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Millions of New Yorkers witnessed the attacks on the World Trade Center of Sept. 11, 2001, whether from inside the buildings or from afar. A large number of these people – as many as 65 percent by one account – report experiencing resulting emotional problems, including post-traumatic stress disorder (PTSD). As part of two new clinical research studies, these patients can receive virtual-reality therapy at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

The only medical center to offer virtual-reality therapy for Sept. 11-related PTSD, NewYork-Presbyterian/Weill Cornell has proven the therapy effective and successfully treated patients since first offering it in 2002. The two new studies, which build on the established therapy, are the first to (1) employ a virtual-reality simulation of the interior of the World Trade Center buildings and (2) to offer virtual-reality therapy in conjunction with D-cycloserine, a drug that has been shown to enhance learning.

In the virtual-reality therapy, patients wear a helmet that immediately immerses them in a three-dimensional environment – when they look down or sideways, the scenery shifts. The patient experiences depictions of the World Trade Center before, during and after the attacks. Scenes range from a plane flying past the first tower, to a re-enactment of two planes hitting both towers and their collapses, accompanied by realistic sound effects. And for the first time, for those who were inside the World Trade Center when the attack occurred, a 3-D graphic re-enactment of the escape from the interior will be used. Patients progress through the scenes in a gradual fashion with supervision by the therapist, ensuring that they will not become overwhelmed.

"Traditionally, exposure therapy involves having the patient retell their experiences of that day, while offering other behavioral and cognitive coping techniques. The virtual-reality therapy incorporates all of these aspects into its treatment, while employing a virtual world that engages the patient through all their senses," says Dr. JoAnn Difede, director of the Program for Anxiety and Traumatic Stress Studies at NewYork-Presbyterian/Weill Cornell and associate professor of psychology in psychiatry at Weill Cornell Medical College.

The first study is open to patients with symptoms of PTSD that experienced the World Trade Center attacks from inside one of the buildings, and will evaluate the efficacy of virtual reality in the treatment of PTSD. The study is supported by a grant from the National Institute of Drug and Alcohol Abuse. The virtual-reality simulation of the World Trade Center interior was jointly developed with Ken Graap and colleagues at Virtually Better of Atlanta, Ga.

The second study is open to patients with symptoms of PTSD that experienced the World Trade Center attacks from outside the buildings, including from afar. The study will evaluate the use of virtual reality with D-cycloserine, compared to use of virtual reality with placebo to determine whether the drug group shows a greater symptom reduction, quicker reduction of symptoms, or has longer-lasting effects. Patients will be randomly assigned either to a group taking the drug or placebo; both groups will receive virtual-reality exposure therapy.

An antibiotic used to treat tuberculosis, D-cycloserine has been found to be effective in helping people to overcome phobias, and in helping children with autism to improve their social and communication skills.

Symptoms of PTSD include, but are not limited to, flashbacks, intrusive emotions and memories, nightmares, dissociative states, irritability, panic and sleep disturbance.

For more information, patients may call 866-NYP-NEWS.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and its academic partner, Weill Cornell Medical College. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian, which is ranked sixth on the U.S. News & World Report's list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center and its academic affiliate, Columbia University College of Physicians and Surgeons.