A puzzle game can predict your risk of infection

If your alertness and reaction time are wobbly than usual, you may be more susceptible to viral illness
.

That's the key finding
of an experiment led by researchers at the University of Michigan in close collaboration with researchers at Duke University School of Medicine and the University of Virginia.

"We all know that if we're stressed, or sleep deprived, our immune system becomes less resilient," said Alfred Herro, the John H.
Holland Distinguished Professor of Electrical Engineering and Computer Science at the University of Michigan, who was the corresponding author
of the study in Scientific Reports.

"This is the first exposure study in humans to show that a person's cognitive performance before exposure to respiratory viruses can predict the severity
of infection," he said.

Subtle changes in daily cognitive performance may signal changes in brain states that are known to increase the risk of
diseases such as stress, fatigue, and sleep deprivation.
The team wanted to measure cognitive function and explore whether it could predict immune performance
after exposure to respiratory viruses.
Through digital self-tests conducted at home, cognitive variability proved to be highly predictive
.

The team studied 18 healthy volunteers who were tested for brain function three times a day for three days before being exposed to a cold virus
called human rhinovirus.
The software provides measures of 18 cognitive functions, including reaction time, attention, and rapid switching between numbers and symbols, which combine to produce a variability index
.

"Initially, we didn't find a significant association between cognitive function and disease susceptibility because we were using raw scores
.
But later, when we looked at changes over time, we found that changes in cognitive function were strongly associated with immunity and susceptibility," said Yaya Zhai, Ph.
D.
, bioinformatics at the University of Michigan, who is the study's first author
.
She and Hero led the development of
the cognitive variation index.

The team assessed viral shedding
by rinsing the participants' nasal passages with a saline solution.
They determined the presence of viral infection and the amount of virus in the liquid by growing the
virus in cell culture media.
As for symptoms, the team used the Jackson score, in which participants rated 8 common cold symptoms on a scale of 1 to 3
.

"This is an interesting observation from a relatively small study
.
I hope to have the opportunity to confirm these findings in larger, more definitive studies," said Ronald Turner, professor emeritus of pediatrics at the University of Virginia who led
the experiment.

The team is optimistic that smartphone use could eventually help identify predisposing times, monitor cognitive metrics such as typing speed and accuracy, and how long
users sleep.

P.
Murali Doraiswamy, director of the neurocognitive disorders program at Duke University School of Medicine who designed the neurocognitive component of the study, said, "Traditional clinical cognitive assessments, which look at raw scores at a single point in time, often do not provide a true picture of
brain health.
"

Doraiswamy said: "At home, regular cognitive monitoring via self-testing digital platforms is the future of
brain health assessment.
"

The study was part of a project funded by the Defense Advanced Research Projects Agency to discover whether it was possible to predict a soldier's
susceptibility to disease.
The project was led by Geoffrey Ginsburg, then a professor at Duke University's Center for Applied Genomics and Precision Medicine, who led a team that analyzed blood samples for biomarkers that could indicate susceptibility to disease
.

The experiment also identified a number of genetic markers that may indicate decreased immune function, which the team may explore further in future studies
.

The Lumos lab provided their online neurocognitive performance test, but was not involved in the process
of conducting research or publishing reports.

Hero or R.
Jamison and Betty Williams are the Professor of Engineering, Professor of Biomedical Engineering and Professor
of Statistics at the University of Michigan.
Zhai is now a data scientist
at VivoSense.
Ginsburg is now chief medical and scientific officer
for the National Institutes of Health's "All of Us" research program.
Doreswamy is also a professor of psychiatry and medicine at Duke University School of Medicine and a consultant
in the Fluorescence Scintigraphy Laboratory.

The University of Michigan and Duke University have filed patent protections
for the cognitive variation index.