Abstract:
A method for measuring cognitive efficiency uses the following cognitive tests: Simple Reaction Time; Running Memory Continuous Performance Task; Matching to Sample; and Mathematical Processing Task. A device for measuring cognitive efficiency includes a microprocessor having a memory; the aforementioned cognitive tests loaded into the memory; a baseline stored in the memory, means for computing the score on a run of these tests and for storing the score in the memory; the means for computing being operative for comparing the score to the stored baseline; and means for indicating a cognitive change from the baseline. Changes in cognitive efficiency may be measured by comparing the results of the cognitive tests to a baseline.

Description:
CROSS REFERENCES 
     This application is a continuation-in-part of U.S. application Ser. No. 09/185,310, filed Nov. 3, 1998 now U.S. Pat. No. 6,066,092 which claims benefit of Provisional No. 60/064,879 filed Nov. 6, 1997. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates generally to the medical field and, more particularly, to a method and device for measuring cognitive efficiency in humans. 
     BACKGROUND OF THE INVENTION 
     The measurement of cognitive efficiency has been limited to testing of a subjective nature, and results of such testing have not been available in real-time. In addition, current testing methods are limited in their ability to detect positive and negative changes in the cognitive efficiency of a test subject. It would be desirable to develop a method of measuring the level of cognitive efficiency and subsequent changes in cognitive efficiency by means of a purely objective test that yields results in real-time. Such a test should take into consideration reaction time, memory, spatial relationships, and mathematical integration. 
     The Automated Neuropsychological Assessment Metrics (ANAM) is a set of standardized batteries of cognitive tests, modified by neuropsychologists in the U.S. Armed Forces for precise measurement of cognitive processing efficiency of military personnel. The tests assess sustained concentration and attention, mental flexibility, spatial processing, cognitive processing efficiency, mood, arousal/fatigue level, and short-term, long-term and working memory. The ANAM is now in the public domain. The most recent version is ANAM V3.11a/96 which includes the following battery of tests: 
     1. Subject Demographics Form 
     2. Stanford Sleepiness or Sleep/Fatigue Scale 
     3. Mood Scale  2   
     4. Simple and Two-Choice Reaction Time 
     5. Sternberg Memory Search Tasks 
     6. Running Memory Continuous Performance Task 
     7. Mathematical Processing Task 
     8. Digit Set Comparison Task 
     9. Logical Reasoning-Symbolic 
     10. Tower of Hanoi (Tower Puzzle) 
     11. Stroop Color/Word Interference 
     12. Code Substitution (Letter/Symbol Comparison) 
     13. Code Substitution (Immediate and Delayed Recall) 
     14. Spatial Processing Task (Simultaneous) 
     15. Matching to Sample 
     16. Tapping (Left and Right Index Finger) 
     17. Modified Orientation and Amnesia Test 
     It would be desirable to be able to use a subset of these tests to measure the cognitive efficiency of a human. 
     SUMMARY OF THE INVENTION 
     The present invention provides a method for measuring the cognitive efficiency in a human using the following cognitive tests: Simple Reaction Time; Running Memory Continuous Performance Task; Matching to Sample; Mathematical Processing Task. Change in cognitive efficiency may be measured by comparing the results of the cognitive tests to a baseline. Preferably the tests are administered in the listed sequence. Advantageously the tests are preceded by the Stanford Sleepiness Scale and Mood Scale  2  tests. 
     In a preferred arrangement there is provided a cognitive efficiency measurement device including a microprocessor having a memory, a battery of tests loaded into the memory of the microprocessor and including a Simple Reaction Time, a Running Memory Continuous Performance Task, a Matching to Sample, and a Mathematical Processing Task; a baseline stored in memory; means for computing the score on a run of the tests; the means for computing being perative for comparing the score to the stored baseline; and means for indicating a cognitive change. 
     These and other objects, aspects, features and advantages of the present invention will become apparent from the following detailed description when taken in conjunction with the referenced drawings. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     Reference is now made more particularly to the drawings which illustrate the best presently known mode of carrying out the invention and wherein similar reference characters indicate the same parts throughout the views. 
     The accompanying drawings illustrate two devices and one method for carrying out the present invention and wherein: 
     FIG. 1 is a plan view of a hand-held computer which is one apparatus for determining cognitive change in a human; 
     FIG. 1A is a plan view of a palm-top type computer which is another apparatus for determining cognitive change in a human; 
     FIG. 2 is a flow chart illustrating the steps and sequence of a method for measuring cognitive efficiency and change in cognitive efficiency in humans; 
     FIG. 3A is a schematic view of an apparatus to control the operation of a machine with a starting mechanism; 
     FIG. 3B is a schematic view of an apparatus to control the operation of a machine without a starting mechanism. 
    
    
     DETAILED DESCRIPTION 
     FIG. 1 shows a cognitive efficiency measurement device in the form of a hand-held computer, generally designated  10 , and having a key pad  12  and a screen  14  which advantageously is at least four inches (10.16 cm.) square. A hinge  15  is provided so the screen  14  may be conveniently folded down upon the key pad  12  for storage or transporting. When open the computer  10  is conveniently about 5″×9″ (12.7 cm. by 22.86 cm.) in size. The key pad  12  has a built-in set of two mouse buttons  16 , 18 , a start/stop or on/off button  22 , an enter key  24 , and Mood Scale  2  keys  1 ,  2  and  3 . As used herein the terms “buttons” and “keys” are intended to mean the same thing. The computer  10  contains memory chips (not shown) which have a set of programmed cognitive tests  103 - 106  (hereafter described) and which record a person&#39;s performance time in milliseconds on those tests. An objective standard may be directly entered and stored in the memory chips as a baseline, or a score from a prior battery of tests, converted to stanine, may be used as the baseline. Subsequent trials are similarly scored, converted to stanine, and compared to the baseline. 
     FIG. 1A shows a palm-top type computer  10   a  which, when programmed with the cognitive tests  103 - 106 , performs the same functions as hand-held computer  10 . Accordingly, the same functional parts identified in FIG. 1, are identified in FIG. 1A with the same numerals and the letter “a”. Further description is deemed unnecessary. It is believed that the largest palm-top computer now available is 7.8 inches (19.81 cm.) long and the screen  14   a  is not as large as the desired four inches (10.16 cm.) square. However, this deficiency is offset by the savings in using mass produced devices. 
     FIG. 2 shows the sequence of a cognitive efficiency measurement method. From the seventeen tests of the original ANAM, four subtests were selected and sequenced for measuring cognitive processing efficiency, as follows: 
     1. Simple Reaction Time (SMRT),  103   
     2. Running Memory Continuous Performance Task (CPT),  104   
     3. Matching to Sample (M 2 SP),  105   
     4. Mathematical Processing Task (MATH),  106   
     Also included are two preliminary measures of alertness and mood that are also part of the ANAM: 
     1. Stanford Sleepiness Scale,  101   
     2. Mood Scale  2 ,  102 . 
     Description of Subtests 
     1. The first step  101  is Stanford Sleepiness Scale which consists of seven statements that describe the present state of alertness or sleepiness and are numbered from one to seven, with one being highly alert and seven being close to sleep. Individuals rate their level of alertness prior to taking the first subtest of the battery. It provides a way to monitor fatigue over the course of repeated measures. Subjective ratings may be correlated with measured performance. 
     2. The second step  102  is Mood Scale  2  which consists of a list of thirty-six adjectives that are rated on a three-point scale. Using mouse button  16  participants respond to each adjective by indicating “yes,” “moderately,” or “no,” based on how they feel at the present time. The Mood Scale  2  categories include anger, happiness, fear (anxiety), depression, activity, and fatigue. 
     3. The third step  103  is Simple Reaction Time (SMRT) which presents a simple stimulus on the screen (*). In response, the individual presses the mouse button  16  each time the stimulus appears. The Reaction Time measures the speed of the motor response, the peripheral nerve conduction velocity. This represents the “hardware” of the nervous system in terms of input, followed by motor response. Actual cognitive processing time is not involved in this test. 
     4. The fourth step  104  is Running Memory Continuous Performance Test (CPT) which is a continuous letter comparison task. A randomized sequence of upper-case letters, A through Z, is presented one at a time in the center of the computer screen  14 . The person presses button  16  if the letter on the screen matches the letter that immediately preceded it; and different button  18  if the letter on the screen is different than the immediately preceding letter. The task lasts approximately five minutes. The CPT was specifically designed to assess components of memory, attention, efficiency and consistency. This task is forced paced, with individuals having only a brief time in which to respond. 
     5. The fifth step  105  is Matching to Sample (M 2 SP) and consists of a number of trials that begins with a first design being presented in the center of the screen  14  for three seconds, followed by a showing that contains two designs. The person matches one of the two designs with the first design or sample by pressing the appropriate button  16  or  18 . The design is a 4×4 checkerboard and varies by the number of cells that are shaded from one cell through twelve cells. 
     6. The sixth step  106  is Mathematical Processing (MATH) and involves arithmetic problems presented in the middle of the screen  14 . Working from left to right, the person solves the addition and subtraction and decides if the answer is greater or less than the number  5 . 
     As indicated, the scores are recorded in the memory of the computer  10  and the score on the third trial of these sequenced cognitive tests  103 - 106  is used as a baseline. As indicated above, a standardized baseline may also be stored in the computer memory. Subsequent trials measure cognitive change as compared to the baseline. An objective standard score or scores received by other tested humans may be directly entered into and stored in the computer as the baseline if it is desired to compare the cognitive efficiency of a human to an objective standard or to other humans. 
     It will be appreciated by those in the art that the above described tests are purely objective and examine four key areas of cognitive function: reaction time, memory, spatial relationships, and mathematical integration. In addition, the method provides results from these tests almost immediately. The method also allows for the detection of positive or negative change in cognitive efficiency of a test subject by comparing the most recent test results to an established baseline cognitive efficiency measurement for the test subject. 
     The method of measuring cognitive efficiency has practical applications as both a testing means and a security apparatus. The method can be used to determine the effects of new pharmaceuticals on humans prior to their distribution. For instance, trials by pharmaceutical companies or the Food and Drug Administration could determine whether a new drug induces drowsiness in or otherwise impairs a user of the medication by comparing measurements taken after administration of the medication with a baseline. 
     The method can also be incorporated into an apparatus arranged to prevent an operator from using motive or stationary machinery, such as an automobile, truck, tractor, airplane, watercraft, power tool, or industrial equipment, while in a fatigued condition or under the influence of alcohol or drugs. As an example, a cognitive efficiency measurement device can be connected between a power source and a work device. In one embodiment shown in FIG. 3A, a connection of the cognitive efficiency measurement device  30  with a starting mechanism  32 , such as an ignition circuit or power switch, and an engine  34  or other motive force of a machine is in the form of a switch  36  that, when open, breaks the connection between the starting mechanism  32  and the engine  34 , thereby preventing starting of the engine  34 . The switch  36  can be moved to the closed position, thereby reconnecting the starting mechanism  32  and the engine  34  and allowing the engine  34  to be started, only when the cognitive efficiency device  30  sends a signal to the switch  36 . In this arrangement, the starting mechanism  32  is allowed to initiate operation of the machine when the switch  36  is in the closed position. In another arrangement shown in FIG. 3B, the cognitive efficiency device  30  acts as the starting mechanism. Therefore, the operation of the machine is immediately initiated when the switch  36  moves to the closed position. The device  30  would send the signal only when the operator activates the cognitive efficiency device  30  and receives a satisfactory score on the cognitive tests. A satisfactory score would be defined as a score that equals or surpasses a standard baseline entered directly into the device or the operator&#39;s personal baseline measurement. 
     Other objects, features and advantages of the present invention will be apparent to those skilled in the art. While preferred steps of the method have been illustrated and described, this had been by way of illustration and the invention should not be limited except as required by the scope of the appended claims.