Psychologists and neuroscientists at Hadassah-University Medical Center on Jerusalem's Mount Scopus campus are pioneers in the use of virtual reality (VR) to help stroke victims recover movement of their limbs, relieve migraine and tension headaches and fight chronic pain. Soon due to launch Phase II clinical trials, the team - including rehabilitational psychologist Shimon Shiri and neuroscientist Uri Feintuch from the Hebrew University-Hadassah School of Occupational Therapy - has developed a novel virtual reality system to recover motor functioning among post-stroke patients. Functional magnetic resonance imaging (fMRI) will be used to monitor brain processes. Shiri, who presented his research at Thursday's Gerry Schwartz and Heather Reisman Second International Congress on Chronic Disorders and Disabilities in Children at the Jerusalem Regency Hotel, told The Jerusalem Post that small numbers of patients had shown significant improvement, but that the technique had to be proven in clinical trials. VR, which involves interacting with artificial environments via 3-D computer images, has been used for some time to relieve phobias such as fear of heights and flying in planes, and to distract patients, including children, undergoing painful procedures. A University of Haifa team has found that autistic children can be taught to cross the street safely using VR, looking to the left and right with a simulator, and that it is more effective than practicing in a natural setting or in school. But Shiri has invented a VR system called VirHab that he believes will treat physical disorders such as chronic pain and rehabilitate stroke victims whose brains have been damaged. "VirHab does not replicate reality, but rather influences it," he explained. For example, stroke victims who can hardly move their limbs see themselves in real time on a screen via a simulation system. They use a joystick or mouse, which they move slightly to maneuver limbs on the screen, even though they can't actually move their arms. This is regarded as a "corrective learning process." The VR system is also used to help children and adults suffering from chronic headaches. "Headache-sufferers learn to relax constricted muscles and learn to associate between relaxed behavior and the image of themselves as pain-free," Shiri said. The clinical trial on headaches is due to begin in two months. Chronic pain victims, Shiri suggests, can "reeducate" their brains as the virtual experience triggers neurons to alleviate the pain. He says the brain changes as a result of chronic pain, but fortunately the brain is very "plastic" in that it is able to reorganize neural pathways throughout life. The growing number of patients with chronic pain who continue to suffer despite analgesic drugs and even operations, Shiri believes, may fail to get help because the brain becomes "imprinted" by the pain experience. When the brain "sees," through the eyes viewing the screen, that the person's limbs can be moved virtually, it may be tricked into believing it has recovered, he hypothesizes. So far, only a handful of patients have completed the trial, but preliminary results have shown a decrease in pain and in fear of pain, improvement in functioning, and better emotional and physical conditions in patients, Shiri said. The patent-pending system is being marketed by Hadasit - the Hadassah Medical Organization's technology transfer company. Two versions are being planned - one for professional use in clinics and hospitals, and the other for home use by the patient or therapist. It is believed that the system could eventually be applied to many more pain and disability conditions, such as chronic back pain.