Cognitive and neural outcomes of executive function training in healthy adults: A systematic review

Cognitive training can strengthen executive functions, essential cognitive abilities for adaptive behavior. While prior reviews have emphasized task-specific outcomes or age-related decline prevention, few have systematically integrated evidence on both cognitive and neural adaptations in healthy adults. This systematic review (PROSPERO: CRD420251107775), conducted under PRISMA 2020 guidelines, synthesizes 26 randomized controlled trials (2018–2025) that examined executive functions training with cognitive and neural outcomes in healthy adults. Across studies (N _total = 1370; n _intervention = 704; n _control = 666), training reliably improved working memory and inhibitory control, with adaptive and multidomain protocols yielding the broadest transfer effects. Cognitive gains were moderate to large (Cohen’s d = 0.6–1.7), and some studies reported very large effects (Hedges’ g > 2.0). More modest effects emerged in mindfulness and exergame protocols, whereas a few trials reported null findings. Neural evidence revealed consistent functional plasticity, including modulation of Event Related Potential components, theta–gamma coupling, β / α asymmetry, and increased prefrontal or frontoparietal activation, while structural changes were more heterogeneous. Notably, 11 studies reported direct brain–behavior correlations ( r = .35–.63), mainly involving prefrontal, frontoparietal, and hippocampal networks and oscillatory dynamics. These findings indicate that behavioral improvements often reflect genuine neural reorganization rather than mere task practice. Nonetheless, methodological constraints (small samples, short interventions, and limited preregistration) challenge the overall certainty of evidence. In conclusion, cognitive training represents a promising approach to strengthen EF and promote cognitive resilience in healthy adults, underscoring the need for larger, ecologically valid, and multimodal trials to support translational applications.