Over 28% of people with epilepsy (PwE) struggle from at least one anxiety disorder, making anxiety the most common psychiatric comorbidity in this population. Exposure therapy (ET) can be helpful in managing anxiety in PwE and Virtual Reality (or VR) has been shown to be an effective tool for delivering ET for several anxiety disorders. 

 

The use of untethered-VR headsets to deliver ET in this population offers numerous potential benefits. For example, it may not be practical to do exposures in-person during COVID-19. And even outside of the pandemic, VR reduces the need for travel, which is difficult for PwE in normal circumstances as driver’s licenses are typically suspended after a confirmed seizure. It also allows for more equitable access to healthcare resources for those who may not live in urban centers and saves money and time. Despite these benefits, to-date, no research has been conducted to-date on VR-ET in PwE. 

 

This was a three phase trial that involved: 

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1. Surveying PwE and people with lived experience to better understand anxiety related to epilepsy and seizures

2. Co-designing a VR-ET program

3. Evaluating the feasibility, acceptability, and efficacy of our VR-ET program with 5 PwE in a home setting

 

The VR-ET program demonstrated high feasibility and tolerability, achieving a 100% completion rate. Epilepsy Anxiety Instrument Scores and subjective reports of the VR-ET’s impact showed the intervention’s potential to reduce epilepsy-specific interictal anxiety.

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ClinicalTrials ID: NCT05296057

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Publications​

• Gray, H.G., Tchao, D., Lewis-Fung, S., Carmany-Gray, G., Pardini, S., Harris, L. R. & Appel, L.  Feasibility and impact of virtual reality exposure therapy on epilepsy-specific anxiety: Phase 3 of the AnxEpiVR clinical trial (in press).

• Lewis-Fung, S., Tchao, D., Gray, H. G.*, Nguyen, E., Pardini, S.*, Harris, L. R., ... & APPEL L. (2023) Designing Virtual Reality Exposure Scenarios to Treat Anxiety in People with Epilepsy: Phase 2 of the AnxEpiVR Clinical Trial Authors. Frontiers in Virtual Reality, 4, 1209535. https://www.frontiersin.org/articles/10.3389/frvir.2023.1209535/full

• Tchao, D., Gray, G. H.*, Lewis S., Pardini, S.*, Harris, R. L., APPEL L. (2023) Describing Epilepsy-Related Anxiety to Inform the Design of a Virtual Reality Exposure Therapy: Results from Phase 1 of the AnxEpiVR Clinical Trial. Epilepsy and Behaviour Reports https://doi.org/10.1016/j.ebr.2023.100588    

• Gray, G. H.*, Tchao, D., Lewis S., Pardini, S.*, Harris, R. L., APPEL L. (2023) Virtual Reality Therapy for People With Epilepsy and Related Anxiety (AnxEpiVR): Protocol for a Three-Phase Pilot Clinical Trial. JMIR Research Protocols: https://www.researchprotocols.org/2023/1/e41523