Contents

1. Problem
2. Solution
3. Architecture
4. Challenges we faced
5. Future prospects

Promo video: https://www.youtube.com/watch?v=PSdzIfHG5DQ&t=4s

Scene captures

Scene 1: An abstract alien environment designed to disconnect the user from reality, and take them into a world that is quiet, serene, and devoid of the rush of life.

Scene 2: Journey to our attempt at recreating Atlantis. More additions to follow soon.

Download Link of the both scenes (.apk): https://drive.google.com/drive/folders/1GUQ_AiSX4lm-cWq6yAf4FsIp6h5K9sE3?usp=sharing

Problem

According to a study reported in WHO, DEPRESSION is a common illness worldwide, with more than 264 million people affected. At its worst, depression can lead to suicide. Close to 800,000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds. Although there are known, effective treatments for mental disorders, between 76% and 85% of people in low and middle-income countries receive no treatment for their disorder.

Solution

We have accessed research articles that discuss the effect of music and light on depressive mood symptoms. We carefully analyzed ~ 30 articles, in which participants were administered music therapy in a setting of their choice. However, such music therapy is not common, due to lack of awareness and low mental health worker to population ratio.

We intend to begin solving this problem by using Virtual Reality to create such environments which can help the users to disconnect for a while from disturbing realities, allowing them to enter entirely new worlds. In the backdrop, we would be rigging binaural treatment (which is research-proven to relax various centers of the brain notorious for anxiety and related problems).

Architecture

To implement this solution on VR, we have mainly used Unity and Maya to create immersive environments with the aforementioned sounds. We have chosen Unity since it offers a Light-Weight Render Pipeline that can support quality graphics on commonplace Android devices. Our product supports a minimum Android API level 19 and is built for Google Cardboard as a minimum (furthering supporting Daydream, Oculus, HTC Vive, etc).

Detailed Tech stack:

1. Unity 3D
2. Unreal Engine (for Level of Depth-LOD generation)
3. Adobe Premier Pro
4. Adobe Photoshop
5. Autodesk Maya

Research

Music Therapy

1. A pilot study comparing reduction of anxiety by binaural beat audio and patient-selected music in the pre-operative period. (https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2044.2006.04944_12.x): Inducing brain-wave states with binaural auditory beats has been used to decrease anxiety and behavioral problems, and improve mood

2. Auditory Beats in the brain. (https://www.ncbi.nlm.nih.gov/pubmed/4727697): Binaural beats have been used to entrain the brain toward a desired frequency.

3. A comprehensive review of the psychological effects of brainwave entrainment (https://www.ncbi.nlm.nih.gov/pubmed/18780583): Recent review suggesting that alpha stimulation was preferable for relaxation, short-term stress, and pain relief, but the effectiveness of binaural beats for mood need further research.

4. A prospective, randomised, controlled study examining binaural beat audio and pre-operative anxiety in patients undergoing general anaesthesia for day case surgery. (https://www.ncbi.nlm.nih.gov/pubmed/16115248): In an interesting study, Padmanabhan and colleagues applied binaural-beat stimulation to patients suffering from pre-operative anxiety

5. Binaural beat technology in humans: a pilot study to assess psychologic and physiologic effects. (https://www.ncbi.nlm.nih.gov/pubmed/17309374): In this study, it was reported that patients who received binaural-beat stimulation in the delta frequency for 30 min daily over 60 days showed a significant decrease in trait anxiety scores assessed with the STA-I. There was a decrease in trait anxiety (p = 0.004), an increase in quality of life (p = 0.03), and a decrease in insulin-like growth factor-1 (p = 0.01) and dopamine (p = 0.02) observed between pre- and post-intervention measurements. Binaural beat technology may exhibit positive effect on self-reported psychologic measures, especially anxiety. Further research is warranted to explore the effects on anxiety using a larger, randomized and controlled trial.

6. An empirical investigation into the effect of beta- frequency binaural-beat audio signals on four measures of human memory (https://hemi-sync.com/research-papers/an-empirical-investigation-into-the-effect-of-beta-frequency-binaural-beat-audio-signals-on-four-measures-of-human-memory/): Preliminary experimental studies suggest that binaural auditory beats in the EEG beta frequency range can enhance attention and memory task performance.

7. Binaural beats: Brain wave induction and the use of binaural beats to induce brain wave patterns (https://www.pulsus.com/scholarly-articles/binaural-beats-brain-wave-induction-and-the-use-of-binaural-beatsto-induce-brain-wave-patterns-4698.html): Thus, binaural pulse is a feature that allows modifying the performance and the state of mind of an individual.

8. Application that handles brain waves by means of binaural frequencies. (https://www.researchgate.net/publication/327265120_Binaural_beats_Brain_wave_induction_and_the_use_of_binaural_beats_to_induce_brain_wave_patterns): Binaural sounds can be used to change the frequency of the predominant brain waves, inducing the generation of waves capable of producing relaxation, sleep, altered states of consciousness, lucid dreams, creativity, analgesia

9. System for monitoring brain waves in studies of binaural pulses with theta rhythm on cognitive and emotional processes. (https://www.researchgate.net/publication/327265120_Binaural_beats_Brain_wave_induction_and_the_use_of_binaural_beats_to_induce_brain_wave_patterns): By subjecting the brain to certain waves, cognitive processes can be improved, it takes a while before the prevailing frequency (the frequency at which the brain is working) changes, generating the frequency of the stimulus (frequency of the binaural pulse)

10. Cumulative effects of theta binaural beats on brain power and functional connectivity (https://www.sciencedirect.com/science/article/abs/pii/S1746809418300296): Key results:- Binaural beats are capable of entraining the brain. 7 Hz binaural beats increase relative power of theta band in parietal and temporal lobes. Lengthening the duration of stimuli will result in more effective entrainment.

11. Binaural Auditory Beats affect vigilance performance and mood (https://www.monroeinstitute.org/article/2664): The results of this study provide evidence that presentation of simple binaural auditory beat stimuli during a 30-min vigilance task can affect both the task performance and the changes in mood associated with the task. The observed effects were consistent with our predictions regarding differential effects on alertness and mood. Binaural beats in the beta EEG frequency range were associated with relative improvements in target detection and reduction in the number of false alarms compared to binaural beats in the theta/delta EEG frequency range. Moreover, beta binaural beats were associated with smaller increases in task-related confusion and fatigue compared to theta/delta beats, and the two conditions had different effects on scores for depression/dejection. Together the scales suggested in the study suggest that the negative changes in mood produced by a monotonous task may have been partially ameliorated by the presentation of beta-frequency binaural beats.

12. This is your brain on binaural beats (https://www.healthline.com/health-news/your-brain-on-binaural-beats#1): For instance, a Montreal study of 15 “mildly anxious” volunteers found a significant reduction in their anxiety when they listened to binaural beats at least 5 times each week for a month. And when researchers in Richmond, Virginia, requested 36 adults with chronic pain to listen to two recordings of binaural beats for 20 minutes each day for 2 weeks, 77 percent felt their pain lessened.

13. The Impact of Monaural Beat Stimulation on Anxiety and Cognition (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430051/): The study reports that monaural beat stimulation at gamma (40 Hz), theta (6 Hz) and alpha (10 Hz) frequencies was effective in reducing state-anxiety scores (as assessed using the STAI-S).

14. Original sound compositions reduce anxiety in emergency department patients: a randomised controlled trial. (https://www.ncbi.nlm.nih.gov/pubmed/22171868): Of 291 patients assessed for eligibility, 170 patients completed the pre-intervention anxiety self-assessment and 169 completed the post-intervention assessment. Significant decreases (all P < 0.001) in anxiety level were observed among patients exposed to the electroacoustic musical composition (pre-intervention mean, 39; post-intervention mean, 34), audio field recordings (42; 35) or audio field recordings with embedded binaural beats (43; 37) when compared with those allocated to receive simulated ED ambient noise (40; 41) or headphones only (44; 44).

15. A prospective, randomised, controlled study examining binaural beat audio and pre-operative anxiety in patients undergoing general anaesthesia for day case surgery. (https://www.ncbi.nlm.nih.gov/pubmed/16115248): Binaural beat audio has the potential to decrease acute pre-operative anxiety significantly. (Abstract)

16. Impact of auditory stimulation at a frequency of 5 Hz in verbal memory. (https://www.ncbi.nlm.nih.gov/pubmed/18985458):Auditory stimulation over a long time at a frequency of 5 Hz generates a coupling of brain activity that increases the capacity of immediate verbal memory.

17. Pilot feasibility study of binaural auditory beats for reducing symptoms of inattention in children and adolescents with attention-deficit/hyperactivity disorder. (https://www.ncbi.nlm.nih.gov/pubmed/20117669): The results from this study indicate that binaural auditory beat stimulation did not significantly reduce the symptom of inattention in the experimental group. However, parents and adolescents stated that homework problems due to inattention improved during the 3-week study. Parents and participants stated that the modality was easy to use and helpful. Therefore, this modality should be studied over a longer time frame in a larger sample to further its effectiveness to reduce the symptom of inattention in those diagnosed with attention-deficit/hyperactivity disorder. (More in depth research needed)

18. Binaural auditory beats affect vigilance performance and mood. (https://www.ncbi.nlm.nih.gov/pubmed/9423966): Presentation of beta-frequency binaural beats yielded more correct target detections and fewer false alarms than presentation of theta/delta frequency binaural beats. In addition, the beta-frequency beats were associated with less negative mood. Results suggest that the presentation of binaural auditory beats can affect psychomotor performance and mood. This technology may have applications for the control of attention and arousal and the enhancement of human performance.

19. The Impact of Monaural Beat Stimulation on Anxiety and Cognition (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430051/): Results: Although auditory beat research has tended toward using binaural beats as stimuli, our findings suggest a potential role for monaural beat stimulation in treating symptoms of anxiety disorders, in a fast and non-invasive manner. Future studies will aim at identifying ideal target populations for monaural beat stimulation and at optimizing stimulation parameters, for instance, by increasing the stimulation duration or by repetitive applications of the beat stimuli.

20. Cumulative effects of theta binaural beats on brain power and functional connectivity (https://sci-hub.tw/https://www.sciencedirect.com/science/article/abs/pii/S1746809418300296): As the idea of brain entrainment suggests, because the specific frequency of the stimulation is 7 Hz, observation in the theta power should be in priority which will enable us to achieve effective changes in the brain function

Mood Induction Procedures (MIP)

21. Sense of Presence in Emotional Virtual Environments (https://pdfs.semanticscholar.org/f55f/b706b5d0508380905cd4004f66ce3b5a1933.pdf): Regarding the hypothesis, our results point out that VR-MIPs are able to induce different moods in the users. Data from subjective mood state measurements show that the 4 emotional environments (sad, joy, anxiety, and relax) are able to produce mood changes in the users. The changes in mood were produced in the predicted directions for every single environment. In conclusion, our results point out that the “new technologies” are useful to create mood devices that are able to induce emotions in the users; it is possible to induce “specific emotions” since the different mood devices that have been created allow the induction of an specific “target” emotion.

22. Physical Therapy Enhanced with a Virtual Environment: Impact on Ambulation, Mood, and Cognition (https://www.archives-pmr.org/article/S0003-9993(16)30504-4/fulltext): Although the study concluded that it found no significant difference between PT(physical therapy) and VE (Visual therapy) on multidimensional outcomes, while significant changes were observed within each group. Further research is needed to better understand the usefulness of virtual reality in MS rehabilitation. The study, however, reports that participant satisfaction with the VE system was high.

23. Presence and emotion in virtual environments: the influence of stereoscopy (https://www.researchgate.net/publication/5577384_Presence_and_Emotions_in_Virtual_Environments_The_Influence_of_Stereoscopy): The major difference between previous studies and the current one is the content of the VEs. Our VEs are designed specially for inducing positive moods, whereas previous works employed neutral VEs. It may be that for this specific purpose, stereoscopic presentation is not as critical and technological factors are more relevant for non-emotional environments than for emotional ones.

24. Changing Induced Moods Via Virtual Reality (https://link.springer.com/chapter/10.1007/11755494_3): This study presents data about the efficacy of this procedure not only to induce a mood, but also to change after the mood is induced. (Has the core concept of MIP: Mood Induction Procedures).

Challenges we faced

• Very difficult to render high-quality non-low poly graphics on mobile GPU.
• Reducing the size of the app (dividing the VR scenes into multiple modules)
• Improve rendering, thus reducing flickering of the environment.

Future prospects

• We have a long term aim where we intend to collaborate with hospitals, talk with the mental health division and help introduce economic VR therapy sessions to patients.
• Making the solution available on more devices like Oculus, HTC Vive, etc.

License

Copyright (c) 2019 NDORFINS

Permission is hereby granted, free of charge, to any person obtaining a copy of this software and associated documentation files (the "Software"), to deal in the Software without restriction, including without limitation the rights to use, copy, modify, merge, publish, distribute, sublicense, and/or sell copies of the Software, and to permit persons to whom the Software is furnished to do so, subject to the following conditions:

The above copyright notice and this permission notice shall be included in all copies or substantial portions of the Software.

THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM, OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN THE SOFTWARE.