10-minute neurocognitive measure valid in schizophrenia

Canadian researchers have developed a 10-minute tool that they claim can “rapidly, easily, and validly” assess global neurocognition in people with schizophrenia.

Furthermore, scores on the Brief Neurocognitive Assessment (BNA) tool were associated with important clinical outcomes such as symptoms and functional status, with comparable accuracy to that of a full cognitive battery.

“This tool provides clinicians and researchers a means to assess global neurocognitive impairments without requiring extensive neuropsychological testing,” write Gagan Fervaha (Centre for Addiction and Mental Health, Toronto, Ontario) and fellow researchers in the Journal of Psychiatric Research.

Fervaha’s team obtained data on 1303 people with chronic schizophrenia who had participated in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. At baseline, participants were assessed using multiple measures, including the Wechsler Adult Intelligence Scale–Revised Digit Symbol Test (DST) and the Letter-Number sequencing test (LNS).

Scores from the individual tests were translated into five cognitive domain scores and averaged to create a neurocognitive composite score. Bivariate analysis was then used to identify the two individual tests that contributed the greatest amount of variance to the composite score; these were the LNS and the DST, which together accounted for 76% or variance and formed the new BNA.

Additional analyses confirmed the robustness of the BNA in tracking the neurocognitive composite score over time and in applying to subsamples of patients with different sociodemographic and clinical characteristics. Indeed, the composition of the BNA was robust across 99.99% of randomly drawn subsamples, according to the authors.

Finally, the team examined whether the BNA predicted clinical outcomes to a similar extent as the full neuropsychological battery. They found that the BNA and the full battery were both significantly associated with symptoms, functional status, and neurocognition, and that the change in BNA correlated with the change in full battery following 6 months of antipsychotic treatment.

Noting that the BNA should take a total administration time, including set-up and scoring, of approximately 10 minutes, the researchers conclude: “Given the substantially reduced time required to administer, ease of administration, as well as the demonstrated utility, the BNA is well positioned to serve clinicians who would like to rapidly assess this important domain in their patients.”

They add: “Researchers may also choose to employ this measure, especially if the primary interest of a study is beyond that of neurocognition per se.”

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