stroke that significantly restricts rehabilitation. The use of immersive virtual reality for stroke survivors is promising. Herein, we investigated the effects of a novel immersive virtual reality training system on PSD and explored induced effective connectivity alterations in emotional networks using multivariate Granger causality analysis (GCA). Forty-four patients with PSD were equally allocated into an immersive-virtual reality group and a control group. In addition to their usual rehabilitation treatments, the participants in the immersive-virtual reality group participated in an immersive-virtual reality rehabilitation program, while the patients in the control group received 2D virtual reality rehabilitation training. The Hamilton Depression Rating Scale, modified Barthel Index (MBI), and resting-state functional magnetic resonance imaging (rsfMRI) data were collected before and after a 4-week intervention. rsfMRI data were analyzed using multivariate GCA. We found that the immersive virtual reality training was more effective in improving depression in patients with PSD but had no statistically significant improvement in MBI scores compared to the control group. The GCA showed that the following causal connectivities were strengthened after immersive virtual reality training: from the amygdala, insula, middle temporal gyrus, and caudate nucleus to the dorsolateral prefrontal cortex; from the insula to the medial prefrontal cortex; and from the thalamus to the posterior superior temporal sulcus. These causal connectivities were weakened after treatment in the control group. Our results indicated the neurotherapeutic use of immersive virtual reality rehabilitation as an effective non-pharmacological intervention for PSD; the alteration of causal connectivity in emotional networks might constitute the neural mechanisms underlying immersive-virtual reality rehabilitation in PSD.

Keywords: effective connectivity; emotional network; granger causality analysis (GCA); immersive virtual reality; post-stroke depression (PSD).

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The flow diagram of the study process. VR, virtual reality.
FIGURE 2
FIGURE 2
The virtual reality (VR) training scenarios in the immersive-VR group and the control group. (A,B) The 3D virtual scenario shown through the VR helmet for immersive VR training in the immersive-VR group. (C,D) The 2D virtual scenario shown on the screen for VR training in the control group.
FIGURE 3
FIGURE 3
Map illustrating brain of the regions of interest selected in the granger causality analysis. MPFC, medial prefrontal cortex; DLPFC, dorsolateral prefrontal cortex; SFG, superior frontal gyrus; MFG, middle frontal gyrus; OrG, orbital gyrus; STG, superior temporal gyrus; MTG, middle temporal gyrus; ITG, inferior temporal gyrus; FuG, fusiform gyrus; PhG, parahippocampal gyrus; pSTS, posterior superior temporal sulcus; INS, insular gyrus; CG, cingulate gyrus; Amyg, amygdala; Hipp, hippocampus; BG, basal ganglia; CAU, caudate, Tha, Thalamus.
FIGURE 4
FIGURE 4
Map illustrating brain of multivariate GCA signed-path coefficients alteration after treatment in the immersive-VR group (A) and the control group (B). Some brain regions only showed projection position. Blue/red arrows designate significantly weaken/strengthen of causal connectivity after treatment as compared to baseline levels. MPFC, medial prefrontal cortex; DLPFC, dorsolateral prefrontal cortex; MTG, middle temporal gyrus; pSTS, posterior superior temporal sulcus; INS, insular gyrus; CG, cingulate gyrus; Amyg, amygdala; Hipp, hippocampus; CAU, caudate, Tha, Thalamus. GCA, granger causality analysis.
FIGURE 5
FIGURE 5
Circlize maps of signed-path coefficient alteration after treatment in the immersive-VR group (A) and the control group (B) from multivariate granger causality analysis. The parameters represent the intensity of the signed-path coefficients differences after treatment as compared to baseline levels. Blue/red lines designate significantly weaken/strengthen of causal connectivity after treatment as compared to baseline levels. MPFC, medial prefrontal cortex; DLPFC, dorsolateral prefrontal cortex; MTG, middle temporal gyrus; pSTS, posterior superior temporal sulcus; INS, insular gyrus; CG, cingulate gyrus; Amyg, amygdala; Hipp, hippocampus; CAU, caudate, Tha, Thalamus.

References

    1. Craig A. D., Chen K., Bandy D., Reiman E. M. (2000). Thermosensory activation of insular cortex. Nat. Neurosci. 3 184–190. 10.1038/72131 - DOI - PubMed
    1. DeYoung C. G., Hirsh J. B., Shane M. S., Papademetris X., Rajeevan N., Gray J. R. (2010). Testing predictions from personality neuroscience: brain structure and the big five. Psychol. Sci. 21 820–828. 10.1177/0956797610370159 - DOI - PMC - PubMed
    1. Fan L., Li H., Zhuo J., Zhang Y., Wang J., Chen L., et al. (2016). The human brainnetome atlas: a new brain atlas based on connectional architecture. Cereb. Cortex 26 3508–3526. 10.1093/cercor/bhw157 - DOI - PMC - PubMed
    1. Fang P., An J., Zeng L.-L., Shen H., Qiu S., Hu D. (2017). Mapping the convergent temporal epileptic network in left and right temporal lobe epilepsy. Neurosci. Lett. 639 179–184. 10.1016/j.neulet.2016.12.029 - DOI - PubMed
    1. Feitosa J. A., Fernandes C. A., Casseb R. F., Castellano G. (2022). Effects of virtual reality-based motor rehabilitation: a systematic review of fMRI studies. J. Neural Eng. 19:011002. 10.1088/1741-2552/ac456e - DOI - PubMed

LinkOut - more resources