Virtual Reality: A Potential New Tool in Healthcare and Therapy R&D

Andrew Huberman, researcher in the Stanford University Department of Neurobiology, is taking an unusual approach to investigating possible treatments for glaucoma and anxiety disorders—virtual reality. Although uncommon, the use of virtual reality and various high-level imaging techniques are being used in several areas of drug development and treatment.

Huberman’s approach for glaucoma, a disease of the eye caused by a buildup of optical pressure that can lead to blindness, is to use a virtual reality device that causes visual stimulation to try to encourage the damaged neurons in the eye to regenerate. The basis of the work was described in a 2016 Nature Neuroscience article where Humberman and colleagues used gene therapy and focused light stimulation on mice with glaucoma. It wasn’t a dazzling success—no pun intended—with less than five percent of the neurons (retinal ganglion cells) growing back. But it was an improvement.

A clinical trial in humans so far has two glaucoma patients, a 17-year-old woman and a 76-year-old man, with a goal of 200 glaucoma patients who have lost partial vision, but are not completely blind. It doesn’t utilize the gene therapy, but uses virtual reality eyewear and flashes white lights into the part of the eye where there are visual “holes” caused by damage to the neural retina. As STAT writes, “To keep things interesting, the virtual reality experience involves more than white dots. When patients put on special headsets, they’re transported into an art gallery with empty frames on the walls. They can move their eyes or their head to explore the gallery, but the point of it all is the visual stimulation: those flashing white dots, which dance across the screen for periods of one to three minutes at different sizes and speeds.”

They are then regarded with a look at a great work of art. It’s an interesting approach, although three vision specialists consulted by STAT thought it sounded like fairly longshot research, although who knows? For a person losing vision, if it’s even able to slow the process down, it could be worthwhile.

Another component of Huberman’s virtual reality work is on anxiety. As such, he’s developed virtual reality films that last at least 10 minutes of frightening experiences using a special 360-degree camera. They include a claustrophobic elevator, climbing a 250-feet tree in the San Francisco Bay area, being attacked by a 120-pound pit bull, and swimming with sharks. The study isn’t a formal clinical trial, but has recruited 85 volunteers with the goal of enrolling a total of 250, some of whom have been diagnosed with anxiety.

It sounds like if it doesn’t work to treat anxiety, Huberman should form a virtual reality video game company.

Virtual reality is also being investigated for pain relief, particularly for palliative patients. A Cedars-Sinai study used VR-records with 15-minute videos, and found they reduced pain by 13 percent, with the use of special game programs cutting pain by 24 percent.

Another example—the video is pretty cool!—is at Hermes Pardini Labs in Sao Paulo, Brazil, they are using virtual reality video games to distract children while they receive immunizations. They wear the goggles and are introduced into the game while the nurse follows along and gives the injection at a point during the game.

Akili Interactive, headquartered in Boston, closed on a $55 million Series C financing round in May 2018, led by Temasek and joined by Baillie Gifford, Amgen Ventures, M Ventures (the CVC fund of Merck KGaA), JAZZ Venture Partners, Canepa Advanced Healthcare Fund, and Brooklands Capital strategies.

The company develops “prescription digital medicine.” Which is to say, they treat specific disorders using high-quality video games. As the company website states, “Built on extensive peer-reviewed research, Akili’s products deliver specific stimuli to selectively target and activate specific cognitive neural systems in the brain that exhibit deficiencies from various medical conditions.”

Its lead candidate, AKL-T01, is being developed for children with attention-deficit/hyperactivity disorder (ADHD). It is moving through U.S. Food and Drug Administration (FDA) protocols similar to those for prescription drugs. It also is developing programs for Autism Spectrum Disorder, major depressive disorder, multiple sclerosis, Parkinson’s disease, Traumatic Brain Injury, ICU delirium and others.

Virtual reality and 3D imaging technologies also have obvious applications for medical education. Swedish company Mentice recently published research in the journal Stroke based on its VIST physics-based, high-fidelity stimulator to train interventional neuroradiologists. The technology is used to train physicians for a minimally invasive surgical procedure, a thrombectomy—removing a blood clot from the brain’s vasculature.

Relay Therapeutics, based in Cambridge, Massachusetts, closed on a $63 million Series B financing in December 2017. The company focuses on developing therapeutics based on protein motion. For decades, the technology hasn’t been available or affordable to completely evaluate the movement of proteins, which in the body are in constant motion. Sanjiv Patel, Relay’s president and chief executive officer, told BioSpace in 2017, “Relay was formed based on that premise, visualizing protein motion, and understanding how they move, using technology with experimentation as well as computation to create consensus movies to design better drugs. So, we have a very powerful experimentation part using emerging techniques that allow us to visualize motion, such as X-ray crystallography and cryo-electron microscopy, which was the winner of this year’s Nobel for Chemistry. One of the other challenges is the amount of data that’s involved in visualizing motion. Earlier, it would have taken several years and been cost-prohibitive. But the cost has come down, so the experimental techniques and the increasing power of computation allows us for the first time to visualize proteins moving in the body and using that insight to design better drugs.”

Although virtual reality seems unlikely to become a dominant modality in drug development and healthcare, it clearly has possibilities as a tool that can be used creatively in various research studies.