Abstract
The origins and rationale of the Cambridge Neuropsychological Test Automated Battery (CANTAB) as a cross-species translational instrument suitable for use in human neuropsychopharmacological studies are reviewed. We focus on its use for the early assessment and detection of Alzheimer’s disease, in particular the Paired Associates Learning (PAL) test. We consider its psychometric properties, neural validation, and utility, including studies on large samples of healthy volunteers, patients with mild cognitive impairment (MCI), and Alzheimer’s disease. We demonstrate how it can be applied in cross-species studies using experimental animals to bridge the cross-species translational ‘gap’. We also show how the CANTAB PAL has bridged a second translational ‘gap’ through its application to the early detection of memory problems in primary care clinics, using iPad technology.
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References
Alladi S, Arnold R, Mitchell J et al (2006) Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile. Psychol Med 36:507–515. doi:10.1017/S0033291705006744
Barnett JH, Damian M, Verhey FRJ et al (2011) Cognitive and CSF biomarkers in older adults, MCI, and dementia. Alzheimer’s Dement 7:S129–S130. doi:10.1016/j.jalz.2011.05.340
Barnett JH, Sahakian BJ, Werners U et al (2005) Visuospatial learning and executive function are independently impaired in first-episode psychosis. Psychol Med 35:1031–1041
Barson FP, Kinsella GJ, Ong B, Mathers SE (2000) A neuropsychological investigation of dementia in motor neurone disease (MND). J Neurol Sci 180:107–113
Bartko SJ, Vendrell I, Saksida LM, Bussey TJ (2011) A computer-automated touchscreen Paired Associates Learning (PAL) task for mice: impairments following administration of scopolamine or dicyclomine and improvements following donepezil. Psychopharmacology 214:537–548. doi:10.1007/s00213-010-2050-1
Beglinger LJ, Tangphao-Daniels O, Kareken DA et al (2005) Neuropsychological test performance in healthy elderly volunteers Before and after Donepezil administration. J Clin Psychopharmacol 25:159–165. doi:10.1097/01.jcp.0000155822.51962.b4
Blackwell AD, Barnett JH, Hayat S et al (2010) The effect of age, sex and education on visuospatial Paired Associates Learning ability: preliminary data from a British population study. Alzheimers Dement 6:S485
Blackwell AD, Sahakian BJ, Vesey R et al (2004) Detecting dementia: novel neuropsychological markers of preclinical Alzheimer’s disease. Dement Geriatr Cogn Disord 17:42–48
Braak H, Braak E (1991) Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol 82:239–259
Brisard C, Safirstein B, Booth K et al (2010) Safety, tolerability, and preliminary efficacy of SAM-531, a 5HT-6 antagonist, in subjects with mild-to-moderate Alzheimer’s disease: results from a phase 2a study. Alzheimer’s Dement 6:S311. doi:10.1016/j.jalz.2010.05.1013
Brodaty H, Low L-F, Gibson L, Burns K (2006) What is the best dementia screening instrument for general practitioners to use? Am J Geriatr Psychiatry 14:391–400. doi:10.1097/01.JGP.0000216181.20416.b2
Chamberlain SR, Blackwell AD, Nathan PJ et al (2011) Differential cognitive deterioration in dementia: a two year longitudinal study. J Alzheimers Dis 24:125–136. doi:10.3233/JAD-2010-100450
Chamberlain SR, Muller U, Deakin JB et al (2007) Lack of deleterious effects of buspirone on cognition in healthy male volunteers. J Psychopharmacol 21:210–215. doi:10.1177/0269881106068066
Chandler J, Marsico M, Harper-Mozley L et al (2008) Cognitive assessment: Discrimination of impairment and detection of decline in Alzheimer’s disease and mild cognitive impairment. Alzheimer’s Dement 4:T551–T552. doi:10.1016/j.jalz.2008.05.1676
Coba MP, Komiyama NH, Nithianantharajah J et al (2012) TNiK is required for postsynaptic and nuclear signaling pathways and cognitive function. J Neurosci 32:13987–13999. doi:10.1523/JNEUROSCI.2433-12.2012
Cooksey D (2006) A review of UK health research funding. Norwich, UK
Coull JT, Middleton HC, Robbins TW, Sahakian BJ (1995) Contrasting effects of clonidine and diazepam on tests of working memory and planning. Psychopharmacology 120:311–321
Dalley JW, Theobald DE, Bouger P et al (2004) Cortical cholinergic function and deficits in visual attentional performance in rats following 192 IgG-saporin-induced lesions of the medial prefrontal cortex. Cereb Cortex 14:922–932. doi:10.1093/cercor/bhh052
De Rover M, Pironti VA, McCabe JA, et al (2011) Hippocampal dysfunction in patients with mild cognitive impairment: a functional neuroimaging study of a visuospatial Paired Associates Learning task. Neuropsychologia 49:2060–70. doi:10.1016/j.neuropsychologia.2011.03.037
Deakin JB, Rahman S, Nestor PJ et al (2004) Paroxetine does not improve symptoms and impairs cognition in frontotemporal dementia: a double-blind randomized controlled trial. Psychopharmacol 172:400–408
Duka T, Tasker R, McGowan JF (2000) The effects of 3-week estrogen hormone replacement on cognition in elderly healthy females. Psychopharmacology 149:129–139
Dunnett SB, Everitt BJ, Robbins TW (1991) The basal forebrain-cortical cholinergic system: interpreting the functional consequences of excitotoxic lesions. Trends Neurosci 14:494–501
Egerházi A, Berecz R, Bartók E, Degrell I (2007) Automated Neuropsychological Test Battery (CANTAB) in mild cognitive impairment and in Alzheimer’s disease. Prog Neuropsychopharmacol Biol Psychiatry 31:746–751. doi:10.1016/j.pnpbp.2007.01.011
Emre M, Cummings JL, Lane RM (2007) Rivastigmine in dementia associated with Parkinson’s disease and Alzheimer’s disease: similarities and differences. J Alzheimers Dis 11:509–519
Fowler KS, Saling MM, Conway EL et al (1995) Computerized delayed matching to sample and paired associate performance in the early detection of dementia. Appl Neuropsychol 2:72–78. doi:10.1207/s15324826an0202_4
Fowler KS, Saling MM, Conway EL et al (1997) Computerized neuropsychological tests in the early detection of dementia: prospective findings. J Int Neuropsychol Soc 3:139–146
Fowler KS, Saling MM, Conway EL et al (2002) Paired associate performance in the early detection of DAT. J Int Neuropsychol Soc 8:58–71
Galloway P, Sahgal A, McKeith IG et al (1992) Visual pattern recognition memory and learning deficits in senile dementias of the Alzheimer and Lewy Body types. Dementias 3:101–107
Gijsman HJ, Scarnà A, Harmer CJ et al (2002) A dose-finding study on the effects of branch chain amino acids on surrogate markers of brain dopamine function. Psychopharmacology 160:192–197. doi:10.1007/s00213-001-0970-5
Greig NH, Sambamurti K, Yu Q et al (2005) An overview of phenserine tartrate, a novel acetylcholinesterase inhibitor for the treatment of Alzheimer’s disease. Curr Alzheimer Res 2:281–290
Harmer CJ, McTavish SFB, Clark L et al (2001) Tyrosine depletion attenuates dopamine function in healthy volunteers. Psychopharmacology 154:105–111. doi:10.1007/s002130000613
Hobart J (2010) Developing the ADAS-Cog to enhance its measurement performance for clinical trials of MCI. In: Clinical trials on Alzheimer’s disease. Toulouse, France
Horner AE, Heath CJ, Hvoslef-Eide M et al (2013) The touchscreen operant platform for testing learning and memory in rats and mice. Nat Protoc 8:1961–1984. doi:10.1038/nprot.2013.122
Howard R, McShane R, Lindesay J et al (2012) Donepezil and memantine for moderate-to-severe Alzheimer’s disease. N Engl J Med 366:893–903. doi:10.1056/NEJMoa1106668
Hughes JH, Gallagher P, Stewart ME et al (2003) The effects of acute tryptophan depletion on neuropsychological function. J Psychopharmacol 17:300–309. doi:10.1177/02698811030173012
Hvoslef-Eide M, Mar A, Nilsson S, et al (2015) The NEWMEDS rodent touchscreen test battery for cognition relevant to schizophrenia. Psychopharmacology 232:3853-3872
Ito K, Corrigan B, Zhao Q et al (2010) Disease progression model for cognitive deterioration from Alzheimer’s disease neuroimaging initiative database. Alzheimers Dement 7:151–160. doi:10.1016/j.jalz.2010.03.018
Katner SN, Davis SA, Kirsten AJ, Taffe MA (2004) Effects of nicotine and mecamylamine on cognition in rhesus monkeys. Psychopharmacology 175:225–240. doi:10.1007/s00213-004-1804-z
Kay DW, Henderson AS, Scott R et al (1985) Dementia and depression among the elderly living in the Hobart community: the effect of the diagnostic criteria on the prevalence rates. Psychol Med 15:771–788
Kéri S, Szamosi A, Benedek G, Kelemen O (2012) How does the hippocampal formation mediate memory for stimuli processed by the magnocellular and parvocellular visual pathways? Evidence from the comparison of schizophrenia and amnestic mild cognitive impairment (aMCI). Neuropsychologia 50:3193–3199. doi:10.1016/j.neuropsychologia.2012.10.010
Kim CH, Heath CJ, Kent BA et al (2015) The role of the dorsal hippocampus in two versions of the touchscreen automated Paired Associates Learning (PAL) task for mice. Psychopharmacology. doi:10.1007/s00213-015-3949-3
Lange KW, Sahakian BJ, Quinn NP et al (1995) Comparison of executive and visuospatial memory function in Huntington’s disease and dementia of Alzheimer type matched for degree of dementia. J Neurol Neurosurg Psychiatry 58:598–606
Lee ACH, Rahman S, Hodges JR et al (2003) Associative and recognition memory for novel objects in dementia: implications for diagnosis. Eur J Neurosci 18:1660–1670
Lesk VE, Honey TEM, de Jager CA (2009) The effect of recent consumption of caffeine-containing foodstuffs on neuropsychological tests in the elderly. Dement Geriatr Cogn Disord 27:322–328. doi:10.1159/000207445
Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological Assessment, 4th edn. Oxford University Press, Oxford
Livingston G, Hawkins A, Graham N et al (1990) The gospel oak study: prevalence rates of dementia, depression and activity limitation among elderly residents in inner London. Psychol Med 20:137–146
Lowe C, Rabbitt P (1998) Test/re-test reliability of the CANTAB and ISPOCD neuropsychological batteries: theoretical and practical issues. Cambridge neuropsychological test automated battery. International study of post-operative cognitive dysfunction. Neuropsychologia 36:915–923
Maguire EA, Frith CD, Burgess N et al (1998) Knowing where things are: parahippocampal involvement in encoding object locations in virtual large-scale space. J Cogn Neurosci 10:61–76. doi:10.1162/089892998563789
Mathuranath PS, Nestor PJ, Berrios GE et al (2000) A brief cognitive test battery to differentiate Alzheimer’s disease and frontotemporal dementia. Neurology 55:1613–1620
McAllister K, Mar A, Theobald DE, Saksida LM, Bussey TJ (2015) Comparing the effects of subchronic phencyclidine and medial prefrontal cortex lesions on cognitive tests relevant to schizophrenia. Psycopharmacology 232:3883–3898
McDonald RJ, White NM (1993) A triple dissociation of memory systems: hippocampus, amygdala, and dorsal striatum. Behav Neurosci 107:3–22
McKenna P, Warrington EK (1980) Testing for nominal dysphasia. J Neurol Neurosurg Psychiatry 43:781–788
Mehta MA, Sahakian BJ, McKenna PJ, Robbins TW (1999) Systemic sulpiride in young adult volunteers simulates the profile of cognitive deficits in Parkinson’s disease. Psychopharmacology 146:162–174. doi:10.1007/s002130051102
Mitchell J, Arnold R, Dawson K et al (2009) Outcome in subgroups of mild cognitive impairment (MCI) is highly predictable using a simple algorithm. J Neurol 256:1500–1509. doi:10.1007/s00415-009-5152-0
Miyashita Y, Kameyama M, Hasegawa I, Fukushima T (1998) Consolidation of visual associative long-term memory in the temporal cortex of primates. Neurobiol Learn Mem 70:197–211. doi:10.1006/nlme.1998.3848
Morris SB, DeShon RP (2002) Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychol Methods 7:105–125
Muir JL, Everitt BJ, Robbins TW (1995) Reversal of visual attentional dysfunction following lesions of the cholinergic basal forebrain by physostigmine and nicotine but not by the 5-HT3 receptor antagonist, ondansetron. Psychopharmacology 118:82–92
Müller U, Clark L, Lam ML et al (2005) Lack of effects of guanfacine on executive and memory functions in healthy male volunteers. Psychopharmacology 182:205–213. doi:10.1007/s00213-005-0078-4
National Collaborating Centre for Mental Health (2007) Dementia: a NICE-SCIE Guideline on supporting people with dementia and their carers in health and social care. The British Psychological Society
Nithianantharajah J, Komiyama NH, McKechanie A et al (2013) Synaptic scaffold evolution generated components of vertebrate cognitive complexity. Nat Neurosci 16:16–24. doi:10.1038/nn.3276
Owen AM, Beksinska M, James M et al (1993) Visuospatial memory deficits at different stages of Parkinson’s disease. Neuropsychologia 31:627–644
Owen AM, Milner B, Petrides M, Evans AC (1996) A specific role for the right parahippocampal gyrus in the retrieval of object-location: a positron emission tomography study. J Cogn Neurosci 8:588–602. doi:10.1162/jocn.1996.8.6.588
Owen AM, Sahakian BJ, Semple J et al (1995) Visuo-spatial short-term recognition memory and learning after temporal lobe excisions, frontal lobe excisions or amygdalo-hippocampectomy in man. Neuropsychologia 33:1–24
Park S, Coull JT, Mcshane R et al (1994) Tryptophan depletion in normal volunteers produces selective impairments in learning and memory. Neuropharmacology 33:575–588. doi:10.1016/0028-3908(94)90089-2
Parkinson J, Murray E, Mishkin M (1988) A selective mnemonic role for the hippocampus in monkeys: memory for the location of objects. J Neurosci 8:4159–4167
Rhodes SM, Coghill DR, Matthews K (2006) Acute neuropsychological effects of methylphenidate in stimulant drug-naive boys with ADHD II–broader executive and non-executive domains. J Child Psychol Psychiatry 47:1184–1194
Robbins TW (2002) The 5-choice serial reaction time task: behavioural pharmacology and functional neurochemistry. Psychopharmacol 163:362–380
Robbins TW, James M, Owen AM et al (1994) Cambridge neuropsychological test automated battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia 5:266–281
Robbins TW, Semple J, Kumar R et al (1997a) Effects of scopolamine on delayed-matching-to-sample and paired associates tests of visual memory and learning in human subjects: comparison with diazepam and implications for dementia. Psychopharmacol 134:95–106
Robbins TW, Semple J, Kumar R et al (1997b) Effects of scopolamine on delayed-matching-to-sample and paired associates tests of visual memory and learning in human subjects: comparison with diazepam and implications for dementia. Psychopharmacology 134:95–106
Romberg C, Mattson MP, Mughal MR et al (2011) Impaired attention in the 3xTgAD mouse model of Alzheimer’s disease: rescue by donepezil (Aricept). J Neurosci 31:3500–3507. doi:10.1523/JNEUROSCI.5242-10.2011
Rusted JM, Warburton DM (1988) The effects of scopolamine on working memory in healthy young volunteers. Psychopharmacology 96:145–152
Sahakian BJ (2014) What do experts think we should do to achieve brain health? Neurosci Biobehav Rev 43:240–258. doi:10.1016/j.neubiorev.2014.04.002
Sahakian BJ, Coull JJ, Hodges JR (1994) Selective enhancement of executive function by idazoxan in a patient with dementia of the frontal lobe type. J Neurol Neurosurg Psychiatry 57:120–121
Sahakian BJ, Morris RG, Evenden JL, et al (1988) A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson’s disease. Brain 111 (Pt 3:695–718)
Sahakian BJ, Owen AM, Morant NJ et al (1993) Further analysis of the cognitive effects of tetrahydroaminoacridine (THA) in Alzheimer’s disease: assessment of attentional and mnemonic function using CANTAB. Psychopharmacol 110:395–401
Sahgal A, Galloway P, McKeith IG et al (1992) A comparative study of attentional deficits in senile dementias of the Alzheimer and lewy body types. Dementia 3:350–354
Sahgal A, Sahakian BJ, Robbins TW et al (1991) Detection of visual memory and learning deficits in Alzheimer’s disease using the Cambridge neuropsychological test automated battery. Dementia 2:150–158
Scheltens P, Boada M, Dorflinger E et al (2014) Baseline patient characteristics from the Phase 3 SCarlet RoAD trial, a study of gantenerumab in patients with prodromal AD. JPAD 1:231–232
Smith ML, Milner B (1981) The role of the right hippocampus in the recall of spatial location. Neuropsychologia 19:781–793
Swainson R, Hodges JR, Galton CJ et al (2001) Early detection and differential diagnosis of Alzheimer’s disease and depression with neuropsychological tasks. Dement Geriatr Cogn Disord 12:265–280
Taffe MA (2012) Δ9 Tetrahydrocannabinol impairs visuo-spatial associative learning and spatial working memory in rhesus macaques. J Psychopharmacol 26:1299–1306. doi:10.1177/0269881112443743
Taffe MA, Weed MR, Gold LH (1999) Scopolamine alters rhesus monkey performance on a novel neuropsychological test battery. Brain Res Cogn Brain Res 8:203–212
Taffe MA, Weed MR, Gutierrez T et al (2004) Modeling a task that is sensitive to dementia of the Alzheimer’s type: individual differences in acquisition of a visuo-spatial Paired Associate Learning task in rhesus monkeys. Behav Brain Res 149:123–133
Taffe MA, Weed MR, Gutierrez T et al (2002) Differential muscarinic and NMDA contributions to visuo-spatial Paired Associate Learning in rhesus monkeys. Psychopharmacol 160:253–262
Talpos JC, Winters BD, Dias R et al (2009) A novel touchscreen-automated Paired Associate Learning (PAL) task sensitive to pharmacological manipulation of the hippocampus: a translational rodent model of cognitive impairments in neurodegenerative disease. Psychopharmacology 205:157–168. doi:10.1007/s00213-009-1526-3
Turner DC, Robbins TW, Clark L et al (2003a) Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology 165:260–269
Turner DC, Robbins TW, Clark L et al (2003b) Relative lack of cognitive effects of methylphenidate in elderly male volunteers. Psychopharmacology 168:455–464. doi:10.1007/s00213-003-1457-3
Vellas B, Carrillo MC, Sampaio C et al (2013) Designing drug trials for Alzheimer’s disease: what we have learned from the release of the phase III antibody trials: a report from the EU/US/CTAD Task Force. Alzheimers Dement 9:438–444. doi:10.1016/j.jalz.2013.03.007
Weed MR, Taffe MA, Polis I et al (1999) Performance norms for a rhesus monkey neuropsychological testing battery: acquisition and long-term performance. Brain Res Cogn Brain Res 8:185–201
Wright MJ, Taffe MA (2014) Chronic periadolescent alcohol consumption produces persistent cognitive deficits in rhesus macaques. Neuropharmacology 86:78–87. doi:10.1016/j.neuropharm.2014.07.003
Wright MJ, Vandewater SA, Angrish D et al (2012) Mephedrone (4-methylmethcathinone) and d-methamphetamine improve visuospatial associative memory, but not spatial working memory, in rhesus macaques. Br J Pharmacol 167:1342–1352. doi:10.1111/j.1476-5381.2012.02091.x
Wright MJ, Vandewater SA, Taffe MA (2013) Cannabidiol attenuates deficits of visuospatial associative memory induced by Δ(9) tetrahydrocannabinol. Br J Pharmacol 170:1365–1373. doi:10.1111/bph.12199
Yarnall AJ, Breen DP, Duncan GW et al (2014) Characterizing mild cognitive impairment in incident Parkinson disease: the ICICLE-PD study. Neurology 82:308–316. doi:10.1212/WNL.0000000000000066
Young AH, Sahakian BJ, Robbins TW, Cowen PJ (1999) The effects of chronic administration of hydrocortisone on cognitive function in normal male volunteers. Psychopharmacology 145:260–266
Declaration of Interest and Acknowledgements
JHB is an employee of and ADB a director of Cambridge Cognition, the company that develops and markets the CANTAB cognitive testing system. JB, AB, and BJS own shares and/or share options in Cambridge Cognition. BJS consults for Cambridge Cognition, Peak, Otsuka, Lundbeck, and Servier, holds a grant from Janssen/J&J, and owns shares in CeNeS. TWR consults for Cambridge Cognition, Eli Lilly, Shire, Lundbeck, Teva, Otsuka, and Chempartners. He holds grants from Lilly, Lundbeck, and GSK and receives royalties from Cambridge Cognition for CANTAB.
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Barnett, J.H., Blackwell, A.D., Sahakian, B.J., Robbins, T.W. (2015). The Paired Associates Learning (PAL) Test: 30 Years of CANTAB Translational Neuroscience from Laboratory to Bedside in Dementia Research. In: Robbins, T.W., Sahakian, B.J. (eds) Translational Neuropsychopharmacology. Current Topics in Behavioral Neurosciences, vol 28. Springer, Cham. https://doi.org/10.1007/7854_2015_5001
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