Hamada Takehiko, Seki Masaki, Nango Eishu, Shibata Taro, Imai Shinya, Miyata Toshio
Waseda University, Waseda Research Institute for Science and Engineering, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.
Okute Hospital, 121 Okutecho, Mizunami, Gifu 509-6471, Japan; Dokkyo Medical University Graduate School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
Psychiatry Res. 2025 Jun;348:116447. doi: 10.1016/j.psychres.2025.116447. Epub 2025 Mar 15.
While numerous reviews examine digital interventions, including computer game-based, evidence regarding their effectiveness for ADHD symptoms remains mixed. Focusing on computer game-based interventions, this study aims to identify specific intervention features and trial-related factors that influence outcomes in pediatric ADHD symptoms through a systematic review and meta-analysis of randomized controlled trials.
Comprehensive literature searches were conducted in Web of Science, PubMed and PsycINFO. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Seventeen studies were included. Beyond common game characteristics, some interventions incorporated additional elements-such as neurofeedback, physical exercise via virtual reality (VR) and social components-allowing subgroup analyses. The neurofeedback subgroup showed the largest effect size (standardized mean difference (SMD)=-0.51, 95 % confidence interval (CI) [-0.88, -0.15], heterogeneity index (I)=45.85 %, p < 0.05, very low certainty of evidence), followed by the physical exercise/VR subgroup (SMD=-0.40, 95 %CI [-0.76, -0.04], I=0.00 %, p < 0.05, very low certainty of evidence). Other subgroups, including those with social components or without additional elements, did not show significant effect sizes. The physical exercise/VR subgroup demonstrated small-to-medium effect sizes in both inattention and hyperactivity/impulsivity subscales, whereas the neurofeedback subgroup showed similar effects only in inattention. Trial-level factors, including participant demographics and intervention duration, showed no significant relationship with SMD in meta-regression.
Although inconclusive, synergizing with game dynamics, neurofeedback and physical exercise/VR may enhance effectiveness of computer game-based interventions in addressing pediatric ADHD symptoms. Particularly, interventions with physical exercise/VR have potential to address both inattention and hyperactivity/impulsivity.
虽然有许多综述探讨了数字干预措施，包括基于电脑游戏的干预措施，但关于其对多动症症状有效性的证据仍然不一。本研究聚焦于基于电脑游戏的干预措施，旨在通过对随机对照试验进行系统综述和荟萃分析，确定影响儿童多动症症状治疗效果的特定干预特征和与试验相关的因素。
在科学网、PubMed和PsycINFO数据库中进行了全面的文献检索。使用推荐分级评估、制定和评价（GRADE）方法评估证据的确定性。
纳入了17项研究。除了常见的游戏特征外，一些干预措施还纳入了其他元素，如神经反馈、通过虚拟现实（VR）进行体育锻炼和社交成分，从而能够进行亚组分析。神经反馈亚组的效应量最大（标准化均数差（SMD）=-0.51，95%置信区间（CI）[-0.88，-0.15]，异质性指数（I）=45.85%，p<0.05，证据确定性极低），其次是体育锻炼/VR亚组（SMD=-0.40，95%CI[-0.76，-0.04]，I=0.00%，p<0.05，证据确定性极低）。其他亚组，包括那些有社交成分或没有其他元素的亚组，均未显示出显著的效应量。体育锻炼/VR亚组在注意力不集中和多动/冲动分量表中均显示出小到中等的效应量，而神经反馈亚组仅在注意力不集中方面显示出类似的效应。试验层面的因素，包括参与者人口统计学特征和干预持续时间，在Meta回归中与SMD均无显著关系。
虽然尚无定论，但与游戏动态、神经反馈和体育锻炼/VR相结合，可能会提高基于电脑游戏的干预措施在解决儿童多动症症状方面的有效性。特别是，包含体育锻炼/VR的干预措施有潜力同时解决注意力不集中和多动/冲动问题。
