Immersive virtual reality for improving cognitive deficits in children with ADHD: a systematic review and meta-analysis

Corrigan, Niamh; Păsărelu, Costina-Ruxandra; Voinescu, Alexandra

doi:10.1007/s10055-023-00768-1

Cited by 30 publications

(13 citation statements)

References 81 publications

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“…Nevertheless, most of the mentioned reports in systematic reviews do not mention monitoring complications of this technology, as if it comes with pure benefit. [6,7,12,13] In this study, we identified a total of 4 controlled trials on skill development in autism, ADHD, and dyslexia; comprising a total of 208 patients, a sample size that does not match a very large population of interest. [8][9][10][11] Moreover, the age ranged in the four studies from 6-16 years, which means that VR technology is still not extensively available for early training of patients with learning difficulties.…”

Section: Discussionmentioning

confidence: 99%

Revisiting VR training in developmental disorders, is it a friend or foe? A scoping review

AbdelMassih,

AlHammadi,

AlHosani

et al. 2024

Preprint

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Background: Immersive and non-immersive VR technology has been increasingly employed in training. This has encouraged physicians working in skill development to try using it to improve the learning, emotional recognition, and social skills of various disorders. This study aimed to explore the controlled trials employing VR in autism, ADHD, and dyslexia. Methodology:A literature review has been conducted, on PubMed, Scopus, and Web of Science. Any controlled trial in the pediatric age group, involving the comparison of VR training with other types of therapies in autism, ADHD, and dyslexia was included. Results:Only four controlled trials were identified, comprising a total of 208 patients, with ages ranging from 6-16 years. Out of these studies, two involved patients with autism, one with ADHD, and one with dyslexia. VR was successful in improving emotional recognition but not social interaction in autism. All trials did not mention thoroughly possible complications of prolonged use of VR. Conclusion: Despite being a promising technology, there is still a long road to prove the validity of using VR in skills development. Few controlled trials have been tailored to explore VR advantages over conventional training and therapies, most of them have a limited sample size, a short training course, and no mention of possible setbacks, such as ocular effects and social isolation.

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Section: Discussionmentioning

confidence: 99%

Revisiting VR training in developmental disorders, is it a friend or foe? A scoping review

AbdelMassih,

AlHammadi,

AlHosani

et al. 2024

Preprint

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“…In individuals with severe phobias, a systematic review found VR exposure therapy to be just as effective as in vivo therapies, particularly for cases of acrophobia (the fear of heights), claustrophobia, and blood injection phobia (the fear of injection exposure), with significant reductions in levels of fear, anxiety, and avoidance [ 54 ]. Other successful use cases with meta-analytic evidence include VR in palliative care [ 55 ], physical therapy and rehabilitation [ 56 ], and cognitive functioning (eg, memory and attention) [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Positive Psychological Intervention Delivered Using Virtual Reality in Patients on Hemodialysis With Comorbid Depression: Protocol and Design for the Joviality Randomized Controlled Trial

Hernandez¹,

Wilund²,

Solai³

et al. 2023

JMIR Res Protoc

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Background Depression is highly prevalent in individuals on hemodialysis, but it is infrequently identified and remains undertreated. In this paper, we present details of the methodology of a randomized controlled trial (RCT) aimed at testing the feasibility and preliminary efficacy of a 5-week positive psychological intervention in individuals on hemodialysis with comorbid depression delivered using immersive virtual reality (VR) technology. Objective We aim to describe the protocol and design of the Joviality trial whose main objectives are 2-fold: determine the feasibility of the Joviality VR software through metrics capturing rates of recruitment, refusal, retention, noncompliance, and adherence, as well as end-user feedback; and assess preliminary efficacy for outcomes measures of depressive symptoms, psychological well-being and distress, quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalizations. Methods This 2-arm RCT is scheduled to enroll 84 individuals on hemodialysis with comorbid depression from multiple outpatient centers in Chicago, Illinois, United States. Enrollees will be randomized to the following groups: VR-based Joviality positive psychological intervention or sham VR (2D wildlife footage and nature-based settings with inert music presented using a head-mounted display). To be eligible, individuals must be on hemodialysis for at least 3 months, have Beck Depression Inventory-II scores of ≥11 (ie, indicative of mild-to-severe depressive symptoms), be aged ≥21 years, and be fluent in English or Spanish. The Joviality VR software was built using agile design principles and incorporates fully immersive content, digital avatars, and multiplex features of interactability. Targeted skills of the intervention include noticing positive events, positive reappraisal, gratitude, acts of kindness, and mindful or nonjudgmental awareness. The primary outcomes include metrics of feasibility and acceptability, along with preliminary efficacy focused on decreasing symptoms of depression. The secondary and tertiary outcomes include quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalization rates. There are 4 assessment time points: baseline, immediately after the intervention, 3 months after the intervention, and 6 months after the intervention. We hypothesize that depressive symptoms and hemodialysis-related markers of disease will substantially improve in participants randomized to the VR-based Joviality positive psychology treatment arm compared with those in the attention control condition. Results This RCT is funded by the National Institute of Diabetes and Digestive and Kidney Diseases and is scheduled to commence participant recruitment in June 2023. Conclusions This trial will be the first to test custom-built VR software to deliver a positive psychological intervention, chairside, in individuals on hemodialysis to reduce symptoms of depression. Within the context of an RCT using an active control arm, if proven effective, VR technology may become a potent tool to deliver mental health programming in clinical populations during their outpatient treatment sessions. Trial Registration ClinicalTrials.gov NCT05642364; https://clinicaltrials.gov/ct2/show/NCT05642364 International Registered Report Identifier (IRRID) PRR1-10.2196/45100

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“…In recent years, some scholars have attempted to use game interventions to assist in the treatment of ADHD patients, with VR being one of the new intervention methods [18]. VR technology, also known as 'spiritual realm' technology, is a comprehensive information technology that integrates computer graphics, digital image processing, multimedia technology, computer simulation technology, sensor technology, display technology, and network parallel processing technology [19].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Integrated Neurofeedback and Virtual Reality Training in Children with ADHD: A Randomized Controlled Trial

Wu,

Fang

et al. 2024

Preprint

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Objective: This research aims to explore the therapeutic outcomes of combining Neurofeedback (NF) with Virtual Reality (VR) training on children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) through a randomized controlled trial. Methods: ADHD patients from the Children's Psychiatry Outpatient and Inpatient Departments of the Seventh People's Hospital in Hangzhou were randomly divided into two groups from March 2021 to December 2022. One group received standard neurofeedback therapy (control group), and the other underwent a combined neurofeedback therapy and a VR-based training system (intervention group). The intervention lasted for three months. This research utilized the SNAP-IV (Swanson, Nolan, and Pelham-IV) Attention Rating Scale for comparative analysis between the groups before and after the intervention. Results: This study found that combining neurofeedback and virtual reality training has a positive impact on inattention, hyperactivity/impulsivity, and oppositional defiant disorder (ODD)in children with ADHD. Specifically, within the intervention group, the average inattention score decreased significantly from 24.0 (SD = 2.6) before the intervention to 16.8 (SD = 2.7) after the intervention, with an effect size of 2.72 (95% CI: 2.01, 3.42). Similarly, the hyperactivity/impulsivity score decreased significantly from 19.0 (SD = 3.3) to 14.6 (SD = 2.8), with an effect size of 1.44 (95% CI: 0.87, 2.01), and the ODD score decreased from 16.6 (SD = 3.6) to 12.5 (SD = 2.2), with an effect size of 1.37 (95% CI: 0.81, 1.94). After the intervention, intergroup comparisons showed that compared to the intervention group (mean 16.8, SD=2.7), the control group (mean 19.9, SD=3.1) had significantly higher scores in inattention, with an effect size of 1.08 (95% CI: 0.54, 1.62). The difference in hyperactivity/impulsivity scores was smaller but statistically significant, with the control group averaging 16.17 (SD=2.84) and the intervention group 14.60 (SD=2.77), with an effect size of 0.56 (95% CI: 0.04, 1.07). The ODD scores were also higher in the control group (13.93, SD=2.98) compared to the intervention group (12.53, SD=2.21), with an effect size of 0.53 (95% CI: 0.02, 1.05). The intervention group, combining neurofeedback and VR attention training, showed a significant reduction in inattention (average decrease of 7.2, SD=3.6, effect size -0.68 (95% CI: -1.20, -0.16)), with less and non-significant reductions in hyperactivity/impulsivity and ODD symptoms, highlighting the targeted efficacy of the intervention on attention deficits. Conclusion: Integrating neurofeedback and VR training significantly reduces inattention in children with ADHD, offering a promising approach for targeting core symptoms of the disorder.

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Immersive virtual reality for improving cognitive deficits in children with ADHD: a systematic review and meta-analysis

Cited by 30 publications

References 81 publications

Revisiting VR training in developmental disorders, is it a friend or foe? A scoping review

Revisiting VR training in developmental disorders, is it a friend or foe? A scoping review

Positive Psychological Intervention Delivered Using Virtual Reality in Patients on Hemodialysis With Comorbid Depression: Protocol and Design for the Joviality Randomized Controlled Trial

Efficacy of Integrated Neurofeedback and Virtual Reality Training in Children with ADHD: A Randomized Controlled Trial

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