The Application of Virtual Reality in the Diagnosis, Rehabilitation, and Surgical Interventions of Neurological Disorders: A Brief Scoping Review

Document Type : Review Articles

Authors
1 PhD Candidate, Department of Management and Information Technology, School of Management and Information Technology, Science and Research Branch, Islamic Azad University, Tehran, Iran
2 Associate Professor, Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.48305/jrrs.2026.42673.1090
Abstract
Introduction: Technological advancements in the healthcare industry have introduced transformative opportunities to enhance patients' quality of life and optimize clinical services. As an emerging technology, Virtual Reality (VR) provides simulated three-dimensional environments with diverse interactive capabilities. In academic fields, the application of VR is expanding into various medical sciences, including neurological disorders. It plays a valuable role in cognitive assessments for diagnosis, rehabilitation, and medical education. Furthermore, it serves as an effective tool for training residents in preoperative planning and intraoperative procedures, as well as in interventional radiology. This study aims to review the scientific literature on the application of virtual reality in the diagnosis, rehabilitation, and surgery of neurological disorders.
Materials and Methods: In this review, a total of 30 articles were selected from an initial pool of English and Persian studies identified through PubMed and Magiran databases, accessed via Google Scholar and Science Direct. The search targeted publications indexed between 2010 and 2023 for English sources and between 2017 and 2024 for Persian sources using keywords such as “Virtual Reality”, “Rehabilitation”, “Neurological Disorders”, and “Neurosurgery”, and their Persian equivalents. In scoping studies, assessing the quality and risk of bias in articles is not mandatory; therefore, these evaluations were not performed in this study.
Results: It appears that following the application of virtual reality in disorders related to the central nervous system, a significant improvement has been observed in patients' cognitive-behavioral issues, such as attention, concentration, and stress. Based on the reviewed articles, this technology can be used to assess symptoms associated with the onset of neurological disorders. Additionally, it can be utilized in training residents both before and during surgical procedures.
Conclusion: Given the diverse applications of this technology in rehabilitation, diagnosis, and pre- and intra-surgical training, it is recommended that systematic review studies be conducted specifically within each domain, namely assessment, diagnosis, surgical treatment, and rehabilitation of neurological problems. Furthermore, such studies should explore the integration of artificial intelligence. If possible, the most optimal clinical approach for each domain should be identified.

Keywords

Subjects


1.     Gitler A, Dhillon P, Shorter J. Neurodegenerative disease: models, mechanisms, and a new hope. Disease Models & Mechanisms 2017; 10(5): 499-502.
2.     Muñoz D, Barria P, Cifuentes CA, Aguilar R, Baleta K, Azorín JM, Múnera M. EEG Evaluation in a Neuropsychological Intervention Program Based on Virtual Reality in Adults with Parkinson's Disease. Biosensors (Basel). 2022; 12(9): 751.
3.     Wang Y, Chen R, Yang Z, Wen Q, Cao X, Zhao N, Yan J. Protective Effects of Polysaccharides in Neurodegenerative Diseases. Front Aging Neurosci. 2022; 14: 917629.
4.     Vayssiere P, Constanthin P, Herbelin B, Blanke O, Schaller K, et al. Application of virtual reality in neurosurgery: Patient missing. A systematic review. clinical Neuroscience 2022; 95: 55-62
5.     Alaraj A, Lemole MG, Finkle JH, Yudkowsky R, Wallace A, Luciano C, Banerjee PP, Rizzi SH, Charbel FT. Virtual reality training in neurosurgery: Review of current status and future applications. Surg Neurol Int. 2011; 2: 52.
6.     Lasaponara S, Marson F, Doricchi F, Cavallo M. A Scoping Review of Cognitive Training in Neurodegenerative Diseases via Computerized and Virtual Reality Tools: What We Know So Far. Brain Sci. 2021; 11(5): 528.
7.     Monaghesh E, Negahdari R, Samad-Soltani T. Application of virtual reality in dental implants: a systematic review. BMC Oral Health. 2023; 23(1): 603.
8.     Venkatesan M, Mohan H, Ryan JR, Schürch CM, Nolan GP, Frakes DH, Coskun AF. Virtual and augmented reality for biomedical applications. Cell Rep Med. 2021; 2(7): 100348.
9.     Viñas-Diz S, Sobrido-Prieto M. Realidad virtual con fines terapéuticos en pacientes con ictus: revisión sistemática [Virtual reality for therapeutic purposes in stroke: A systematic review]. Neurologia. 2016; 31(4): 255-77.
10.  Calderone A, Carta D, Cardile D, Quartarone A, Rifici C, Calabrò RS, Corallo F. Use of Virtual Reality in Patients with Acquired Brain Injury: A Systematic Review. J Clin Med. 2023; 12(24): 7680.
11.  Rodríguez-Mansilla J, Bedmar-Vargas C, Garrido-Ardila EM, Torres-Piles ST, González-Sánchez B, Rodríguez-Domínguez MT, Ramírez-Durán MV, Jiménez-Palomares M. Effects of Virtual Reality in the Rehabilitation of Parkinson's Disease: A Systematic Review. J Clin Med. 2023; 12(15): 4896.
12.  Mazurek J, Kiper P, Cieślik B, Rutkowski S. Virtual reality in medicine: A brief overview and future research directions. Human Movement 2019; 20(3): 16-22.
13.  Ali SG, Wang X, Li P, Jung Y, Bi L, Kim J, Chen Y, Feng DD, Magnenat Thalmann N, Wang J, Sheng B. A systematic review: Virtual-reality-based techniques for human exercises and health improvement. Front Public Health. 2023; 11: 1143947.
14.  Ntakakis G, Plomariti C, Frantzidis C, Antoniou PE, Bamidis PD, Tsoulfas G. Exploring the use of virtual reality in surgical education. World J Transplant 2023; 13(2): 36-43.
15.  Ching Yeh SH, Chin Chen Yu, Tsai CH, Rizzo A. An innovative virtual reality system for mild cognitive impairment: Diagnosis and evaluation. IEEE-EMBS Conference on Biomedical Engineering and Sciences.2012 Dec 17-19; Langkawi, Malaysia [Abstract].
16.  Scribano Parada MDLP, González Palau F, Valladares Rodríguez S, Rincon M, Rico Barroeta MJ, García Rodriguez M, Bueno Aguado Y, Herrero Blanco A, Díaz-López E, Bachiller Mayoral M, Losada Durán R Preclinical Cognitive Markers of Alzheimer Disease and Early Diagnosis Using Virtual Reality and Artificial Intelligence: Literature Review JMIR Med Inform 2024; 13: e62914.
17.  Colombo E, Lutters B, Kos T, van Doormaal T. Application of virtual and mixed reality for 3D visualization in intracranial aneurysm surgery planning: a systematic review. Front Surg. 2023; 10: 1227510.
18.  Zaed I, Chibbaro S, Ganau M, et al. Simulation and virtual reality in intracranial aneurysms neurosurgical training: a systematic review. Journal of Neurosurgical Sciences. 2022; 66(6): 494-500.
19.  Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021: 372: n71.
20.  Arksey H, Malley O. Scoping studies: Towards a methodological framework, International Journal of Social Research Methodology: Theory and Practice, 8(1): 19-32.
21.  Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Scoping Reviews (2020). Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024. Available from: https://synthesismanual.jbi.global.
22.  Tefertiller C, Ketchum JM, Bartelt P, Peckham M, Hays K. Feasibility of virtual reality and treadmill training in traumatic brain injury: A randomized controlled pilot trial. Brain Inj. 2022; 36(7): 898-908.
23.  Gulcan K, Guclu-Gunduz A, Yasar E, Ar U, Sucullu Karadag Y, Saygili F. The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson's disease. Acta Neurol Belg. 2023; 123(5): 1917-25.
24.  Pelosin E, Ponte C, Putzolu M, Lagravinese G, Hausdorff JM, Nieuwboer A, Ginis P, Rochester L, Alcock L, Bloem BR, Nieuwhof F, Cereatti A, Della Croce U, Mirelman A, Avanzino L. Motor-Cognitive Treadmill Training With Virtual Reality in Parkinson's Disease: The Effect of Training Duration. Front Aging Neurosci. 2022; 13:753381.
25.  Shen J, Xiang H, Luna J, Grishchenko A, Patterson J, Strouse RV, Roland M, Lundine JP, Koterba CH, Lever K, Groner JI, Huang Y, Lin ED. Virtual Reality-Based Executive Function Rehabilitation System for Children With Traumatic Brain Injury: Design and Usability Study. JMIR Serious Games. 2020; 8(3): e16947.
26.  Ebrahimi-Nejad F, Oraee-Yazdani S, Vahedi M, Peyravi Dehsorkhi M, Hosseinzadeh S. Relationship between CT-Scan Findings and Longitudinal Blood Markers with the Occurrence of Death among Comatose Patients Due to Traumatic Brain Injury: Retrospective Longitudinal Study. Advances in Medical and Biomedical Research 2023; 31(147): 330-341.
27.  De Luca R, Bonanno M, Rifici C, Pollicino P, Caminiti A, Morone G, Calabrò RS. Does Non-Immersive Virtual Reality Improve Attention Processes in Severe Traumatic Brain Injury? Encouraging Data from a Pilot Study. Brain Sci. 2022; 12(9): 1211.
28.  Morris NA, Wang Y, Felix RB, Rao A, Arnold S, Khalid M, Armahizer MJ, Murthi SB, Colloca L. Adjunctive virtual reality pain relief after traumatic injury: a proof-of-concept within-person randomized trial. Pain. 2023; 164(9): 2122-29.
29.  Shen J, Xiang H, Luna J, Grishchenko A, Patterson J, Strouse RV, Roland M, Lundine JP, Koterba CH, Lever K, Groner JI, Huang Y, Lin ED. Virtual Reality-Based Executive Function Rehabilitation System for Children With Traumatic Brain Injury: Design and Usability Study. JMIR Serious Games. 2020; 8(3): e16947.
30.  Zhu K, Zhang Q, He B, Huang M, Lin R, Li H. Immersive Virtual Reality-Based Cognitive Intervention for the Improvement of Cognitive Function, Depression, and Perceived Stress in Older Adults With Mild Cognitive Impairment and Mild Dementia: Pilot Pre-Post Study. JMIR Serious Games. 2022; 10(1): e32117.
31.  De Luca R, Marra A, Pollicino P, Buda M, Mucari M, Bonanno M, Torregrossa W, Caminiti A, Rifici C, Calabrò RS. Advances in neuroRehabilitation of TREM2-related dementia: A case report on a novel multimodal approach using virtual reality. Medicine (Baltimore). 2022; 101(21): e29470.
32.  De Luca R, Naro A, Colucci PV, Pranio F, Tardiolo G, et al. Improvement of brain functional connectivity in autism spectrum disorders: an exploratory study on the potential use of virtual reality.Neural Transmission. J Neural Transm (Vienna) 2021; 128(3): 371-380.
33.  Zhao J, Zhang X, Lu Y, Wu X, Zhou F, Yang S, Wang L, Wu X, Fei F. Virtual reality technology enhances the cognitive and social communication of children with autism spectrum disorder. Front Public Health. 2022; 10: 1029392.
34.  De Luca R, Leonardi S, Portaro S, Le Cause M, De Domenico C, Colucci PV, Pranio F, Bramanti P, Calabrò RS. Innovative use of virtual reality in autism spectrum disorder: A case-study. Appl Neuropsychol Child. 2021; 10(1): 90-100.
35.  Campo-Prieto P, Cancela-Carral J, Rodríguez-Fuentes G. Immersive virtual reality to improve functional capacities in people with multiple sclerosis: study protocol. Sclerosis 2023; 1(2): 68-75.
36.  Molhemi F, Monjezi S, Mehravar M, Shaterzadeh-Yazdi M, Salehi R, et al. Effects of Virtual Reality vs Conventional Balance Training on Balance and Falls in People with Multiple Sclerosis: A Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102 (2): 290-9.
37.  Ranjbar Z; Molanorouzi K; Arab Ameri E; Shojaei M, Daneshfar A. The Effect of Physical Activity and Virtual Reality on Functional Balance in Spastic Hemiplegic Cerebral Palsy. Motor Behavior 2024; 16(57): 17-36. [In Persian].
38.  Movahedi Y, Pakzad S. The Effect of Video Games Virtual Reality Environment on Motor Function of Children with Cerebral Palsy. Community Health journal 2020; 14(1): 1-10.
39.  Taheri S, Parvinpour S, Balali M. The effect of eight weeks of virtual reality-based physical training on kinematic indicators of gait, muscle strength, and balance in women with Multiple Sclerosis. Advances in Cognitive Sciences 2022; 24(3) :1-16
40.  Lin RC, Chiang SL, Heitkemper MM, Weng SM, Lin CF, Yang FC, Lin CH. Effectiveness of Early Rehabilitation Combined With Virtual Reality Training on Muscle Strength, Mood State, and Functional Status in Patients With Acute Stroke: A Randomized Controlled Trial. Worldviews Evid Based Nurs. 2020; 17(2): 158-67.
41.  Mannan FA, Porffy LA, Joyce DW, Shergill SS, Celiktutan O. Automatic Detection of Cognitive Impairment with Virtual Reality. Sensors (Basel). 2023; 23(2): 1026.
42.  Yun Hsu H, Kuo L, Ching Lin Y, Chin Su F, Hua Yang T, et al. Effects of a Virtual Reality-Based Mirror Therapy Program on Improving Sensorimotor Function of Hands in Chronic Stroke Patients: A Randomized Controlled Trial. Neurorehabil Neural Repair 2022; 36(6): 335-45.
43.  Peláez-Vélez FJ, Eckert M, Gacto-Sánchez M, Martínez-Carrasco Á. Use of Virtual Reality and Videogames in the Physiotherapy Treatment of Stroke Patients: A Pilot Randomized Controlled Trial. Int J Environ Res Public Health. 2023; 20(6): 4747.
44.  Mo DP, Bao SD, Li L, Yi ZQ, Zhang JY, Zhang Y. Virtual reality system for diagnosis and therapeutic planning of cerebral aneurysms. Chin Med J (Engl). 2010; 123(16): 2206-10.
45.  Fabbri L, Mosca IE, Gerli F, Martini L, Pancani S, Lucidi G, Savazzi F, Baglio F, Vannetti F, Macchi C. GOAL working group the games for older adults active life (GOAL) project for people with mild cognitive impairment and vascular cognitive impairment: A study protocol for a randomized controlled trial. Front. Neurol. 2019; 9: 1040.
46.  Realdon O, Serino S, Savazzi F, Rossetto F, Cipresso P, Parsons TD, Cappellini G, Mantovani F, Mendozzi L, Nemni R, et al. An ecological measure to screen executive functioning in MS: The Picture interpretation test (PIT) 360 degrees. Sci. Rep. 2019; 9: 1-8.
47.  Cabinio M, Rossetto F, Isernia S, Saibene FL, Di Cesare M, Borgnis F, Pazzi S, Migliazza T, Alberoni M, Blasi V, Baglio F. The Use of a Virtual Reality Platform for the Assessment of the Memory Decline and the Hippocampal Neural Injury in Subjects with Mild Cognitive Impairment: The Validity of Smart Aging Serious Game (SASG). J Clin Med. 2020; 9(5): 1355.
48.  Hyuk-June Moon, Sungmin Han (2022). Perspective: Present and Future of Virtual Reality for Neurological Disorders Brain Sci. 2022; 12(12): 1692.
49.  Ferroli P, Tringali G, Acerbi F, Schiariti M, Broggi M, Aquino D, Broggi G. Advanced 3-dimensional planning in neurosurgery. Neurosurgery. 2013; 72 Suppl 1: 54-62.
50.  Vayssiere P, Constanthin PE, Herbelin B, Blanke O, Schaller K, Bijlenga P. Application of virtual reality in neurosurgery: Patient missing. A systematic review. J Clin Neurosci. 2022; 95: 55-62.
51.  Gosal JS, Tiwari S, Sharma T, Agrawal M, Garg M, Mahal S, Bhaskar S, Sharma RK, Janu V, Jha DK. Simulation of surgery for supratentorial gliomas in virtual reality using a 3D volume rendering technique: a poor man's neuronavigation. Neurosurg Focus. 2021; 51(2): E23.
52.  Shao X, Yuan Q, Qian D, et al. Virtual reality technology for teaching neurosurgery of skull base tumor. BMC Med Educ 20, 3 (2020).
53.  Hajikarimloo B, Kavousi S, Jahromi GG, Mehmandoost M, Oraee-Yazdani S, Fahim F. Hyperbaric Oxygen Therapy as an Alternative Therapeutic Option for Radiation-Induced Necrosis Following Radiotherapy for Intracranial Pathologies. World Neurosurg. 2024; 186: 51-61.
54.  Sprengel U, Saalfeld P, Stahl J, Mittenentzwei S, Drittel M, Behrendt B, Kaneko N, Behme D, Berg P, Preim B, Saalfeld S. Virtual embolization for treatment support of intracranial AVMs using an interactive desktop and VR application. Int J Comput Assist Radiol Surg. 2021; 16(12): 2119-27.
55.  Hajikarimloo B, Fahim F, Sabbagh Alvani M, Oveisi S, Zali A, Anvari H, Oraee-Yazdani S. Management of Glioblastoma Multiforme During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic: A Review of the Literature. World Neurosurg. 2023; 178: 87-92.
56.  Bernard F, Clavreul A, Casanova M, Besnard J, Lemée JM, Soulard G, Séguier R, Menei P. Virtual Reality-Assisted Awake Craniotomy: A Retrospective Study. Cancers (Basel). 2023; 15(3): 949.
57.  Zawy Alsofy S, Sakellaropoulou I, Nakamura M, Ewelt C, Salma A, Lewitz M, Welzel Saravia H, Sarkis HM, Fortmann T, Stroop R. Impact of Virtual Reality in Arterial Anatomy Detection and Surgical Planning in Patients with Unruptured Anterior Communicating Artery Aneurysms. Brain Sci. 2020; 10(12): 963.
58.  Grazia Maggio M, Stagnitti M, Rizzo E, Andaloro A, Manuli A, et al. Limb apraxia in individuals with multiple sclerosis: is there a role of semi-immersive virtual reality in treating the Cinderella of neuropsychology? Multiple Sclerosis and Related Disorders,69, 104405, 2023
59.  Gabrielle Gray  H, Tchao D, Lewis-Fung S, Pardini S, Harris LR, et al. Virtual Reality therapy for people with Epilepsy and related anxiety: protocol for a 3-phase pilot clinical trial. JMIR research protocols 2023; 12(1): e41523.
Moncada Martins F, Martín S, González V, Alvarez V. Virtual reality and machine learning in the automatic photoparoxysmal response detection. Neural Computing and Applications 2023; 35(8): 5659-843.