COGNITO - Inserm

Introduction
COGNITO is a computerized neuropsychometric examination
based on well-known cognitive tests designed for both
cognition research and clinical assessment. It was originally
developed with MacIntosh Hypercard software (version ECO)
for use in both population and clinical studies of brain ageing
and has now been up-dated into Flash, thus extending its
hardware possibilities. The original version was used in a
prospective population study from general practice from which
normative data was derived, and the ability of the battery to
detect difficulties in information processing two years prior to
the diagnosis of dementia was also established. The battery has
been subsequently used to track cognitive changes due to
depression, following anesthesia, as a consequence of
anticholinergic drug use, and in the development of diagnostic
criteria for mild cognitive impairment (MCI). More recently
COGNITO has been used to monitor cognitive changes during
treatment in schizophrenia. COGNITO assesses reaction time,
primary and working memory (an articulation sub-test further
permitting identification of problems related to the articulatory
loop) visuospatial and verbal secondary memory (with free,
cued and multiple choice paradigms) , implicit learning
(priming), language skills (word and syntax comprehension,
naming, verbal fluency), functional and semantic
categorization of visual data (visual reasoning and form
perception), focused and divided attention (visual and auditory
modalities) and crystallized intelligence (vocabulary).
Responses are made via a tactile screen which permits the
recording of response latency (deducting reaction time provides
an estimation of information processing time). The
examination may be carried out by trained lay interviewers
with the possibility of the interviewer’s voice being replaced by
pre-recorded instructions. The interpretation of the results can
only, however, be made by a clinician competent in
neuropsychology. Qualitative aspects of performance
(perseveration, intrusions, visual field neglect) are also
recorded. The test is suitable for children over 12 and adults of
any age provided they are able to read, hear instructions and
see the words and images. Practice trials are given which may
be repeated until the subject has understood what is required.
In order to be able to test highly performing persons some of
the tasks become very challenging, so some tests stop
automatically after repeated failures to avoid discouragement.
The examination takes 45 minutes to an hour to complete
depending on the ability of the subject. While it is possible to
select and administer specific tests, it is suggested that the
whole battery be given where possible in order to standardize
fatigue effects and the time delay between the presentation of
memory stimuli and the recall trials.
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