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REVIEW ARTICLE

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

Nikolaos Drakatos1,2* ,  Pantelis Pergantis1* ,  Andreas Petropoulos3,4 ,  Nikolaos Bardis2 ,  Nikolaos Doukas2 ,  Athanasios Drigas1*
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1 Net Media Lab & Mind & Brain R&D, Institute of Informatics & Telecommunications, National Centre of Scientific Research “Demokritos,” Agia Paraskevi , Greece
2 Hellenic Army Academy, Leoforos Eyelpidon (Varis – Koropiou) Avenue Vari , Greece
3 Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens , Greece
4 Department of Physiotherapy, School of of Health Sciences, University of Thessaly, Lamia , Greece
Advanced Neurology, 026290039 https://doi.org/10.36922/AN026290039
Received: 17 July 2026 | Revised: 12 August 2026 | Accepted: 18 August 2026 | Published online: 27 August 2026
(This article belongs to the Special Issue Mechanisms and Interventions for Emotional and Cognitive Disorders)
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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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.

Keywords
Virtual reality
Executive functions
Cognitive training
Inhibition
Cognitive flexibility
Working memory
Funding
None.
Conflict of interest
The authors declare no conflicts of interest.
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