Assessing the impact of immersive virtual reality technology on the psychological recovery of patients with Parkinson’s disease depression: study protocol of a randomized controlled trial

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Background: Depression in Parkinson’s disease (DPD) has a high incidence rate in Parkinson's patients. It is common non-motor symptom of Parkinson's disease, which seriously affects patients’ quality of life. Thus, improving Parkinson's depression is important for improving patients’ quality of life. Psychotherapy for depression is limited for many reasons, and only a few patients are able to benefit. Many studies have proven that relaxation therapy, play, and exercise therapy are effective treatment for depression. VR has rapidly developed as a form of rehabilitation in recent years, due to its immersive characteristics and accessibility. Further, it has been applied to the psychological treatment of phobia and anxiety. However, there is no relevant research on the treatment of Parkinson's depression with VR, The aim of this study is to assess the effect of immersive VR-assisted training on DPD patients. Methods: : The study design is a single-blind randomized controlled trial. Seventy-four DPD patients will be recruited and chosen as subjects, then randomly allocated into two groups. The VR group (n=37) will accept VR-assisted training (40min) 3 times/week for 8 weeks. The non-VR training group (n= 37) will receive treatment as usual (TAU). The outcome measures will be measured before intervention, at 8 weeks, at 3 months, and at 6 months post-intervention. The primary outcomes will include Hamilton Depression Scale-24 (HAM-D24). The secondary outcomes will include the short-form 36 item health survey questionnaire (SF-36), neuroinflammation factors (BDNF, IL-6, CRP), and functional magnetic resonance imaging (fMRI). Discussion: The traditional treatment of depression has limited resources and requires a lot of time and energy. It is not suitable for PD patients with mobility difficulties and in remote areas. VR is able to make up for limitations in traditional treatment methods. An advantage of VR is that it makes patients more invested in active participation. This study may provide an improved method for the clinical treatment of DPD patients, which is helpful for clinical decision-making and future practice. Trial registration: The study has been registered in the Chinese Clinical Trial Registry ChiCTR2200065843, 16 November 2022.

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