Below you will find posters and articles detailing cognition and rater training data for indications including: PD, MCI, AAMI, AD, Schizophrenia, Bipolar disorder, Substance Abuse and Depression. General information about the Assessment Platform (e.g., standardization study, fMRI study, and our assessment equivalent of the MATRICS battery) can also be seen by selecting from the drop down box below.

Rater Training on HAM-D, MADRS and YMRS – What were the difficult items to rate? NCDEU’s 50th Anniversary Meeting: Learning from the Past to Advance the Future of Mental Health Treatment, June 14, 2010–June 17, 2010, Boca Raton, Florida Adobe Acrobat
Training of raters on pre-set rating conventions is critical to increase the reliability of ratings in CNS drug trials. Identification of items anticipated to be most challenging for raters to assess in order to optimize rater training programs. This study examined raters’ ratings provided in an online rater training program on the Hamilton Depression Rating Scale (HAM-D), Montgomery Asberg Rating Scale (MADRS), and Young Mania Rating Scale (YMRS) for a Bipolar Disorder trial.

Computerized Cognitive Testing in Idiopathic PD with Motor Fluctuations: Patient Experiences-ISCTM 6th Annual Scientific Meeting, Washington D.C., USA, 22-24 February, 2010 Adobe Acrobat
Cognitive impairment in Parkinson's disease (PD) is well established. Computerized cognitive batteries have been used with PD in clinical trials. The ability of PD patients to use such tests has not been formally examined. We examined early to late PD patients' capacity to perform computerized cognitive testing. We measured the percent of PD patients failing to complete the battery, identified the specific tests not completed, and reasons for incomplete tests.

A preliminary, randomized, double-blind, placebo-controlled trial of L-carnosine to improve cognition in schizophrenia Adobe Acrobat
Targeting glutamatergic dysfunction provides an exciting opportunity to improve cognitive impairment in schizophrenia. One treatment approach has targeted inadequate antioxidant defenses at glutamatergic synapses. Animal and human data suggest NMDA antagonists worsen executive cognitive controls—e.g. increase preservative responses and impair set-shifting. We conducted a preliminary study to test the hypothesis that L-carnosine, an antioxidant and anti-glycation agent which is co-localized and released with glutamate would improve executive dysfunction, a cognitive domain associated with glutamate.

An Interview Guide for the Scale for Assessment of Negative Symptoms (IG-SANS) Adobe Acrobat
Negative symptoms of schizophrenia (NSx) are notoriously difficult to assess since it is a challenge to elicit reliable information/behavior from a disengaged patient during clinical interview and accurately determine the overall lack of symptom presentation. The Scale for the Assessment of Negative Symptoms (SANS) is regularly used as a primary outcome measure in clinical trials (Andreasen 1984).

Computerized Cognitive Testing in Idiopathic PD with Motor Fluctuations: Patient Experiences-XVIII WFN World Congress on Parkinson's Desease and Related Disorders, Miami Beach, FL, USA, December 13-16, 2009 Adobe Acrobat
Parkinson's disease (PD) is a neurodegenerative disorder, where the motor symptoms like bradykinesia, tremor and rigidity, are accompanied by changes in cognition. Most of the patients with Parkinson's disease may suffer from selective cognitive impairments, including difficulties with attention, concentration, problem-solving, set-shifting and memory (Basset, 2005).

Training Raters on UPDRS - Early PD and Advanced PD Patients Adobe Acrobat
The Unified Parkinson's Disease Rating Scale (UPDRS) is widely used for the clinical evaluation of Parkinson's disease (PD). Our objective was to determine if the stage of PD (early vs advanced) affected rater performance on UPDRS section III -motor examination.

Rater Training on UPDRS (Part-III) Motor Section Adobe Acrobat
Training and evaluation of investigators, particularly on the motor section of the UPDRS, is critical before clinical trial initiation. This study examines an approach to rater training and certification on the UPDRS focusing on improving inter-rater reliability.

Rater Training on SANS and Monitoring of Rater Performance during Clinical Trials Adobe Acrobat
Training a heterogeneous group of raters on the Scale for the Assessment of Negative Symptoms (SANS) is challenging as negative symptoms of schizophrenia are notoriously difficult to measure. This study evaluated ratings on the SANS and presents a novel methodology, iSignal for iPad, used in monitoring rater performance during the trial.

Rater Training: Evaluation of Two Different Training Methodologies Adobe Acrobat
As primary outcome measures in CNS clinical trials rating scales significantly impact signal detection and study outcome. Rater training is incorporated into trials in an effort to increase the quality and reliability of clinical interviews. The design of the rater training programs may ultimately influence the quality of the clinical assessment. It is important to assess the effectiveness of programs, thus we report on two different methods for rater training.

Verbal, visuospatial and face working memory impairment in multiple episode schizophrenia patients Adobe Acrobat
Memory impairment has been acknowledged as a core cognitive deficit in schizophrenia, and it is present irrespective of specific features related to the patient or the evolution of the disorder. It is suggested that distinct functional subsystems of memory are differently impaired in these patients, hence the broad range of levels of functioning affected in this specific population. The aim of this study was to assess working memory performance in multiple episode schizophrenia patients. A group of patients diagnosed with schizophrenia and a control group of healthy subjects were comparatively evaluated with 3 neurocognitive tests which require the use of working memory subsystems.

Expert Rater Assisted Score Evaluation (ERASE): A New Method to Enhance Signal Detection in Randomized, Placebo-Controlled, Clinical Trials Adobe Acrobat
Numerous factors related to the design, conduct and evaluation of randomized clinical trials (RCTs) have been considered over the years to account for the relatively high placebo response rate in psychiatric diseases 1-3. Surprisingly little attention has been given to the process of data collection itself, i.e. the clinical interview and correct interpretation of a patient's condition 4. Here we exhibit a new method, involving expert rater assisted score evaluation (ERASE), developed and implemented for the first time in a multinational RCT in schizophrenia, with the aim to control for interview quality and enhance signal detection.

Are we adequately evaluating and monitoring rater performance in clinical trials with dementia? Adobe Acrobat
The Alzheimer's Disease Assessment Scale-Cognitive Scale (ADAS-cog) is widely used in clinical trials of Alzheimer's disease. A rater training program to train and certify raters on the ADAS-cog was examined to determine the efficacy of the program and to identify the items having the greatest scoring difference compared with the Gold Consensus Ratings (GCRs).

Urschel DB APA Poster 20080501-FINAL Adobe Acrobat

Cogtest Tests and Corresponding Domains Adobe Acrobat

Clinical global impression of cognition in schizophrenia (CGI-CogS): Reliability and validity of a co-primary measure of cognition. Adobe Acrobat
The study involved the 35 schizophrenia patient-and-caregiver pairs recruited from the UCLA and West Los Angeles VA Outpatient Psychiatry Departments that were assessed with the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS), an interview-based rating scale of cognitive functioning, on 3 occasions (baseline, 1 month, and 3 months). A computerized neurocognitive battery (Cogtest), an assessment of functioning, and symptom measures were administered at two occasions (baseline and one month). The study revealed that CGI-CogS appears to offer a reliable and valid method for clinical rating of cognitive deficits and their impact on everyday functioning in schizophrenia.

The effects of scopolamine in elderly volunteers using the Cogtest battery Adobe Acrobat

Cognitive Effects of a Partial Agonist at the Alpha7 Nicotinic Acetylcholine Receptor in Mild Alzheimer’s Disease Adobe Acrobat

Cogtest is More Sensitive than the ADAS-cog in Detecting Change in Clinical Trials of Early Alzheimer’s Disease Adobe Acrobat

Cognitive Performance in Healthy Volunteers on The Cogtest Computerized Neurocognitive Battery Adobe Acrobat

COGTEST Identifies Impairment in Multiple Memory Domains in Age Associated Memory Impairment Adobe Acrobat
We examined verbal, visual, and working memory performance in individuals with AAMI (n=146) to determine if a domain specific or generalized memory performance deficit exists, compared to normal aging peers (HC; n=50). We also examined the utility of Cogtest, a computerized cognitive testing battery, to identify memory impairment in AAMI.

Memory Deficits in Mild Cognitive Impairment are Identified with COGTEST Adobe Acrobat
We examined verbal, visual, and working memory performance in 44 subjects with MCI to determine if a domain specific or generalized memory performance deficit existed.

The Young Mania Rating Scale: Response on item 8 "Content" Adobe Acrobat
Accurate ratings are critical for the success of CNS clinical trials. The Young Mania Rating Scale (YMRS) assesses the severity of mania in clinical trials of bipolar disorder. Previous research has shown that 4 items on the YMRS (irritability, speech, content, disruptive -aggressive behavior) are difficult to rate and lead to the possibility of inaccurate ratings. Ratings on all 11 items of the scale were analyzed and variation in the ratings was studied.

Cogtest Equivalent of the MATRICS Battery Adobe Acrobat

Cognitive effects of nicotine in humans: an fMRI study (AD and Schizophrenia Implications) Adobe Acrobat
To elucidate the neural correlates of cognitive effects of nicotine, we examined behavioral performance and blood oxygenation level-dependent regional brain activity, using functional magnetic resonance imaging, during a parametric "n-back" task in healthy nonsmoking males after the administration of nicotine (12 g/kg body weight) or saline.

Standardisation Study of COGTEST: Neurocognitive Battery for Clinical Trials Adobe Acrobat
This poster presents the findings on the standardization and cross-validation of Cogtest, an automated Neurocognitive battery with electronic data capturing ability. 200 cognitively healthy individuals took part in two studies, one aimed at assessing concurrent validity with respect to paper-and-pencil measures and another to establish norms for individual Cogtest endpoints that comprise a Neurocognitive Global Score (NGS) for use in clinical trials.

Neurocognitive Function in Unmedicated Manic and Medicated Euthymic Pediatric Bipolar Patients Adobe Acrobat
The objective of the study is to systematically evaluate the neuropsychological functioning in individuals with pediatric bipolar disorder to clarify the types of cognitive deficits that are associated with acutely ill and Euthymic phases of the disorder and the effects of medication on these deficits.

Cognitive Functioning and Acute Sedative Effects of Risperidone and Quetiapine in Patients With Stable Bipolar I Disorder: A Randomized, Double-Blind, Crossover Study Adobe Acrobat
The objective of this double-blind study was to compare the effects of treatment initiation with risperidone and quetiapine on cognitive function in subjects with stable bipolar disorder. Cognitive function, including attention, working memory, declarative memory, processing speed, and executive functions was measured before and after dosing.

Cognitive Function in Patients with Resistant Depression (Risperidone Augmentation) Adobe Acrobat
In this poster we present preliminary findings on Neurocognitive function in patients with resistant Major Depressive Disorder (MDD) from a treatment trial of Risperidone augmentation of standard antidepressant therapy. These analyses evaluate the effect of standard antidepressant therapy and Risperidone augmentation on cognitive function, and explore the relationships between cognition, clinical symptoms, and quality of life.

A Normative Study of Neuropsychological Performance in Treatment Resistant Depression Adobe Acrobat
In a large, multinational study of atypical antipsychotic treatment of TRD, a structured baseline cognitive assessment was performed on 297 of 489 patients. This computerized assessment measured multiple cognitive domains, including processing speed, working and episodic memory, and executive functioning. Normative data for healthy comparison subjects matched to the TRD population in age, education, and gender were also collected using the same assessment methodology.

Cognitive Functional Improvement with Risperidone Adobe Acrobat
Schizophrenia patients receiving atypical antipsychotics, including Risperidone, have shown improved cognition and independent role functioning. These outcomes may not be related. This preliminary report examines interim cognitive and functioning results from a 12-month study of long-acting Risperidone.

Sensitivity of the Cogtest System to Scopolamine Challenge: Relevance to Studies of Cognitive Enhancement in Schizophrenia Adobe Acrobat
In order to verify the sensitivity of the Cogtest system tests to pharmaceutical interventions, we administered a single 0.3mg subcutaneous dose of scopolamine to eight elderly healthy volunteers. Scopolamine has been routinely used to induce cognitive dysfunction in a bid to mimic the loss of acetylcholine transmission seen in patients with Alzheimer´s Disease.

Cognitive Improvements in Patients with Schizophrenia with Risperidone Long-Acting Injectable Adobe Acrobat
This poster reports findings from a 52-week efficacy and safety clinical trial that examined the effects of a long-acting, Injectable formulation of Risperidone as maintenance therapy on patient´s cognitive functioning.

Overlap of cognitive deficits in Parkinson´s Disease (PD) and Alzheimer´s Disease (AD): Potential use of Safinamide Adobe Acrobat
We performed a comparison of the cognitive domains affected in AD and in early PD patients and also determined the potential benefits of safinamide in treating the cognitive deficits and the activities of daily living (ADL) of AD based on recent results from a trial in early PD patients.

Cognitive effects of safinamide in early Parkinson´s disease (PD)
Adobe Acrobat

This study evaluated the cognitive effects of 100 and 200 mg/day doses of safinamide, a new anti-PD agent that combines selective, reversible MAO-B and glutamate release inhibition, compared to placebo as an add-on therapy in nonfluctuating, early idiopathic PD patients receiving a stable dose of a single DA-agonist.


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"We enjoyed a number of benefits while using the Cogtest System. This included no transcription errors thus greater accuracy of our patient data; our staffing costs were minimized; and the staff who used Cogtest received full support from the highly responsive Cogtest Team."

Dr. Roy Chengappa
Professor of Psychiatry, University of Pittsburgh School of Medicine