Brain–Computer Interface Games for Cognitive Assessment: A Scoping Review

BACKGROUND: Traditional cognitive assessments rely on verbal or motor responses, posing challenges for individuals with communication or mobility impairments. Brain-computer interface (BCI) games could enable cognitive assessments without motor or verbal demands. OBJECTIVE: This scoping review synthesizes the current literature on BCI games for cognitive assessment, identifying trends, gaps and future research directions, to inform the development of more accessible electroencephalogram (EEG)-based tools. METHODS: Seven electronic databases were systematically searched using Arksey and O'Malley's framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews guidelines. Studies were reviewed based on game types, BCI paradigms, electrode placement, brainwave frequencies and cognitive skills assessed. Study design, population characteristics and comparisons to standardized assessments were extracted. RESULTS: Of the 4735 screened studies, 33 met the inclusion criteria, totaling 694 participants. Most studies (61%) examined adults, 33% focused on children and 6% on older adults. Neurotypical individuals comprised 76%, with 18% having attention deficit hyperactivity disorder. Attention was the most studied cognitive skill (88%), followed by memory (27%), inhibition (18%) and spatial perception (12%). The most used BCI devices were MindWave (42%) and Emotiv EPOC+ (21%), which analyzed β and θ brainwaves. Only 27% investigated the relationship between BCI games and cognitive standardized assessments, with most showing moderate-to-strong correlations. CONCLUSION: BCI games show promise as adapted cognitive assessment tools but require further validation. Expanding research beyond attention to include diverse populations will enhance inclusivity. The predominance of attention-focused tasks and consumer-grade EEG devices highlights the need for rigorous, population-specific validation frameworks to advance BCI games as clinically credible assessment tools.