The impact of virtual reality on the emotional state of patients with aphasia during rehabilitation

Introduction: Current statistics indicate a high number of psycho-emotional disorders among patients with aphasia despite the use of traditional psychological interventions. An alternative non-verbal method for stress relief has appeared to be virtual reality (VR) with the possibility of exploring the world outside the hospital environment. Aim: To assess the impact of VR with daily «promenades» in relaxing environments on the psycho-emotional state of patients with aphasia and compare it with traditional psychological interventions. To analyse preliminarily the functional reorganisation of brain speech areas after immersion in VR. Methodology: A single-center controlled study with adult patients suffering from secondary aphasias and being randomised into two groups. Both groups received the standard rehabilitation for 20 days, the only difference between them was the psychological i ntervention. Thei r emotional state was assessed on the 1, 14, and 21 days via two depression scales for aphasia, the Perceived Stress Scale, and the EQ-VAS scale. Resting functional MRI (fMRI) was recorded before and after rehabilitation, followed by Seed-Based Connectivity analysis of Broca’s and Wernicke’s areas. Results: Forty patients completed the study, baseline statistics did not differ between the groups, the mean age was 54 years, both sexes were equally distributed, the average time of stroke was roughly 6 months, the predominant type of stroke was ischemic and the type of aphasia was motor with mild to moderate severity. At the end of the study, all scales revealed a significant improvement of patients’ emotional state in both groups without a significant difference between them except only the EQ-VAS scale with slightly better results in the study group. Resting fMRI data demonstrated both hypoactivation and hyperactivation of the contralateral speech areas without detectable patterns. Conclusion: Escapes in VR from hospitals significantly improved the emotional stated of patients with aphasia comparable to the standard psychological care. However, such positive impact should be cautiously interpreted owing to overall recovering effect of the rehabilitation.