Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia
Background: Cognitive-behavioral therapy (CBT) with exposure is the treatment of choice for specific phobia. Virtual reality exposure therapy (VRET) has shown benefits for the treatment and prevention of the return of fear in specific phobias by addressing the therapeutic limitations of exposure to...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/16/3505 |
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| author | Yolanda Álvarez-Pérez Francisco Rivero Manuel Herrero Conrado Viña Ascensión Fumero Moisés Betancort Wenceslao Peñate |
| author_facet | Yolanda Álvarez-Pérez Francisco Rivero Manuel Herrero Conrado Viña Ascensión Fumero Moisés Betancort Wenceslao Peñate |
| author_sort | Yolanda Álvarez-Pérez |
| collection | DOAJ |
| description | Background: Cognitive-behavioral therapy (CBT) with exposure is the treatment of choice for specific phobia. Virtual reality exposure therapy (VRET) has shown benefits for the treatment and prevention of the return of fear in specific phobias by addressing the therapeutic limitations of exposure to real images. Method: Thirty-one participants with specific phobias to small animals were included: 14 were treated with CBT + VRET (intervention group), and 17 were treated with CBT + exposure to real images (active control group). Participants’ scores in anxiety and phobia levels were measured at baseline, post-treatment, and 3-month follow-up, and brain activation was measured through functional magnetic resonance imaging (fMRI) baseline and post-treatment. Results: Both groups showed a significant decrease in anxiety and phobia scores after the therapy and were maintained until follow-up. There were no significant differences between both groups. Overall, fMRI tests showed a significant decrease in brain activity after treatment in some structures (e.g., prefrontal and frontal cortex) and other structures (e.g., precuneus) showed an increasing activity after therapy. However, structures such as the amygdala remained active in both groups. Conclusions: The efficacy of CBT + VRET was observed in the significant decrease in anxiety responses. However, the results of brain activity observed suggest that there was still a fear response in the brain, despite the significant decrease in subjective anxiety levels. |
| first_indexed | 2024-03-10T08:43:08Z |
| format | Article |
| id | doaj.art-a00ff22cc4614034ae176a8cd2832f80 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T08:43:08Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a00ff22cc4614034ae176a8cd2832f802023-11-22T08:09:19ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011016350510.3390/jcm10163505Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific PhobiaYolanda Álvarez-Pérez0Francisco Rivero1Manuel Herrero2Conrado Viña3Ascensión Fumero4Moisés Betancort5Wenceslao Peñate6Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, SpainDepartment of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Tenerife, SpainDepartment of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Tenerife, SpainDepartment of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Tenerife, SpainDepartment of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Tenerife, SpainDepartment of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Tenerife, SpainDepartment of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, 38200 Tenerife, SpainBackground: Cognitive-behavioral therapy (CBT) with exposure is the treatment of choice for specific phobia. Virtual reality exposure therapy (VRET) has shown benefits for the treatment and prevention of the return of fear in specific phobias by addressing the therapeutic limitations of exposure to real images. Method: Thirty-one participants with specific phobias to small animals were included: 14 were treated with CBT + VRET (intervention group), and 17 were treated with CBT + exposure to real images (active control group). Participants’ scores in anxiety and phobia levels were measured at baseline, post-treatment, and 3-month follow-up, and brain activation was measured through functional magnetic resonance imaging (fMRI) baseline and post-treatment. Results: Both groups showed a significant decrease in anxiety and phobia scores after the therapy and were maintained until follow-up. There were no significant differences between both groups. Overall, fMRI tests showed a significant decrease in brain activity after treatment in some structures (e.g., prefrontal and frontal cortex) and other structures (e.g., precuneus) showed an increasing activity after therapy. However, structures such as the amygdala remained active in both groups. Conclusions: The efficacy of CBT + VRET was observed in the significant decrease in anxiety responses. However, the results of brain activity observed suggest that there was still a fear response in the brain, despite the significant decrease in subjective anxiety levels.https://www.mdpi.com/2077-0383/10/16/3505specific phobiavirtual realitycognitive-behavioral therapymagnetic resonance imaging |
| spellingShingle | Yolanda Álvarez-Pérez Francisco Rivero Manuel Herrero Conrado Viña Ascensión Fumero Moisés Betancort Wenceslao Peñate Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia Journal of Clinical Medicine specific phobia virtual reality cognitive-behavioral therapy magnetic resonance imaging |
| title | Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia |
| title_full | Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia |
| title_fullStr | Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia |
| title_full_unstemmed | Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia |
| title_short | Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia |
| title_sort | changes in brain activation through cognitive behavioral therapy with exposure to virtual reality a neuroimaging study of specific phobia |
| topic | specific phobia virtual reality cognitive-behavioral therapy magnetic resonance imaging |
| url | https://www.mdpi.com/2077-0383/10/16/3505 |
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