Grant: Project Grant

Classic tests of cognition (TOCs) are a key part of the clinical exams for patients with brain conditions. Many TOCs are "pen-and-paper tests", which are scored using simple metrics like the time to complete the test, or the number of errors. By comparing the patient's TOC score to those tabulated from many healthy individuals, it is possible to assess whether their cognitive status is abnormal, suggesting brain disease. This research project aims to modernize the detection and diagnosis capabilities of TOCs, using the detailed, digitized information that can be recorded with a tablet to improve on the classic scoring systems. We will focus on one specific TOC that is commonly used for early detection of cognitive impairment, called the Trail-Making Test (TMT). The TMT requires the patient to perform a series of drawing movements to link numbers (1-2-3...), and numbers and letters (1-A-2-B-3-C..) randomly positioned on a page. We will implement the TMT on a novel touch-sensitive tablet to digitize and quantify test responses in detail. The tablet has been specially designed so that the TMT can be performed while brain activity is recorded, which we will undertake using a method called functional magnetic resonance imaging, and a cheaper, more widely available method called electroencephalography. We will also use an eye-tracking device to record exactly where the patient looks throughout. The brain activity and eye-tracking will be used to improve scoring of the tablet-related TMT performance measurements. We will apply our experimental protocol to study patients (individuals with mild cognitive impairment - a risk factor for dementia) in relation to healthy adults, and identify features within the tablet data which increase TMT detection and diagnosis of brain impairment. This work is relevant to neuroscience researchers and clinicians; and in the long-term to patients in Canada - who will consequently receive improved healthcare delivery for brain conditions.