Effect of Video Games or Virtual Reality in Reducing Symptoms of Cognitive Deficits in Children and Adolescents with ADHD: A Systematic Review
Authors:   Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy, Ambrosio Luca ,   Università Campus Bio-Medico di Roma, Rome, Italy, Marian Sibin ,   Principles and Practice of Clinical Research, Harvard TH Chan School of Public Health ECPE, Boston, USA, Gameiro Rodrigo Rosa ,   Universidade Federal do Paraná (UFPR) Paraná, Brazil, Mohammed Tajudeen Olakunle ,   Obafemi Awolowo University Teaching Hospitals Complex, IleIfe, Nigeria, Couto Moreira Ana Paula ,   University Federal Fluminense, Niteroi, Brazil, Mateus André Ricardo ,   Head of Department of Otorhinolaryngology, Oswaldo Cruz German Hospital, Sao Paulo, Coimbra Brendha Cação ,   Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Piotto Bruna Fornazieri ,   Associação Beneficente Síria Hcor, São Paulo, Brazil, Alvarez Huaman Claudia Sheyla ,   Universidad científica del Sur (UCSUR), Peru, Junger de Oliveira Daniel Athayde ,   Multivix School of Medicina Cachoeira de Itapemirim, ES, Brazil, Mesquita Arra Dante Altenfelder Silva ,   Ac Camargo Câncer center São Paulo, Brazil, Lincango Eddy P. ,   Ciencias Medicas Universidad Central del Ecuador Quito, Ecuador, Ledesma Elizabeth Guzmán ,   Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic, Garza Frias Emiliano ,   Massachusetts General Hospital, Harvard Medical School, Boston, Peixoto de Miranda Érique José Farias ,   Butantan Institute São Paulo, Brazil, Morales Ubico Erika Elizabeth ,   Universidad Francisco Marroquín, Guatemala, Velasquez Hammerle Maria Virginia ,   Massachusetts General Hospital, Harvard Medical School, Boston, Moreira Lemos Marta Maria ,   Ac Camargo Câncer center São Paulo, Brazil, Coelho Rafael Correa ,   Programa de Pos Graduação em Ciências Médicas Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil, Gomes de Molla Raissa Pavoni ,   Ac Camargo Câncer center São Paulo, Brazil, Guatibonza-García Valentina ,   Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Grudtner Roberta Rossi ,   São Pedro Psychiatric Hospital, Secretaria Estadual da Saúde Rio Grande do Sul, Porto Alegre, Brasil
Published: July 2023

Introduction: Attention-deficit hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental diseases affecting children and adolescents worldwide. Standard treatments often include a combination of pharmacotherapy and cognitive interventions. In the last decade, the effects of video game- and virtual reality (VR)-based treatments have been investigated as viable additional strategies to tackle ADHD symptoms. Methods: A systematic literature review was conducted to identify studies that compared video game or VR-based interventions with standard care in children and adolescents affected by ADHD, evaluating cognitive, motor, and behavioral outcomes. The RoB-2 and MINORS tools were utilized to assess the risk of bias in included studies. Results: Five studies published between 2001 and 2021 were included (437 patients, mean age: 10.74). Four studies investigated a video game-based intervention, and the remaining study employed VR. Collectively, the studies showed little to no effects on investigated outcomes. However, most of them were also affected by severe methodological issues carrying a moderate-to-high risk of bias. Discussion: ADHD is a complex disorder often needing a multi-dimensional, individualized therapeutical approach. Video games and VR carry substantial advantages, such as higher patient involvement, cost-effectiveness, and subtle improvements in cognitive and behavioral outcomes. However, additional well-designed clinical trials are needed to prove their efficacy in pediatric patients with ADHD.