Effects of fully immersive virtual reality training on cognitive function in patients with mild cognitive impairment: a systematic review and meta-analysis.
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Abstract
Background: Mild cognitive impairment (MCI) is a prodromal stage of dementia. There is no specific medication to slow the progression of MCI. Recent studies have confirmed the positive effects of virtual reality (VR). However, the results are inconsistent due to different types of VR interventions, small sample sizes, and the varying quality of the literature. This study aimed to assess the effects of fully immersive VR on cognitive function in MCI patients.
Methods: A systematic review of published literature was conducted using PubMed, Cochrane Library, Embase, CINAHL, Web of Science, SinoMed, CNKI, Wanfang, and VIP Database. The search period was from inception through March 1, 2024. Eligible studies were randomized controlled trials evaluating the effects of fully immersive virtual reality training on cognitive function in MCI patients. Two investigators independently performed literature screening, data extraction, and quality assessment; a meta-analysis of the included literature was performed using RevMan 5.4. The Cochrane Risk of Bias tool was used to assess the methodological quality.
Results: A total of 11 randomized controlled trials with 525 patients were included. The meta-analysis showed that fully immersive virtual reality training had significant effects on global cognitive function (MD = 2.34, 95% CI [0.55, 4.12], p = 0.01); (MD = 0.93, 95% CI [0.30, 1.56], p < 0.01), executive function (SMD = -0.60, 95% CI [-0.84, -0.35], p < 0.01), and attention (MD = 0.69, 95% CI [0.15, 1.23], p = 0.01). Still, the difference in memory (SMD = 0.27, 95% CI [-0.24, 0.78], p = 0.30) was not statistically significant. Subgroup analyses showed that executive function could be improved only when the intervention duration was ≥40 h. In contrast, excessive training (≥30 times) was counterproductive.
Conclusion: Fully immersive virtual reality training improved cognitive functioning, executive functioning, and attention in MCI patients but was less effective in improving memory. Subgroup analysis suggests that fully immersive VR training must ensure sufficient intervention duration while avoiding frequent interventions.
背景：轻度认知障碍（Mild cognitive impairment， MCI）是痴呆的前驱阶段。没有特定的药物可以减缓轻度认知损伤的进展。最近的研究证实了虚拟现实（VR）的积极影响。然而，由于不同类型的虚拟现实干预、小样本量和文献质量不同，结果不一致。本研究旨在评估完全沉浸式VR对轻度认知损伤患者认知功能的影响。方法：采用PubMed、Cochrane Library、Embase、CINAHL、Web of Science、SinoMed、CNKI、万方、VIP数据库对已发表文献进行系统综述。搜索期从开始到2024年3月1日。符合条件的研究是随机对照试验，评估完全沉浸式虚拟现实训练对轻度认知障碍患者认知功能的影响。两名研究者独立进行文献筛选、数据提取和质量评估；采用RevMan 5.4对纳入的文献进行meta分析。采用Cochrane偏倚风险工具评估方法学质量。结果：共纳入11项随机对照试验，525例患者。meta分析显示，完全沉浸式虚拟现实训练对整体认知功能有显著影响（MD = 2.34,95% CI [0.55, 4.12], p = 0.01）；（MD = 0.93,95% CI [0.30, 1.56], p p p = 0.01）。然而，在记忆方面的差异（SMD = 0.27,95% CI [-0.24, 0.78], p = 0.30）无统计学意义。亚组分析显示，只有当干预时间≥40小时时，执行功能才能得到改善。相反，过度训练（≥30次）会适得其反。结论：完全沉浸式虚拟现实训练改善了MCI患者的认知功能、执行功能和注意力，但在改善记忆方面效果较差。亚组分析表明，完全沉浸式VR训练必须确保足够的干预时间，同时避免频繁的干预。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/, PROSPERO （CRD42024498629）。
期刊介绍：
Frontiers in Human Neuroscience is a first-tier electronic journal devoted to understanding the brain mechanisms supporting cognitive and social behavior in humans, and how these mechanisms might be altered in disease states. The last 25 years have seen an explosive growth in both the methods and the theoretical constructs available to study the human brain. Advances in electrophysiological, neuroimaging, neuropsychological, psychophysical, neuropharmacological and computational approaches have provided key insights into the mechanisms of a broad range of human behaviors in both health and disease. Work in human neuroscience ranges from the cognitive domain, including areas such as memory, attention, language and perception to the social domain, with this last subject addressing topics, such as interpersonal interactions, social discourse and emotional regulation. How these processes unfold during development, mature in adulthood and often decline in aging, and how they are altered in a host of developmental, neurological and psychiatric disorders, has become increasingly amenable to human neuroscience research approaches. Work in human neuroscience has influenced many areas of inquiry ranging from social and cognitive psychology to economics, law and public policy. Accordingly, our journal will provide a forum for human research spanning all areas of human cognitive, social, developmental and translational neuroscience using any research approach.
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