Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales

Online cognitive monitoring technology for people with Parkinson’s disease and REM sleep behavioural disorder

“…More broadly, the observation of superior patient-group discrimination aligned with studies applying online assessment tasks in other clinical populations, e.g., Multiple Sclerosis 11 , dementia 29 , traumatic brain injury 10 , 12 , COVID-19 30 and autoimmune limbic encephalitis 33 . Taken together, the achieved accessibility, heightened discriminability, and superior assessment detail indicate potential value for evaluating early-stage and prodromal patients, enabling the detection of subtle cognitive changes and measuring early-stage intervention effects.…”

“…Online testing alleviates these burdens and reduces costs. With careful design, it has the potential to engage participants more effectively through gamification and, crucially, may be repeated many times 10 , enabling large-scale regular longitudinal monitoring accessible from individuals’ homes for research purposes 11 and as an adjunct to in-person assessments 12 . The advantages of unsupervised online deployment extend to automated scoring and data export, minimising the time individual assessors spend on data management following appointments 12 .…”

“…With careful design, it has the potential to engage participants more effectively through gamification and, crucially, may be repeated many times 10 , enabling large-scale regular longitudinal monitoring accessible from individuals’ homes for research purposes 11 and as an adjunct to in-person assessments 12 . The advantages of unsupervised online deployment extend to automated scoring and data export, minimising the time individual assessors spend on data management following appointments 12 . Furthermore, modelling of detailed performance timecourses can output model-based and contrast measures of specific aspects of cognitive processing, e.g., subtracting out and quantifying components of performance variance that relate to basic visuomotor slowing 13 , 14 .…”

“…A new battery assessing cognition in PD should be at least as sensitive to PD and RBD as these scales. Indeed, it would be advantageous to outperform them, as they are known to have limited detail across cognitive domains and poor sensitivity to subtle cognitive changes 12 , especially in early-stage PD 26 , whereas computerised assessments can provide more detailed and precise outputs 13 . Consequently, an optimal assessment battery might also capture cognitive domains that are divergent from those scales whilst being affected in early and prodromal PD.…”

“…Specifically, we objectively assessed the cognitive performance of control, PD and RBD participants from the Oxford Discovery Cohort 28 using a superset of 19 candidate tasks spanning cognitive domains previously reported to be affected in these populations. The tasks were selected from the broad library available on the Cognition online assessment platform, which has been successfully deployed in diverse clinical and non-clinical population studies with >500,000 participants 12 , 29 – 32 . First, we identified tasks that were (a) sensitive to cognitive deficits in PD and RBD, (b) insensitive to device-related confounds, and (c) decorrelated in relation to each other within a data-driven factor model of cognitive domains.…”