Source: www.brainhq.com
Copyright: Posit Science Corporation
URL: https://www.brainhq.com/why-brainhq/about-the-brainhq-exercises/attention/double-decision
License: Public Domain (CC0)
Large Implications for Cognitive Aging and Dementia
San Francisco, July 7, 2025 (GlobeNewswire) — For the first time, a study shows that a digital assessment can provide a scientific measure of acetylcholine—a key brain chemical whose decline signals the progression of cognitive impairment and Alzheimer disease. The assessment can be self-administered and completed in about 3 minutes on internet-connected devices and has big implications for cognitive aging and dementia. The assessment was developed by Posit Science, the maker of BrainHQ brain training exercises and assessments, and was examined as part of a National Institutes of Health (NIH)–funded study in collaboration with researchers at McGill University.
“Currently, it’s impossible for doctors to monitor this brain chemical despite its importance because it requires expensive imaging equipment and special expertise available at few research centers. This breakthrough shows a new path for routine monitoring of brain health by doctors and individuals,” said Dr. Henry Mahncke, CEO of Posit Science.
The brain’s neuromodulatory system produces brain chemicals that impact mood, learning, attention, responsiveness, and memory. Brain scientists have known for decades that the system (and its subsystems that produce various brain chemicals) operate more sluggishly (ie, down-regulate) with aging and various health conditions.
The assessment focuses on the cholinergic system, a subsystem that produces the brain chemical acetylcholine, which is sometimes called the “pay attention” chemical, because it is produced when one pays attention. The production of acetylcholine is known to down-regulate with normal aging and is more severely affected by predementia and Alzheimer disease and related dementias (ADRD).
Cholinergic function is recognized as a key biomarker of overall brain health. It regulates the ability of the brain to change (ie, “plasticity”) and is associated with stronger cognitive performance, specifically in sensory processing, attention, learning, memory, and executive function. Poor cholinergic function is linked to the production of plaque and tangles associated with ADRD as well as deficits in other conditions.
Currently, there is no easily accessible way to measure cholinergic function; no standardized blood test to directly measure it exists. Positron emission tomography (PET) brain imaging techniques can be used; however, this method is costly, requires specialized expertise, and exposes participants to radiation, limiting its use in clinical practice.
“We developed a digital cognitive test to be a sensitive measure of brain health. To validate the test, we approached the researchers at The Neuro at McGill University, because it is one of a small number of places on the planet with the imaging technology to measure acetylcholine directly,” said Dr Henry Mahncke. “In this study, they measured acetylcholine alongside cognitive performance using our assessment.”
The imaging study enrolled 92 healthy older adults (average age 72 years). Each was measured using a BrainHQ assessment (Double Decision), two other validated neuropsychological assessments, and a PET scan using a tracer to evaluate cholinergic neurotransmission.
The study showed better scores on the Double Decision assessment that were correlated with higher cholinergic function, indicating that the assessment could estimate cholinergic function without the complexity and risk of doing a PET scan. These results align with prior studies that show a significant relationship between cholinergic function and cognitive performance as measured by clinician-administered tools.
The assessment was brief, taking an average of 3 minutes to complete, and demonstrated good usability with reasonable descriptive and psychometric properties. It was sensitive to age within the narrow band measured (65-83 years) and was not influenced by demographic factors such as years of education or gender.
The researchers concluded that “The results support the adoption of this scalable form of biomarker-informed cognitive assessment available to individuals with an internet-connected device.”
“These researchers also are looking at whether our brain exercises can up-regulate acetylcholine, which would have a tremendous impact on cognitive aging and ADRD research,” Dr Mahncke added. “We look forward to learning more.”
BrainHQ exercises have shown benefits in more than 300 studies. Such benefits include gains in cognition (eg, attention, speed, memory, decision-making), quality of life (eg, depressive symptoms, confidence and control, health-related quality of life), and real-world activities (eg, health outcomes, balance, driving, workplace activities). BrainHQ is used by leading health plans, including Medicare Advantage; leading medical centers, clinics, and communities; and elite athletes, the military, and other organizations focused on peak performance. Consumers can try a free BrainHQ exercise daily at https://www.brainhq.com.
This research was supported by the National Institute on Aging of the NIH (awards R44AG039965 and 3R44AG039965-06S1). This content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Contact: media@brainhq.com
Citation: Attarha, M., De Figueiredo Pelegrino, A., Ouellet, L., Toussaint, P-J., Grant, S-J., Van Vleet, T., de Villers-Sidani, E. Association of a Brief Computerized Cognitive Assessment With Cholinergic Neurotransmission: Assessment Validation Study. JMIR Form Res.
http://dx.doi.org/10.2196/68374