JMIR Publications

ABSTRACT

Background:

Virtual reality (VR) technology has emerged as a promising tool for cognitive rehabilitation in neuropsychiatric patients. These patients often suffer from significant cognitive impairments, which are associated with decreased quality of life and increased disease burden. Traditional treatments have limited in improving cognitive functions, making VR-based interventions an area of growing interest.

Objective:

This meta-analysis aims to evaluate the effectiveness of VR-based interventions on cognitive function in neuropsychiatric patients by synthesizing data from randomized controlled trials (RCTs).

Methods:

Following PRISMA guidelines, we conducted a comprehensive search across PubMed, Web of Science, Medline, EMBASE, and Cochrane Library for RCTs from January 2010 to December 2024. Studies were included if they evaluated VR-based interventions’ impact on cognitive outcomes in patients with neuropsychiatric disorders. Data extraction and risk of bias assessment were performed independently by two researchers. Meta-analyses were conducted using random-effects models, and standardized mean differences (SMD) as effect size.

Results:

A total of 21 RCTs involving 1051 participants were included. Overall, VR-based interventions significantly improved cognitive functions of neuropsychiatric patients (SMD, 95% CI: 0.67 [0.33, 1.01], Z = 3.85, P = .0001). Subgroup analyses revealed significant benefits for Cognitive Rehabilitation Training (SMD, 95% CI: 0.75 [0.33, 1.17], Z = 3.53, P = .0004), Exergame-based Training (SMD, 95% CI: 1.09 [0.26, 1.91], Z = 2.57, P = .01), and Tele-rehabilitation and Social Functioning Training (SMD, 95% CI: 2.21 [1.11, 3.32], Z = 3.92, P <.0001). Conversely, Immersive Cognitive Training, Music Attention Training, and Vocational and Problem-Solving Skills Training did not yield significant improvements (Z = 1.86, P = .06; Z = 0.35, P = .72; Z = 0.88, P = .38). Disease-type subgroup analyses indicated significant improvements in schizophrenia (SMD, 95% CI: 0.92[0.22, 1.62], Z = 2.58, P =.01), and mild cognitive impairment (SMD, 95% CI: 0.75[0.16, 1.35], Z = 2.47, P =.01), but not in brain injuries, Parkinson's disease, or stroke (Z=0.34, P=.73; Z=1.26, P=.21; Z=1.16, P=.24).

Conclusions:

This meta-analysis revealed that VR-based interventions can improve cognitive functions among individuals with neuropsychiatric disorders, with significant improvements observed in Cognitive Rehabilitation Training, Exergame-based Training, and Tele-rehabilitation and Social Functioning Training. These results offer vital evidence supporting the use of VR technology in rehabilitation for neuropsychiatric conditions and guide the optimization of future intervention approaches. Clinical Trial: This study has been registered at PROSPERO, and the registration number was CRD42023445000.