Background: Neurodegenerative diseases cause both progressive motor and cognitive impairments for which no curative treatments exist. Virtual reality (VR)-based rehabilitation has emerged as a promising strategy to enhance physical rehabilitation by offering immersive, engaging, and personalized environments. Methods: A systematic review was conducted following the PRISMA guidelines, examining studies published between 2020 and 2025 in the Web of Science and Scopus. Twelve studies met the inclusion criteria, focusing on VR-based physical rehabilitation in individuals with neurodegenerative diseases. Results: Most studies reported significant improvements in balance, gait, postural control, and motor function. Some studies also found benefits in processing speed, executive function, emotional well-being, and activities of daily living. Across different levels of immersion, VR interventions showed high usability and were well tolerated, even among older adults. However, methodological limitations, such as small sample sizes, a lack of control groups, and short intervention durations, were prevalent. Conclusions: VR has demonstrated to be an effective and well-tolerated tool for the rehabilitation of individuals with neurodegenerative diseases such as Parkinson’s disease and multiple sclerosis. However, the confirmation of its clinical efficacy and long-term impact necessitates the execution of randomized controlled trials with larger samples and extended follow-up periods.

Spatial memory, a fundamental cognitive function, enables individuals to encode, store, and retrieve information about their surroundings. Traditional assessment methods, such as paper-based tests and laboratory paradigms, often lack ecological validity and fail to capture the complexities of real-world navigation. Recent advancements in digital technologies, particularly virtual reality (VR) and mixed reality (MR), have introduced innovative tools for more immersive and accurate spatial memory assessments. VR provides controlled, replicable environments that simulate real-world navigation, while MR enhances engagement by blending virtual elements with physical spaces. This narrative review explores the cognitive mechanisms underlying spatial memory, highlighting the roles of egocentric and allocentric reference frames, as well as the neural substrates involved. The review also examines key factors influencing spatial memory performance, such as age, sex, neurological and neurodegenerative diseases. Digital tools such as the virtual Morris water maze and the VR Supermarket Test have been shown to possess enhanced ecological validity and diagnostic potential, particularly in the context of detecting early cognitive decline in Alzheimer’s disease. However, the field confronts several challenges, including the necessity for standardized protocols, the potential for adverse effects such as cybersickness, and the substantial cost associated with VR and MR systems. Future research directions in this field should include the integration of artificial intelligence for personalized assessments, and the combination of VR and MR tasks with neurophysiological techniques to advance understanding of spatial memory. Standardization, accessibility, and the creation of adaptive assessment for clinical populations will be crucial for optimizing the use of digital technologies in spatial memory research.

Although sex differences in spatial cognition have been widely studied, the extent to which men and women differ in their use of egocentric and allocentric spatial strategies remains unclear. This systematic review summarizes findings from 21 studies published between 2014 and 2024 that examined sex differences in spatial strategy use throughout development, adulthood, and aging. Studies were identified through searches of Scopus, Web of Science, PubMed, and PsycINFO, in accordance with PRISMA guidelines. Eligible articles examined egocentric and allocentric spatial strategies in humans and reported results by sex. Results demonstrated male advantages in allocentric strategy, as observed in thirteen studies involving children, young adults, and older adults. Men also outperformed women in several navigation outcomes, including target retrieval, route efficiency, and directional accuracy. Evidence for a female advantage in egocentric strategies was limited and inconsistent. Seven studies reported no sex differences, particularly those using small-scale, familiar, or less immersive tasks. This suggests that methodological factors and task demands strongly influence the observed effects. Age also influenced outcomes. Male advantages in allocentric strategies emerged in early childhood. Older women showed relatively preserved egocentric abilities, but greater decline in allocentric tasks. Men showed stronger hippocampal-parietal connectivity supporting allocentric processing, while women exhibited enhanced fronto-temporal connectivity. Hormonal studies highlight the context-dependent effects of testosterone and estrogen. These findings indicate that sex differences in spatial strategies are highly sensitive to task complexity, environmental familiarity, cognitive load, and individual factors. These findings emphasize the necessity of integrative models that consider developmental, neurobiological, and sociocultural contributors.

La enseñanza de la neuroanatomía mediante recursos bidimensionales puede dificultar la comprensión espacial de las estructuras cerebrales, lo que ha favorecido la incorporación de metodologías inmersivas en educación superior. Este estudio tuvo como objetivo evaluar la viabilidad pedagógica de la realidad virtual (RV) inmersiva y analizar el aprendizaje asociado a su uso como recurso didáctico para el estudio del sistema nervioso central. Participaron 26 estudiantes de primer curso del Grado en Logopedia, quienes realizaron una sesión práctica con la aplicación Human Anatomy VR. Mediante cuestionarios y una prueba objetiva se evaluaron la sintomatología adversa, el sentido de presencia, la satisfacción y el rendimiento en conocimientos neuroanatómicos y funcionales. Los resultados mostraron ausencia de sintomatología adversa en el 76,44% de los registros del Simulator Sickness Questionnaire (SSQ), un elevado sentido de presencia y altos niveles de satisfacción. Sin embargo, la proporción de aciertos fue menor en los contenidos trabajados mediante RV inmersiva que en los impartidos mediante enseñanza teórica tradicional. En conjunto, la RV inmersiva se mostró como un recurso viable y bien aceptado, aunque es necesario optimizar su diseño instruccional y emplear evaluaciones más controladas para determinar su impacto sobre el aprendizaje.

Background/Objectives: The ability to preserve cognitive health in aging populations increasingly relies on early detection and intervention in neurodegenerative processes. Spatial memory, a fundamental cognitive ability supporting navigation, environmental awareness, and daily independence, often deteriorates in the preclinical stages of neurodegenerative diseases. However, conventional assessment tools frequently lack ecological validity and fail to capture the multifaceted nature of spatial cognition in real-world contexts. This systematic review aims to examine the application of immersive technologies, specifically Immersive Virtual Reality (VR) and Mixed Reality (MR), in the evaluation and rehabilitation of spatial memory. Methods: Following PRISMA guidelines, a total of 42 peer-reviewed studies were selected from SCOPUS, Web of Science, and PubMed databases. We included original, peer-reviewed studies that assessed spatial memory or cognition using VR/MR in adults aged ≥50 or clinical populations at neurodegenerative risk and reported quantitative data or diagnostic validity. A narrative synthesis was performed to examine the most employed immersive tools, assessing their benefits, limitations, and practical challenges. Results: Findings indicate substantial variability in diagnostic sensitivity, ecological validity, and user engagement across platforms. Nevertheless, the evidence supports the potential of immersive environments as effective tools for the early detection of spatial disorientation and cognitive decline, particularly in at-risk populations such as individuals with Mild Cognitive Impairment and Alzheimer’s Disease. Conclusions: Immersive and semi-immersive VR technologies represent a promising advancement in spatial memory assessment and rehabilitation, offering scalable solutions for both clinical and home-based interventions in aging populations.