Cog-Toolkit : new smart apps for the management of cognitive deficits in brain-lesioned patients – Cog-Toolkit

Patients with a brain lesion (of various etiologies, including but not limited to tumors, strokes or degenerative processes) suffers from cognitive deficits. These deficits are underdiagnosed and their importance regarding their impact on the socio-professional lifes of patients is underrecognized. There are two main reasons explaining this suboptimal cognitive management of brain lesioned patients: first, there is a lack of human ressources in the healthcare institutions, and secondly, the existing cognitive tests do not cover the full range of subtypes of deficits, especially for slight deficits.
In order to overcome these limitations, our LABCOM – gathering teams from the research institute “Institut du Cerveau de la Moelle” (ICM) and the company “Scientific Brain Training” (SBT – human matters) – will follow three objectives:
1. The creation, development and validation of new cognitive tasks in a digital format.
These new digital tools of cognitive evaluations will include not only the existing ones already developed by SBT, but also new tests under development by the ICM teams, and targeting ‘higher-order’ cognitive functions (motivation, fatigability, creativity, social cognition, …). In a first step, two different batteries will be implemented: a short duration one, aiming to get a rough overview of cognitive deficits for any brain lesioned patient, and an extensive one, exploring all domains in great details, and targeting subgroups of patients with mild deficits (like those patients operated on in awake conditions for a low-grade brain tumor). There are many advantages of digitalizing these tests: patients can undergo the testing without the supervision of a neuropsychologist, performances can be measured more accurately (for example, through the recording of reaction times), results can be automated exported for further analysis, …
2. The use of artificial intelligence algorithms to predict the socio-professional
outcomes (rates of divorces, of work resumption, …) from the cognitive scores. To this end, we will take advantage of the high-volume of patients in the clinical departments involved in the project and the durability of the LABCOM. In turn, this ability to predict socio-professional outcomes will enable clinicians to identify patients at risk and to prevent these risks by setting up a personalized rehabilitation program.
3. Finally, we will introduce new methods of cognitive rehabilitation, in order to
enhance the efficiency of current training program. These new tools will rely on the high degree of interactivity offered by digital tools. They will be designed from our renewed understanding of brain functioning at the level of meta-networks. The general idea is the following : the performance of complex tasks requires the synchronized and synergistic interaction of different subnetworks supporting cognitive subcomponents, like working memory, inhibition, flexibility, decision making … In case of failure to a complex task, patients will be overtrained in all elementary subfunctions contributing to the task, and ultimately on the whole task itself.