Effectiveness of virtual reality-based neuropsychological interventions in improving cognitive functioning in patients with mild cognitive impairment: A systematic review and meta-analysis.

Objective: Increased prevalence of mild cognitive impairment (MCI) has led to a need for new neuropsychological intervention tools in this population. This meta-analysis aimed to learn about the efficacy of virtual reality (VR)-based neuropsychological interventions in improving cognitive functioning in patients with MCI. Method: This review followed the recommendations of the PRISMA statement, and it was registered in PROSPERO. The studies examined were collected from the PsycINFO, Web of Science, Pubmed/MEDLINE, Embase, Scopus, and Cochrane Library databases. Results: The systematic search yielded 258 articles, of which 13 randomized controlled trials were selected. VR-based neuropsychological interventions had moderate effects on global cognition ( g  = 0.30; 95% CI = 0.05, 0.56; p  = 0.02), small effects on attention ( g  = 0.27; 95% CI = 0.04, 0.49; p  = 0.02), and large effects on executive function ( g  = 0.60; 95% CI = 0.38, 0.81; p  < 0.0001), but non-significant effects on working memory, episodic memory, language, or visuoconstruction. When the length of the intervention was considered, VR-based interventions of 15 or more hours had moderate effects on working memory ( g  = 0.55; 95% CI = 0.11, 0.99; p  = 0.01), and large effects on language ( g  = 0.60; 95% CI = 0.01, 1.20; p  = 0.05) and visuoconstruction ( g  = 1.13; 95% CI = 0.58, 1.67; p  < 0.0001). Conclusions: Results suggest that VR-based interventions are beneficial for improving cognitive functioning in patients with MCI, and allow us to make recommendations that could have implications for clinical decision-making in this population.