Marianna Contrada -

Objectives: This systematic review examines the combined use of transcranial direct current stimulation (tDCS) and virtual reality (VR) in healthy populations, with the aim of clarifying their synergistic potential for enhancing cognitive performance, emotional regulation, and general skills in non-clinical contexts. Methods: Following PRISMA guidelines, a comprehensive search of electronic databases (2000–September 2025) identified randomized and non-randomized studies employing simultaneous tDCS and VR in healthy individuals. Studies reporting psychological or cognitive quantitative outcomes were included. Risk of bias was assessed using RoB-2 and ROBINS-I tools. Results: Thirteen studies met inclusion criteria. Despite methodological heterogeneity in VR systems, stimulation parameters, and targeted brain regions, several convergent findings emerged. Significant enhancements were observed in sustained attention, inhibitory control, signal detection, and task learning. Emotional-regulation benefits were reported in impulsivity reduction and anxiety attenuation, particularly when anodal tDCS targeted prefrontal areas during VR exposure. Improvements in motor and procedural skills were also documented. Conversely, no consistent effects were found for cybersickness reduction, postural balance training, or spatial navigation. Neurophysiological correlates of behavioral change remain inconclusive across studies. Conclusions: Evidence suggests that combined tDCS–VR protocols may produce additive or synergistic effects on attention, inhibitory control, and anxiety modulation in healthy individuals, outperforming single-modality interventions in several domains. Future research should optimize stimulation targeting, define VR environments tailored for enhancement, and validate neurophysiological markers to advance the preventive and functional potential of this multimodal approach.