Keywords

1 Introduction

Executive functions are a group of higher-order mental abilities that allow humans to consciously control their behavior and cognition [1]. These mental abilities have been described as inhibitory control, working memory, cognitive flexibility, emotional regulation, monitoring, behavioral supervision, verification, planning, initiative, organization of materials, among others [2].

The frontal lobe of the human brain has been related as the neuronal substrate that allows the work of the executive functions and when this structure is immature or affected, the human being presents a disorganization in his behavior in the different spheres in which he operates [3]. For this reason, it is of vital importance to study these mental abilities and the role in the life of the people [4].

In the field of research on executive functions, it has been reported that these mental abilities play a very important role in aspects such as academic performance, success in social relationships, organization of daily activities, participation in sports, achievement of objectives, control of emotions, fidelity and other areas. For this reason, executive functions are a topic of current interest and should be investigated from various areas, as in the case of this article, from technological context [1].

There are three techniques for assessing executive functions. First, techniques developed specifically to measure these skills, e.g. with the Stroop test, Hanoi tower, Wisconsin charts, digit retention, etc. [5]. These types of tests are classically applied in neuropsychological evaluation processes of people with brain damage or some cognitive problem [6].

A second method of evaluation of executive functions are non-specific tests, which are all the psychological evaluation instruments that have been developed to evaluate other mental or behavioral functions, however, in neuropsychology they are widely used to have a clinical criterion of how work executive functions [7].

The third type of evaluation of executive functions is deferred behavioral observation, which is based on the evaluation of these mental abilities through the report of a third person (parent, teacher, psychologist, etc.) or by a self-report of the own person involved in the evaluation process [8]. In this type of evaluation, the use of questionnaires and scales on behavior in daily life is characteristic, where executive functions play an important role [9].

This article focuses on the context of neuropsychological evaluation of executive functions, since we are interested in identifying the technological developments that have been made to evaluate them. In the next part of this article, we present a systematic review study where we have delved into the different technological devices created in the neuropsychological evaluation of executive functions.

2 Method

The present study was carried out using the systematic review methodology of several academic articles. This work was carried out through two procedures: (a) first, inclusion and exclusion criteria were determined for the selection of relevant data for this study; (b) second, a protocol was carried out to analyze the information from the selected articles to achieve the objective of identifying the technological devices developed to evaluate executive functions.

For the systematic review of the research found, it was necessary to comply with five stages (See Fig. 1):

  1. A.

    Identification stage: a search of academic articles was carried out in the Scopus metabase and main journals in the context of psychology. The temporal range were works published between 2015 and 2023, using keywords in English and Spanish “executive functions, technology, assessment, psychology, frontal lobe”. Regarding language, the selected articles were in English or Spanish. Two searches were carried out using the respective keywords and filters in each metabase.

  2. B.

    Duplicate stage: duplicate articles were removed.

  3. C.

    Eligibility stage: inclusion and exclusion criteria were determined to obtain relevant data that contribute to the objective of the study.

  4. D.

    Selection stage: the articles were downloaded to be read completely and through the application of the inclusion and exclusion criteria. The articles related to the investigation were selected.

  5. E.

    Bias stage: An expert in systematic review processes in executive functions supervised the entire process; in addition, constant reviews were carried out to identify adequate compliance with the inclusion and exclusion criteria in the analysis of the articles worked on in the investigation.

2.1 Inclusion and Exclusion Criteria

Inclusion: The article develops or analyzes a technological device to evaluate executive functions. It is an article with the participation of human beings and measurements of the developed device.

Exclusion: The article analyzes a paper and pencil or traditional procedure, without technological elements, to evaluate executive functions. The article develops a rehabilitation investigation and not an evaluation.

Figure 1 shows the flowchart that guided this research with the phases: 1 Identification, 2 Duplicate, 3 Eligibility, 4 Selection and 5 Bias. After the analysis process of the articles, eight papers were included which are processed in the following results section.

Fig. 1.
figure 1

Systematic review followed in this research.

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3 Results

After carrying out the analysis, eight studies [10,11,12,13,14,15,16,17,18] were identified with which the results were processed. Regarding the average number of participants found in the studies, an average sample size of M = 242.38 (SD = 533.79) was found. In most investigations were found a frequency between 0 and 100 participants. This data can be seen in Fig. 2.

Fig. 2.
figure 2

Study sample size ranges.

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In relation to the countries where selected investigations were carried out, it was found that Italy as the country with the highest index of technological development to evaluate executive functions. Figure 3 shows these results.

Fig. 3.
figure 3

Countries that have generated technology to assess executive functions.

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Regarding the type of population that benefits from technological developments for the evaluation of executive functions, we worked with participants with a minimum level of primary education. Figure 4 shows the characteristics of the participants.

Fig. 4.
figure 4

Characteristics of the participants.

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After carrying out the analysis of the eight articles, seven technological devices developed to assess executive functions were found. These data are presented in the bar graph of Fig. 5.

Fig. 5.
figure 5

Technological developments to evaluate executive functions.

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Regarding the limitations of the technological developments found, it could be mentioned that in some of the devices post-evaluation processes are required, in addition to being expensive in some cases, which limits the type of population that could be evaluated.

On the other hand, some devices are new and the sample of their studies is small, which requires further investigation with a less biased population. Also, some instruments that use virtual reality, the resolution quality is lower compared to others available in the current market.

In relation to the executive functions that are evaluated in the different technological devices, it was found that working memory and inhibition are the ones that are most valued. Figure 6. Shows the executive functions evaluated.

Fig. 6.
figure 6

Executive functions evaluated with the technological devices. Note. EF1: Work Memory. EF2: Verbal Fluency. EF3: Inhibition. EF4: Cognitive Flexibility. EF5: Planning. EF6: Troubleshooting. EF7: Decision Making. EF8: Attentional control. EF9: Speed of Thought. EF10: Self-regulation.

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4 Conclusions

In this article we have reported a systematic review investigation that aimed to identify technological devices developed to neuropsychologically assess executive functions. As a result of this review, eight articles were found that have developed technological devices to assess executive functions: Drawing clock test (DCT), EYT (2D) and eFun (3D), Virtual reality and brain measurement, Multiple Errands Test (MET), IRCCS Fondazione Don Carlo Gnochi ONLUS, Activate Test of Embodied Cognitivo (ATEC) and, The Psychological Experiment Building Language (PEBL).

The main aspect of the technological developments found is the evolution that is carried out in the process of neuropsychological evaluation of executive functions, since the only way to evaluate these cognitive abilities was the use of tasks that included the use of pencil and paper, or in the best of cases, some physical object. Which can be an artificial environment for today’s society that bases all its activities on technology.

Advancing in this type of evaluation is a great contribution, since today’s society bases the vast majority of its activities on the use of technological devices and this reality cannot be alien to the neuropsychological evaluation process. In this way, it is achieved that people who receive the evaluation of executive functions do so with devices that are more natural to their current life and not only with obsolete techniques [18].

Regarding aspects that must be improved in the analyzed applications, the fact that the clinician must have specific training for their use is highlighted. Another aspect that should be mentioned lies in the need to have regulatory data to use the devices in the general population. It is also important to motivate a change of attitude in the mental health sciences, where more space is generated for technological development to carry out the work of evaluation or rehabilitation of patients with acquired brain damage, because many times, the proposed activities generate little interest for the patient because they are not updated.

And finally, the importance of carrying out subsequent studies where technological developments are put to the test and their convergent validity with classical neuropsychological tests is assessed. In a future study we intend to carry out a systematic review of the technological devices used in neuropsychological rehabilitation.