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Science & Evidence

Two decades of peer-reviewed neuroscience

Where the claims made across this site are substantiated: validation against established clinical tests, across more than ten conditions, and at population scale.

Browse the publications Ask about a research topic

20+

Years of research

200+

Peer-reviewed studies

10+

Conditions validated

What the evidence shows

Each point is supported by peer-reviewed research, summarised in the sections below.

Agrees with established clinical tests

Results align with trusted neuropsychology tests, including the MoCA, RBANS, ACE-III, and ADAS-Cog.

Detects what screening tools miss

Picks up milder and earlier problems in people who score as normal on common screens.

Reflects changes in the brain

Scores track brain structure on MRI and early disease markers, sometimes before symptoms appear.

Remote testing as reliable as the clinic

People assessed at home, unsupervised, produce results comparable to supervised testing.

Consistent over repeated testing

Minimal practice effects, retest reliability of 0.88 over 18 months, and a clear threshold for meaningful change.

Fair and precise scoring

Results are adjusted for age, education, language, and device, and separate thinking ability from motor impairment.

Population validation

Validated across populations

Cognitron has been used across a wide variety of conditions and in high-performing cohorts. Each person's results are compared with a large normative dataset from the Great British Intelligence Test, adjusted for age, sex, education, first language, and device.

Tasks avoid words unless they are measuring language, so assessment is fairer across cultures, languages, and education levels.

Conditions assessed

One platform across many conditions

Cognitron has been used to assess cognition in specialist patient groups, healthy adults, and high-performing occupational cohorts.

Brain injury

  • Traumatic brain injury (acute and chronic)
  • Stroke
  • Autoimmune limbic encephalitis
  • Normal pressure hydrocephalus

Neurodegeneration

  • Alzheimer's disease and dementia
  • Amyloid and phospho-tau positivity
  • Parkinson's disease
  • REM sleep behaviour disorder
  • Multiple sclerosis

Psychiatry, sleep, and infection

  • Schizophrenia
  • Chronic insomnia
  • COVID-19 and Long COVID

Healthy and high-performing

  • Occupational performance
  • Population-scale studies

Population validation evidence

Validated on multiple conditions

From specialist patient groups to population samples: the studies behind the conditions above.

ConditionStudyWho was testedKey finding
Alzheimer's diseaseDel Giovane et al. 202631 people with Alzheimer's diseaseSeparated Alzheimer's from healthy ageing with 94% accuracy (AUC 0.94), with a distinct memory and language profile
Preclinical Alzheimer's diseaseDel Giovane et al. 2025255 cognitively healthy adults aged about 70Slower memory responses predicted amyloid positivity (odds ratio 1.79) before any symptoms
Normal pressure hydrocephalusDel Giovane et al. 202626 people with normal pressure hydrocephalusSeparated hydrocephalus from healthy ageing (AUC 0.90), and scores predicted walking speed
Traumatic brain injuryDel Giovane et al. 2023126 people with TBI and 84 controlsDistinguished injury severity better than standard clinical scales, with the same results remotely as in person
StrokeGruia et al. 202590 stroke survivors, and 171 followed for up to two yearsFound deficits in patients who scored normal on the MoCA, and separated cognitive ability from hand motor impairment
Autoimmune limbic encephalitisShibata et al. 202421 patients and 54 controlsFound visuospatial and language deficits the ACE-III missed, linked to hippocampal volume on MRI
Parkinson's disease and REM sleep behaviour disorderBălăeţ et al. 202459 people with Parkinson's, 54 with RBD, and 50 controlsFound deficits in memory, language, attention, and executive function where the MoCA showed no group differences
Multiple sclerosisLerede et al. 20254,526 members of the UK MS RegisterIdentified a distinct MS subtype with selective cognitive impairment
COVID-19 and Long COVIDHampshire et al. 2024112,964 adults in EnglandDetected small but measurable deficits, largest in people with unresolved symptoms (-0.42 SD) and those admitted to intensive care (-0.35 SD)
Controlled SARS-CoV-2 infectionTrender et al. 202436 healthy volunteers followed for a yearDetected subtle cognitive changes in infected compared with uninfected participants
Occupational performanceSharpe et al. 2024111 working lifeguardsWorking memory was linked to real-world drowning detection (r = 0.53)

Full references are listed under Publications below.

Comparative evidence

Compared with standard clinical tests

Cognitron has been compared directly with the clinician-administered tests used in memory clinics, neurology services, clinical trials, and research.

Standard testAgreement with CognitronWhat Cognitron added
MoCA (10-minute clinic screen)Moderate to very strong, depending on the condition (r = 0.41 to 0.86)Found deficits the MoCA scored as normal in stroke, Parkinson's disease, and REM sleep behaviour disorder, and distinguished TBI severity better
RBANS (30-minute battery)Very strong shared variance (r = 0.86 and 0.81)Distinguished TBI severity better than the standard scales, of which only one RBANS subscale showed any difference
ACE-III (20-minute clinic screen)Moderate to strong, depending on the condition (r = 0.57 to β = 0.69)Found visuospatial and language deficits the ACE-III missed, as a 15-minute remote assessment
ADAS-Cog (30 to 45 minutes with a trained assessor)Strong (β = -0.76)Delivered as a 15-minute remote assessment, without a clinic visit or trained assessor

Published in

New England Journal of MedicineNature CommunicationsBraineClinicalMedicinenpj Digital MedicineAlzheimer's & DementiaJournal of Neurology, Neurosurgery & PsychiatryAnnals of Clinical and Translational NeurologyBrain CommunicationsImaging NeuroscienceScientific ReportsNeuropsychologiaTrends in NeurosciencesComprehensive PsychiatryApplied Cognitive PsychologyAssessment

Publications

Key studies by topic

A selection from the peer-reviewed studies that use Cognitron. Key studies come first in each topic. Open a topic to see the rest.

Neurodegeneration and dementia

Cognitron separated Alzheimer's disease from healthy ageing with 94% accuracy, predicted amyloid positivity in cognitively healthy adults before any symptoms, and found deficits in Parkinson's disease and REM sleep behaviour disorder where the MoCA showed no group differences.

  1. Online cognitive monitoring technology for people with Parkinson's disease and REM sleep behavioural disorder

    In Parkinson's disease and REM sleep behaviour disorder, a 20-minute battery found deficits in memory, language, attention, and executive function where the MoCA showed no group differences.

    Bălăeţ et al. · npj Digital Medicine · 2024

  2. Remote cognitive tests predict neurodegenerative biomarkers in the Insight 46 cohort

    In 255 cognitively healthy adults aged about 70, slower responses on a memory task predicted amyloid positivity (odds ratio 1.79) and tracked brain shrinkage over two years.

    Giovane MD et al. · Alzheimer's & Dementia · 2025

  3. Digital cognitive phenotyping for differential diagnosis and monitoring in neurological conditions

    A 15-minute online battery separated Alzheimer's disease (AUC 0.94) and normal pressure hydrocephalus (AUC 0.90) from healthy ageing, offering a scalable adjunct to standard testing.

    Del Giovane M, Giunchiglia V, David MCB, Kolanko MA, Trender WR, Hellyer PJ, Kaur H, Sharp DJ, Carswell C, Malhotra PA, Hampshire A · Annals of Clinical and Translational Neurology · 2026

Show all 11 studies

  1. Linking cognitive and behavioral reserve: Evidence from the CAN-PROTECT study

    Guan DX et al. · Alzheimer's & Dementia: Translational Research & Clinical Interventions · 2024

  2. Early life factors and dementia risk: A study of adverse childhood experiences and later-life cognition and behaviour

    Mudalige D et al. · Public Health · 2025

  3. Metacognitive accuracy differences in Parkinson's disease and REM sleep behavioral disorder relative to healthy controls

    Bălăeţ et al. · Frontiers in Neurology · 2024

  4. Online46: Online cognitive assessments in elderly cohorts-The British 1946 birth cohort case study

    Cai Z et al. · Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring · 2025

  5. Computerised cognitive testing and multi-domain structural Magnetic Resonance Imaging in patients with idiopathic Normal Pressure Hydrocephalus and Alzheimer's disease

    Martina Del Giovane et al. · Alzheimers & Dementia · 2023

  6. Limited evidence of a shared genetic relationship between C-reactive protein levels and cognitive function in older UK adults of European ancestry

    Packer A et al. · Frontiers in Dementia · 2023

  7. Pupil-linked arousal, cortical activity, and cognition in Alzheimer's disease

    David MCB et al. · Brain Communications · 2025

  8. Online assessment and monitoring of cognitive decline in neurological conditions

    Annalaura Lerede et al. · Journal of Neurology, Neurosurgery & Psychiatry · 2022

Traumatic brain injury

In traumatic brain injury, Cognitron distinguished injury severity better than standard clinical scales, gave the same results remotely as in person, and revealed when people overestimated their own performance.

  1. Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales

    Detected processing speed, attention, working memory, and executive deficits after moderate to severe TBI, distinguished injury severity better than standard clinical scales, and gave the same results remotely as in clinic.

    Martina Del Giovane et al. · eClinicalMedicine · 2023

  2. Assessing prospective and retrospective metacognitive accuracy following traumatic brain injury remotely across cognitive domains

    People with traumatic brain injury overestimated their performance despite scoring worse than controls, with all testing done remotely on their own smartphones.

    Niall J Bourke et al. · Neuropsychological Rehabilitation · 2023

  3. Distinct patterns of structural damage underlie working memory and reasoning deficits after traumatic brain injury

    Amy E Jolly et al. · Brain · 2020

Show all 5 studies

  1. Sports-related concussion not associated with long-term cognitive or behavioural deficits: the PROTECT-TBI study

    Lennon MJ et al. · Journal of Neurology, Neurosurgery & Psychiatry · 2025

  2. Current and prospective roles of magnetic resonance imaging in mild traumatic brain injury

    Sassani M et al. · Brain Communications · 2025

Stroke

After stroke, Cognitron found deficits in patients the MoCA scored as normal, and separated cognitive ability from hand motor impairment over up to two years of follow-up.

  1. Development and Validation of the IC3: An Online Remote Assessment Technology for Deep Phenotyping and Monitoring of Cognitive Impairment After Stroke

    Validation of the IC3 stroke battery: high test-retest reliability, equivalent results supervised and unsupervised, and minimal learning effects across repeated sessions.

    Gruia DC et al. · Assessment · 2025

  2. Mitigating the impact of motor impairment on self-administered digital tests: a longitudinal cohort study in stroke

    In 171 stroke survivors, hand motor impairment distorted standard scores on 10 tasks. Cognitron's corrected measures were not distorted and matched pen-and-paper tests more closely.

    Gruia DC et al. · eClinicalMedicine · 2025

Multiple sclerosis

One of the world's largest objective studies of cognition in multiple sclerosis (4,526 people) identified a previously unrecognised subtype. Retest reliability over 18 months was r = 0.88.

  1. Large-scale online assessment uncovers a distinct Multiple Sclerosis subtype with selective cognitive impairment

    4,526 members of the UK MS Register: a previously unrecognised MS subtype, reproduced in an independent second sample (r = 0.93 for accuracy, 0.88 for speed).

    Lerede A et al. · Nature Communications · 2025

  2. Mediterranean and MIND Dietary Patterns and Cognitive Performance in Multiple Sclerosis: A Cross-Sectional Analysis of the UK Multiple Sclerosis Register

    Yu M et al. · Nutrients · 2025

COVID-19 and Long COVID

Cognitron remotely assessed 112,964 adults in England after COVID-19, detecting small but measurable deficits, and detected subtle cognitive change in a controlled SARS-CoV-2 human challenge study.

  1. Cognitive deficits in people who have recovered from COVID-19

    Adam Hampshire et al. · eClinicalMedicine · 2021

  2. Cognition and Memory after Covid-19 in a Large Community Sample

    Remote assessment of 112,964 adults in England found small but measurable deficits after COVID-19, largest in people with unresolved symptoms and those admitted to intensive care.

    Hampshire et al. · New England Journal of Medicine · 2024

  3. The effects of COVID-19 on cognitive performance in a community-based cohort: a COVID symptom study biobank prospective cohort study

    Nathan J Cheetham et al. · eClinicalMedicine · 2023

Show all 18 studies

  1. Multivariate profile and acute-phase correlates of cognitive deficits in a COVID-19 hospitalised cohort

    Adam Hampshire et al. · eClinicalMedicine · 2022

  2. Changes in memory and cognition during the SARS-CoV-2 human challenge study

    In a controlled SARS-CoV-2 human challenge study, a baseline-corrected composite score distinguished infected from uninfected volunteers over a year of follow-up.

    Trender et al. · eClinicalMedicine · 2024

  3. Post-hospitalisation COVID-19 cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction

    Wood et al. · Nature Medicine · 2024

  4. Rapid vigilance and episodic memory decrements in COVID-19 survivors

    Sijia Zhao et al. · Brain Communications · 2022

  5. Associations between dimensions of behaviour, personality traits, and mental-health during the COVID-19 pandemic in the United Kingdom

    Adam Hampshire et al. · Nature Communications · 2021

  6. Post-traumatic stress disorder symptoms in COVID-19 survivors: online population survey

    Samuel R Chamberlain et al. · British Journal of Psychiatry open · 2021

  7. Cognitive and psychiatric symptom trajectories 2–3 years after hospital admission for COVID-19: a longitudinal, prospective cohort study in the UK

    Taquet et al. · The Lancet Psychiatry · 2024

  8. Profiles of objective and subjective cognitive function in Post-COVID Syndrome, COVID-19 recovered, and COVID-19 naïve individuals

    Bland et al. · Scientific Reports · 2024

  9. Item-level analysis of mental health symptom trajectories during the COVID-19 pandemic in the UK: associations with age, sex and pre-existing psychiatric conditions

    Adam Hampshire et al. · Comprehensive Psychiatry · 2022

  10. Insights into the impact on daily life of the COVID-19 pandemic and effective coping strategies from free-text analysis of people's collective experiences

    Adam Hampshire et al. · Interface Focus · 2021

  11. Associations between the use of psychedelics and other recreational drugs with mental health and resilience during the COVID-19 pandemic

    Maria Bălăeţ et al. · Frontiers in Psychiatry · 2023

  12. Changes in recreational drug use, reasons for those changes and their consequence during and after the COVID-19 pandemic in the UK

    Bălăeţ M et al. · Comprehensive Psychiatry · 2025

  13. Mapping the sociodemographic distribution and self-reported justifications for non-compliance with COVID-19 guidelines in the United Kingdom

    Maria Bălăeţ et al. · Frontiers in Psychology · 2023

  14. Response to comment about article 'changes in memory and cognition during the SARS-CoV-2 human challenge study'

    Chiu C, Hampshire A · eClinicalMedicine · 2025

  15. Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS-A multicentre case-control study

    Shil RSK et al. · Scientific Reports · 2025

Brain imaging

Cognitron scores track brain structure: smaller hippocampal volume was linked to lower scores in autoimmune limbic encephalitis, and in 34,927 UK Biobank participants the regions that predicted ability matched those linked to language and memory.

  1. Remote digital cognitive assessment reveals cognitive deficits related to hippocampal atrophy in autoimmune limbic encephalitis: a cross-sectional validation study

    In autoimmune limbic encephalitis, found visuospatial and language deficits the ACE-III missed, with scores linked to hippocampal volume on MRI (r = 0.67).

    Kengo Shibata et al. · eClinicalMedicine · 2024

  2. Dissociating frontoparietal brain networks with neuroadaptive Bayesian optimization

    Romy Lorenz et al. · Nature Communications · 2018

  3. Neuroimaging evidence for a network sampling theory of individual differences in human intelligence test performance

    Eyal Soreq et al. · Nature Communications · 2021

Show all 4 studies

  1. The optimisation of functional brain network dynamics when learning to perform complex tasks

    Parkin BL et al. · Neuropsychologia · 2025

Assessment, scoring, and performance

Cognitron's IDoCT scoring separates cognitive ability from visuo-motor speed, device lag, and speed-accuracy trade-offs, validated on data from 388,757 adults. Scores also relate to real-world performance.

  1. Cognition and lifeguard detection performance

    In 111 working lifeguards, working memory was linked to real-world drowning detection (r = 0.53).

    Benjamin T. Sharpe et al. · Applied Cognitive Psychology · 2024

  2. An iterative approach for estimating domain-specific cognitive abilities from large scale online cognitive data

    Using data from 388,757 adults, the IDoCT method separates cognitive ability from device and visuo-motor latencies, non-specific processes, and speed-accuracy trade-offs.

    Giunchiglia et al. · npj Digital Medicine · 2024

  3. Neural correlates of cognitive ability and visuo-motor speed: validation of IDoCT on UK Biobank data

    Applied to 34,927 UK Biobank participants, IDoCT improved test-retest reliability (r = 0.77 vs 0.66) and produced ability and speed measures linked to distinct brain regions.

    Giunchiglia V, Curtis S, Smith S, Allen N, Hampshire A · Imaging Neuroscience · 2024

Show all 5 studies

  1. A large-scale, cross-sectional investigation into the efficacy of brain training

    Adam Hampshire et al. · Frontiers in Human Neuroscience · 2019

  2. The Association Between Autism Spectrum Traits and Age-Related Spatial Working Memory Decline: A Large-Scale Longitudinal Study

    Ghai S et al. · The Gerontologist · 2025

Further research

  1. Defining brain fog across medical conditions

    Denno P, Zhao S, Husain M, Hampshire A · Trends in Neurosciences · 2025

  2. The Negative Relationship between Reasoning and Religiosity Is Underpinned by a Bias for Intuitive Responses Specifically When Intuition and Logic Are in Conflict

    Richard Daws et al. · Frontiers in Psychology · 2017

  3. Measuring compulsivity as a self-reported multidimensional transdiagnostic construct: large-scale (N = 182,000) validation of the Cambridge–Chicago Compulsivity Trait Scale

    Jeggan Tiego et al. · Assessment · 2023

Show all 13 studies

  1. Protocol for a double-blind placebo-controlled randomised controlled trial assessing the impact of oral semaglutide in amyloid positivity (ISAP) in community dwelling UK adults

    Koychev I et al. · BMJ Open · 2024

  2. Brain health concerns in former rugby players: clinical and cognitive phenotypes

    Parker TD et al. · Brain · 2025

  3. Impact of Vitamin D Supplementation on Cognition in Adults With Mild to Moderate Vitamin D Deficiency: Outcomes From the VitaMIND Randomized Controlled Trial

    Corbett A et al. · Journal of the American Medical Directors Association · 2025

  4. It's not rocket science and It's not brain surgery—It's a walk in the park: prospective comparative study

    Inga Usher et al. · British Medical Journal · 2021

  5. Conceptualising compulsivity through network analysis: A two-sample study

    Chang Liu et al. · Comprehensive Psychiatry · 2023

  6. Transdiagnostic Compulsivity Traits in Problematic Use of the Internet Among UK Residents: Cross-Sectional Network Analysis Study

    Liu C et al. · Journal of Medical Internet Research · 2025

  7. Methodological challenges of measuring brain volumes and cortical thickness in idiopathic normal pressure hydrocephalus with a surface-based approach

    Del Giovane M et al. · Frontiers in Neuroscience · 2024

  8. Manipulating visual, rule and motor conflict partially dissociates multiple demand cortex sub-regions

    Mew BG et al. · Neuropsychologia · 2025

  9. Telomere length and cognitive changes in 7,877 older UK adults of European ancestry

    Packer A et al. · Frontiers in Aging · 2024

  10. Correlates and determinants of physical activity among older adults of lower versus higher socio-economic status: a systematic review and meta-analysis

    Malkowski OS et al. · International Journal of Behavioral Nutrition and Physical Activity · 2025

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