Re-Wiring the Brain

Dr. Martin McKeown has created a colourful 3-D environment that stimulates brain activity - photo by Martin Dee
Dr. Martin McKeown has created a colourful 3-D environment that stimulates brain activity – photo by Martin Dee

UBC Reports | Vol. 51 | No. 12 | Dec. 1, 2005

A new Virtual Reality Therapy tool being developed at UBC may provide a non-drug alternative to stroke and Parkinson’s patients

By Hilary Thomson

It may look like a primitive video game, but this virtual environment is a sophisticated tool to help the brain re-wire itself after damage from stroke or Parkinson’s disease.

Prof. Martin McKeown, of the Pacific Parkinson’s Research Centre at UBC Hospital, and colleagues are developing a virtual stimuli exercise that offers patients a non-drug-based therapy to help recover motor ability.

The therapy is the only one of its kind in North America.

“This is a whole new avenue of research,” says McKeown, who is a member of the Brain Research Centre and an investigator with the Vancouver Coastal Health Research Institute. “We’re looking at non-pharmacological treatments by developing optimal sensory environments to help rehabilitate patients.”

The virtual reality (VR) therapy may be available to patients within five years.

A physician with a degree in engineering, McKeown has been working with Prof. Sid Fels of the Faculty of Applied Science to create the VR experiment at UBC. Before McKeown arrived on campus in 2003, he worked on the therapy at Duke University in North Carolina.

The therapy builds on previous research that showed synthetic stimulants, such as amphetamines, helped patients to re-learn movement, even years after they had suffered a stroke. Stimulants release a naturally occurring chemical in the brain called norepinephrine, which acts as a neurotransmitter to relay electrical signals between brain cells, including those brain cells that ultimately control muscles necessary for movement.

The only problem was that giving stimulants to stroke patients carried a risk of heart attack, making proper dosage hard to determine.

“We started looking for ways to stimulate release of norepinephrine without the use of drugs,” says McKeown. “A virtual solution seemed perfect — patients could react to stimuli in a safe environment and we could monitor precisely the electrical activity of muscles.”

The intensity of the stimuli causes the brain to spike production of norepinephrine. These chemical bursts allow the brain to reprogram damaged nerve-signaling pathways. Motor ability improvement is measured by the degree of electrical signaling between muscles.

“The beauty of the VR environment is that we can match stimuli to the electrical activity from muscle groups to learn precisely how stimuli are affecting movement,” says McKeown. In collaboration with Prof. Jane Wang of UBC’s Dept. of Electrical and Computer Engineering, McKeown is also using the experiment to develop an accurate measure of motor performance in brain-injured patients, a long-standing challenge of rehabilitation science.

McKeown, his colleagues from Duke University, and Dr. Yuqing Wei, a visiting neurologist from China, have shown the immediate positive effects of the stimuli in 20 stroke patients and 20 control subjects. The next step in the research is to determine if the VR therapy improves motor performance in the long term.

McKeown believes that the VR method will also be useful in Parkinson’s disease — a progressive neurodegenerative disease that involves loss of the brain cells that ultimately influence movement control. It is estimated that approximately 100,000 Canadians have Parkinson’s disease.

Stroke is a sudden loss of brain function caused by the interruption of blood flow to the brain or rupture of blood vessels in the brain. The fourth leading cause of death in Canada, about 16,000 people die from stroke each year and about 300,000 Canadians live with the effects of stroke.

Co-investigators include medical student Lissette Eigenraam, from Holland; Prof. Wang’s master’s student Joyce Chiang; and research assistant Graeme McCaig. Lab space has been provided by UBC’s Media and Graphics Interdisciplinary Centre (MAGIC).

VR Therapy: How it Works

The therapy involves 15 electrode patches, each about five cm.

in diameter, applied to the patient’s arms and shoulders. The electrodes record electrical activity in the muscles, in particular, communication between groups of muscles.

The patient observes a monitor where coloured balls appear in 3-D and seem to fly toward the subject. The participant is instructed to use their weakened arm to reach out as if to catch the ball. They may be instructed to try to catch all balls or to ignore all but one designated ball.