Updates

Apr 2026PlatformMiniOCTAL

Researchers and clinicians can now track participant progress in real time. A live web dashboard is available for every Mini-OCTAL project, showing at a glance which participants have completed which tasks, with no technical knowledge required. Green means done, grey means outstanding. The dashboard updates automatically within minutes of a participant finishing, so study teams always have an up-to-date picture of data collection without needing to contact the research team.

Apr 2026PlatformMiniOCTAL

Our analysis pipeline has been migrated from MATLAB/Windows to Python running on AWS Linux, reducing costs and significantly improving efficiency. AWS runs 24/7, meaning participant data is processed automatically the moment it arrives, day or night. Preprocessed results for each task are saved directly to each project's repository, ready for download.

Apr 2026PlatformMiniOCTAL

Participant ID field locks automatically when pre-filled via URL, preventing accidental edits in longitudinal studies.

Mar 2026MiniOCTAL

Spanish translation proofread by native speaker (visiting student Miss Ines Millan Martin).

Jan 2026PublicationsOCTAL

Our first methods paper on OCTAL is out in npj Digital Medicine. Across four studies and 1,664 participants we validated the platform against the in-person gold standard, the ACE-III: a 5-minute OCTAL screen told Alzheimer's disease from subjective cognitive decline as accurately as the paper test (AUC 0.92), and a 20-minute subset did better still (AUC 0.97). Scores were stable over six months of repeat testing (118 participants, three visits), tracked healthy ageing domain by domain between 45 and 85, and were equivalent in English and Chinese speakers. Zhao, Toniolo et al. 2026

Nov 2025PublicationsOCTAL

Preprint: OCTAL + NULISA proteomics in 391 patients identifies cognitive resilience biomarkers. [Toniolo, Zhao et al. 2025]

Jan 2025MiniOCTAL

MiniOCTAL now supports 23 languages including Arabic, Farsi, Bengali, Tamil, and Traditional Chinese.

Apr 2024PublicationsOCTAL

OCTAL identifies Alzheimer's remotely; performance correlates with plasma pTau181. [Toniolo, Zhao et al. 2024]

Feb 2024PublicationsOCTAL

Long-COVID patients show severe cognitive slowing on SRT; non-long-COVID had normal speed. [Zhao et al. 2024]

Jan 2022PublicationsOCTAL

Number Vigilance Task detects attention decline in 2 min; COVID-19 patients showed minor deficit. [Zhao et al. 2022]

Publications

7 peer-reviewed papers and one preprint describe OCTAL or report findings made with it. The methods paper comes first and is the one to cite; the rest follow newest first. * co-first authors.

Zhao, S.* & Toniolo, S.* et al. (2026). Remote digital cognitive assessment for aging and dementia using the Oxford Cognitive Testing Portal OCTAL. npj Digital Medicine.
The OCTAL methods paper. Please cite this if you use OCTAL, and for its validation, test-retest reliability and cultural neutrality.
Alzheimer's diseaseAgeing
Toniolo, S. et al. (2026). Test-retest reliability of plasma biomarkers and digital cognitive metrics at clinically meaningful timescales. Alzheimer's Research & Therapy.
OCTAL measures were highly reliable when repeated at the intervals used in clinics and trials, so repeating them adds nothing, whereas plasma p-tau181 was the least reliable measure and the only one that benefited from a repeat sample.
Alzheimer's diseasePlasma biomarker
Toniolo, S. et al. (2026). Novel markers of cognitive impairment and resilience using digital and plasma biomarkers across different neurodegenerative diseases. Molecular Psychiatry, in press.
In 391 memory-clinic patients, a new blood proteomic panel (NULISA) combined with OCTAL scores revealed distinct biomarker patterns across Alzheimer's disease, Lewy body dementia, frontotemporal dementia and related conditions, including markers of cognitive resilience.
Alzheimer's diseaseLewy body dementiaPlasma biomarker
Cherix, A. et al. (2026). A hippocampal neuroimaging signature of neurovascular insulin signalling links metabolism to mood. bioRxiv, preprint.
The first OCTAL study in depression. Unmedicated patients and healthy controls completed the battery on a tablet alongside 7 Tesla brain imaging: hippocampal GABA, lactate and connectivity tracked the severity of mood symptoms more closely than cognition, while the blood-sugar marker HbA1c related to mood, cognition and brain measures alike.
Depression7T brain imaging
Kafashan, M. et al. (2025). Investigating the impact of electroconvulsive therapy on brain networks and sleep: an observational study protocol. BMJ Open.
Protocol of the DNS-ECT study at Washington University in St Louis. Patients with refractory depression take OCTAL at home every week through a course of electroconvulsive therapy, with the Oxford Memory Test and Object-in-Scene as the primary memory outcomes, to relate cognitive side effects to EEG brain networks and sleep.
DepressionElectroconvulsive therapy
Toniolo, S.* & Zhao, S.* et al. (2024). Relationship of plasma biomarkers to digital cognitive tests in Alzheimer's disease. Alzheimer's & Dementia: DADM.
The first validation of OCTAL against blood tests: digital task scores tracked plasma p-tau181, and combining the two classified Alzheimer's disease with high accuracy.
Alzheimer's diseasePlasma biomarker
Zhao, S. et al. (2024). Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study. eClinicalMedicine.
A simple online reaction-time task showed marked cognitive slowing in people with long COVID, consistently across sites in two countries.
Long COVID
Zhao, S. et al. (2022). Rapid vigilance and episodic memory decrements in COVID-19 survivors. Brain Communications.
Months after infection, COVID-19 survivors showed deficits in sustained attention and episodic memory on online tasks, the first OCTAL findings in a clinical population.
Long COVID