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The Cognitive Neurology Research Group at the Nuffield Department of Clinical Neurosciences has shown that remote digital cognitive testing can detect subtle cognitive impairments in chronic autoimmune limbic encephalitis (ALE) patients.

Examples of word and image-related cognitive tests

In recent years, the COVID-19 pandemic and the pressure to reduce healthcare costs have precipitated a move towards contactless medical attention. It is therefore important to establish whether digital and remote testing methods can assess cognition accurately in patients with cognitive decline associated with ageing and neurological disease.

The validation of online cognitive assessment tools significantly facilitates the quantitation of cognition. Further research to assess its ability to track changes in cognition over time is vital to enhance the clinical utility of this digital technology.
- Kengo Shibata

A new research study, led by DPhil student Kengo Shibata and published in eClinicalMedicine, used an online cognitive assessment tool to evaluate cognitive functions in a group of 21 patients with chronic ALE known to have residual cognitive deficits, and 54 age-matched healthy controls. The researchers asked the patients to complete 12 cognitive tasks from the Cognitron online platform, such as remembering images of everyday objects, matching a configuration of tiles by removing shapes from an existing layout, and assessing the associations of two pairs of words.

The researchers compared the scores retrieved online with neuropsychological assessments conducted in the clinic. They then looked at this data alongside information about the extent of damage to specific brain regions revealed through neuroimaging.

The team found that the digital assessments correlated strongly with both traditional pen and paper neuropsychological scores and the extent of brain damage. Furthermore, visuospatial and language deficits, not identified by pen and paper testing was characterised using the online cognitive assessment. Their findings, published in eClinicalMedicine, validate the sensitivity of cognitive online testing.

This research from the Cognitive Neurology Research Group provides a proof of concept that such testing can sensitively assess cognitive functions and facilitates the use of cognition as an outcome measure in various neurological disorders – especially those where subtle cognitive decline is a concern.

Funding for this research was provided by the Wellcome Trust, Medical Research Council, National Institute for Health Research, Rhodes Scholarship, and the Berrow Foundation Scholarship.