Virtual reality interventions targeting executive functions across neurological, neurodevelopmental, neuropsychiatric, and non-clinical populations: A systematic review

Abstract

Virtual reality (VR) offers interactive environments that may support executive-function (EF) training. This systematic review examined the VR technologies used, their effects on EF outcomes, and the maintenance of effects across neurological, neurodevelopmental, neuropsychiatric, and non-clinical populations. Following PRISMA 2020, we searched Web of Science, PubMed, Scopus, and Google Scholar for peer-reviewed empirical studies published from January 1, 2015, to December 31, 2025. Eligible studies examined VR-based interventions targeting one or more EF domains. Fourteen studies met the inclusion criteria. Interventions ranged from non-immersive screen-based systems and telerehabilitation platforms to fully immersive head-mounted display systems. Common approaches included serious games, everyday-life simulations, adaptive difficulty, and performance feedback. The most consistent improvements were reported for inhibitory control, cognitive flexibility or shifting, and planning or problem solving. Findings for working memory or updating were more mixed. Studies using domain-specific EF measures, such as the Stroop test, Trail Making Test, and Tower of London, provided clearer evidence than studies relying mainly on global cognitive measures. Most studies assessed outcomes only immediately after intervention, and few included follow-up assessments. VR-based interventions show promise for improving selected executive processes across clinical and non-clinical populations, but effects vary by population, intervention design, and outcome measure. Longer follow-up, standardized EF measures, and functional outcomes are needed to clarify the durability and clinical relevance of these effects.