ORIGINAL ARTICLE   Open access

European Journal of Physical and Rehabilitation Medicine 2025 Apr 09

DOI: 10.23736/S1973-9087.25.08640-X

Copyright © 2025 THE AUTHORS

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lingua: Inglese

Cog-First: standardization of a tablet-based self-administered cognitive screening

Camille HESLOT ^{1, 2, 3, 4, 5} ✉, Alexis SCHNITZLER ^{3, 4, 5}, Marion HOUOT ^{6, 7, 8}, Valentine FACQUE ⁹, Franck TARPIN-BERNARD ⁹, Melissa JEULIN ¹⁰, Sarah BESSE ¹¹, Romain CAPRON ¹¹, Rajiv REEBYE ^{2, 12}, Emmanuel MANDONNET ^{1, 3, 13}

¹ Paris Brain Institute (ICM), Frontlab, CNRS UMR 7225, INSERM U1127, Paris, France; ² Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada; ³ Paris Cité University, Paris, France; ⁴ Physical Medicine and Rehabilitation Department, GH St Louis Lariboisière F. Widal, Paris, France; ⁵ INSERM Cress UMR1153, Paris, France; ⁶ Center of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; ⁷ Department of Neurology, Institute of Memory and Alzheimer’s Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; ⁸ Clinical Investigation Center for Neurosciences, Brain Institute (ICM), Pitié-Salpêtrière Hospital, Paris, France; ⁹ Humans Matter, Paris, France; ¹⁰ Hôpital Foundation Adolphe de Rotschild, Paris, France; ¹¹ Picardie University, Amiens, France; ¹² Canadian Advances in Neuro-Orthopedics for Spasticity Consortium (CANOSC), Vancouver, BC, Canada; ¹³ Neurosurgery Department, GH St Louis Lariboisière F. Widal, Paris, France

BACKGROUND: Acquired brain injury can lead to subtle cognitive disorders that can be challenging to detect albeit impacting patients’ long-term functional prognosis. Cog-First has been developed as a tablet-based self-administered cognitive screening tool to assess executive function, memory and attention in approximately 20 minutes, in the acute phase following brain injury.
AIM: The aim of this study was to establish reliable normative data for Cog-First to enable meaningful comparisons between patients and a reference population.
DESIGN: Cross-sectional study.
SETTING: This study was conducted at the PRISME platform of Paris Brain Institute.
POPULATION: Four hundred and six healthy French-speaking healthy volunteers were randomly selected from the Paris Brain Institute’s database.
METHODS: Each participant underwent the Cog-First assessment, which comprises seven subtests, in standardized conditions. Ninety-five participants performed the alternative version one month later to assess the test-retest effect. The effects of gender, age, years of education and test version, as well as their two-way interactions, were evaluated by generalized linear models (GLMs). Formulas from the GLMS were extracted to calculate a corrected score that removes the effects of age, sex, version and years of education. This enables us to derive percentiles in a population of healthy volunteers, allowing the development of the standardization process.
RESULTS: The results revealed a significant influence of gender, age, level of education and version on several sub-scores. Based on these results, the standardization process was implemented by calculating the percentiles on the corrected scores in the population of healthy volunteers. Test-retest analyses indicated a learning effect on four out of seven subtests.
CONCLUSIONS: The standardization of Cog-First resulted in the development of score formulas adjusted for gender, age, education and version, integrated within the software for automated scoring.
CLINICAL REHABILITATION IMPACT: This study establishes reliable norms for Cog-First, enabling meaningful score interpretation and clinical use, thereby facilitating early detection of cognitive impairments and potentially improving patient outcomes. Further research is necessary to determine the tool’s applicability and sensitivity in brain-injured patients.

KEY WORDS: Cognition; Brain injuries; Physical medicine and rehabilitation; Neuropsychological tests; Reference standards