TY  - JOUR
AU  - Attarha, Mouna
AU  - De Figueiredo Pelegrino, Ana
AU  - Ouellet, Lydia
AU  - Toussaint, Paule-Joanne
AU  - Grant, Sarah-Jane
AU  - Van Vleet, Thomas
AU  - de Villers-Sidani, Etienne
PY  - 2025
DA  - 2025/7/7
TI  - Association of a Brief Computerized Cognitive Assessment With Cholinergic Neurotransmission: Assessment Validation Study
JO  - JMIR Form Res
SP  - e68374
VL  - 9
KW  - cholinergic function
KW  - acetylcholine
KW  - FEOBV-PET
KW  - web-based cognitive assessment
KW  - brain health
KW  - cognitive status
KW  - assessment accessibility
KW  - anterior cingulate
KW  - computerized cognitive assessment
KW  - cholinergic neurotransmission
KW  - assessment validation study
KW  - self-administered
KW  - vesicular acetylcholine transporter
KW  - VAChT
KW  - positron emission tomography
KW  - PET
KW  - retrospective analysis
KW  - older person
KW  - neurotransmission
KW  - [18F]fluoroethoxybenzovesamicol
AB  - Background: Computerized cognitive assessments are most often validated against standard neuropsychological measures with limited validation against biological indices of brain health. Objective: This study aimed to evaluate whether a self-administered computerized cognitive assessment is associated with cholinergic neurotransmission using the vesicular acetylcholine transporter ligand [18F]fluoroethoxybenzovesamicol (FEOBV) and positron emission tomography (PET). Methods: In a retrospective analysis, we report baseline data from the Improving Neurological Health in Aging via Neuroplasticity-Based Computerized Exercise (INHANCE) trial. This study provides normative data for healthy older adults aged 65 years and above. We evaluate the validity of the Double Decision cognitive assessment (from the BrainHQ assessment platform) by examining its association with tracer binding in the anterior cingulate cortex, as measured by FEOBV-PET. We also assess concurrent validity with neuropsychological performance using standardized measures of executive function and global cognition. Results: The intent-to-treat population from the INHANCE trial analyzed in this study included 92 healthy adults with a mean age of 71.9 (SD 4.86, range 65‐83) years, the majority of whom were female (61/92, 66%), with an average of 16.45 (SD 3.40, range 9‐27) years of education. The Double Decision assessment is associated with FEOBV binding in the anterior cingulate cortex, explaining 8% of the variance, and was associated with neuropsychological performance measures. The assessment was sensitive to age and was not influenced by education level or gender. Psychometric properties supported its usability and the assessment showed an average completion time of 3 (SD 1.12) minutes. Conclusions: We present the first brief, self-administered computerized cognitive assessment associated with cholinergic network health. This tool is scalable and accessible to individuals with an internet-connected device, offering a practical and cost-efficient approach to cognitive screening. The findings provide valuable insights into brain health, particularly for early detection of cognitive decline, and hold significant potential for broad applications across both clinical and nonclinical contexts. Trial Registration: ClinicalTrials.gov NCT04149457; https://clinicaltrials.gov/study/NCT04149457 International Registered Report Identifier (IRRID): RR2-10.2196/59705 
SN  - 2561-326X
UR  - https://formative.jmir.org/2025/1/e68374
UR  - https://doi.org/10.2196/68374
DO  - 10.2196/68374
ID  - info:doi/10.2196/68374
ER  -