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A new smartphone Symbol-Digit Modalities Test (SDMT) offers reliable digital biomarkers for neurodegenerative diseases. This tool shows comparable psychometric properties to traditional methods, aiding in accurate neurological decline assessment.

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Area of Science:

  • Neuroscience
  • Digital Health
  • Biomarker Development

Background:

  • Increasing burden of neurodegenerative diseases necessitates improved methods for assessing complex neurological functions beyond limited clinic visits.
  • Patient-collected digital biomarkers hold promise for continuous monitoring, but their psychometric properties require thorough evaluation.
  • Existing cognitive tests often lack the granularity needed for frequent, remote assessment.

Purpose of the Study:

  • To develop and validate a smartphone-based adaptation of the Symbol-Digit Modalities Test (SDMT) for assessing cognitive function.
  • To evaluate the psychometric properties of the smartphone SDMT in individuals with multiple sclerosis (MS) and healthy volunteers (HV).
  • To compare the performance of the smartphone SDMT against traditional SDMT and neurological/radiological measures.

Main Methods:

  • Developed a smartphone version of the SDMT with randomized symbol-number codes and testing sequences.
  • Recruited 154 MS patients and 39 HV to undergo both smartphone and traditional SDMT.
  • Correlated SDMT performance with cognitive subscores from neurological exams and MRI-measured brain injury.
  • Utilized a separate smartphone test to measure motoric hand disability for mathematical adjustment.

Main Results:

  • The smartphone SDMT demonstrated comparable psychometric properties to the traditional SDMT in both MS patients and HV.
  • Smartphone SDMT showed slightly higher correlations with cognitive function scores (R²=0.75) and MRI-assessed brain injury (Rho=0.83) than the traditional version.
  • Mathematical adjustment for motoric hand disability improved the accuracy of the touch-based smartphone test.
  • Averaging granular home measurements enhanced the accuracy of detecting neurological decline.

Conclusions:

  • The smartphone SDMT is a psychometrically sound digital biomarker for assessing cognitive function in neurodegenerative diseases.
  • This digital tool can provide reliable, granular data for monitoring neurological decline, complementing traditional clinical assessments.
  • Smartphone-based cognitive testing offers a scalable and accessible approach to managing the growing burden of neurological disorders.