JMIR Publications

ABSTRACT

Background:

Natural environments are recognized for supporting cognitive functioning and psychological well-being, possibly through mechanisms such as attentional restoration and stress reduction. Virtual reality (VR) technologies offer a promising and accessible means of simulating natural settings; however, it remains unclear whether these simulated experiences engage the brain and behavior in ways comparable to real nature, particularly among neurodivergent individuals, such as adults with Attention Deficit/Hyperactivity Disorder (ADHD).

Objective:

This study aims to examine the effects of real and virtual nature exposure on cognition, well-being, and brain activity in adults with and without ADHD. Specifically, it seeks to determine whether immersive VR environments can elicit comparable outcomes to real nature exposure and whether these effects differ across neurocognitive profiles.

Methods:

This is a randomized experimental study with a mixed model and longitudinal design. A total of 80 adult participants, 40 with a formal diagnosis of ADHD and 40 neurotypical controls, will be randomly assigned to either a real nature condition or an immersive VR-simulated nature condition. Before and after the exposure session, participants will complete cognitive tasks assessing cognitive flexibility and metacognition, followed by 8 weeks. Brain activity will be measured using a mobile electroencephalogram (EEG) device during the exposure. Self-report measures of emotional well-being and nature connectedness will also be collected.

Results:

The study was preregistered on the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/AY6C2). Ethical approval was granted by the Research Ethics Committee (REC) at Sligo University Hospital on April 7, 2025 (Reference No. 1044). Participant recruitment is expected to begin in September 2025.

Conclusions:

The study was preregistered on the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/AY6C2). Ethical approval was granted by the Research Ethics Committee (REC) at Sligo University Hospital on April 7, 2025 (Reference No. 1044). Participant recruitment is expected to begin in September 2025. Clinical Trial: The study was preregistered on the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/AY6C2).