Examining the Academic Trends in Neuropsychological Tests for Executive Functions Using Virtual Reality: Systematic Literature Review

Abstract

Background In neuropsychology, fully immersive virtual reality (VR) has been spotlighted as a promising tool. It is considered that VR not only overcomes the existing limitation of neuropsychological tests but is also appropriate for treating executive functions (EFs) within activities of daily living (ADL) due to its high ecological validity. While fully immersive VR offers new possibilities of neuropsychological tests, there are few studies that overview the intellectual landscape and academic trends in the research related to mainly targeted EFs with fully immersive VR. Objective The objective of this study is to get an overview of the research trends that use VR in neuropsychological tests and to analyze the research trends using fully immersive VR neuropsychological tests with experimental articles. Methods This review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were searched in three web databases using keywords related to VR, EFs, and cognitive abilities. The study was conducted in two steps, keyword analysis and in-depth systematic review. In the web database search from 2000 to 2019, 1167 articles were initially collected, of which 234 articles in the eligibility phase were used to conduct keyword analysis and a total of 47 articles were included for systematic review. Results In keyword analysis, the number of articles focused on dementia including the keywords “MCI,” “SCD,” and “dementia” were highlighted over the period, rather than other symptoms. In addition, we identified that the use of behavioral and physiological data in virtual environments (VEs) has dramatically increased in recent studies. In the systematic review, we focused on the purpose of study, assessment, treatment, and validation of usability and structure. We found that treatment studies and uncategorized studies including presence and cybersickness issues have emerged in the recent period. In addition, the target symptoms and range of participants were diversified. Conclusions There has been a continuously increasing interest in dealing with neuropsychology by using fully immersive VR. Target cognitive abilities have been diversified, as well as target symptoms. Moreover, the concept of embodied cognition was transplanted in this research area.

Virtual Reality-based Cognitive Intervention for Enhancing Executive Functions in Community-dwelling Older Adults

“…Previously, evidence has suggested the support of enhancing cognitive functioning in healthy older adults by using cognitive-based trainings (Gavelin et al, 2020;Sanjuán et al, 2020). Nevertheless, despite the diversity among applied cognitive interventions in healthy older adults, the VR-based intervention has not been widely adopted for boosting EFs (Kim et al, 2021). EFs (i.e., inhibitory control, WM, and attentional flexibility) has been linked with daily activities since these functions include the ability to evaluate, organize, plan, perform, and achieve goals as well as the capacity to flexibly adapt to changed circumstances (Diamond, 2013;Lezak, 1982).…”

“…VR has several applications for improving (or training) older adults. Although exposure to VR application may result in symptoms of motion sickness for some people (e.g., eye fatigue, headaches, and nausea) (Park et al, 2019), its advantages include a secure environment, high ecological validity, and an inexpensive aid to support active aging (Appel et al, 2020;Kim et al, 2021;Syed-Abdul et al, 2019). A previous study revealed the acceptance (or positive perception) of older adults toward using VR (Mascret et al, 2020), namely, they perceived the VR to be useful, an enjoyable experience, and easy to use (Mascret et al, 2020;Syed-Abdul et al, 2019).…”

EPELI: a novel virtual reality task for the assessment of goal-directed behavior in real-life contexts

“…There are some potential limitations to be considered when interpreting the present findings. First, even though our sample size is larger than in most previous VR studies examining attentional-executive functions (see, e.g., Kim et al, 2021), it is somewhat limited considering the sampling distributions. Especially the age distribution in this sample is relatively narrow, and since the participants were recruited so that the families contacted us based on the advertisements, a sampling bias may be present.…”

“…VR refers to digitally generated, immersive artificial environments. Today, VR-based neuropsychological research targeting, for example, attention, executive functions, and memory (see review by Kim et al, 2021) is being published at an accelerating rate (Krohn et al, 2020). In children, VR has been successfully used to implement conventional experimental tasks, such as a variant of the widely used Continuous Performance Test where the task is performed in a virtual classroom environment (see, e.g., Parsons & Rizzo, 2019).…”

Veterans Affairs Health Care Provider Perceptions of Virtual Reality: Brief Exploratory Survey

“…Ways to seamlessly integrate the use of technology in older adults has been a topic of interest since the late 1980s [ 17 ]. More recently, VR use has been studied in cognitively impaired older adult population for neuropsychiatric testing [ 18 , 19 ], cognitive rehabilitation [ 20 ], and reducing neuropsychiatric symptoms associated with dementia [ 21 ]. Researchers have worked to find innovative ways to reduce neuropsychiatric symptoms in those diagnosed with dementia.…”