Fastball ‐ a new functional biomarker of cognitive impairment

Background Fastball provides a new, rapid, objective EEG method for assessing cognitive function. Fastball is culturally, linguistically and educationally independent. Participants do not need to understand the task, or provide any response, and tasks take just minutes to complete. Fastball has recently been shown to be sensitive to memory deficits in Alzheimer’s disease (Stothart et al., Brain, 2021), and we present the latest findings in Mild Cognitive Impairment (MCI) patients. Method Healthy older adult controls (n = 56, ACE‐III = 96+‐3) and MCI patients (n = 46, ACE‐III = 82+‐10) completed a Fastball task designed to measure their recognition memory at baseline and at 12 month follow up. All EEG data were collected in patients' homes using low‐cost portable EEG. They also completed the ACE‐III and the Delayed Match to Sample 48, a validated neuropsychological measure of recognition memory. Result Between group comparisons, controlling for individual differences in EEG response magnitude, showed amnestic MCI patients had significantly reduced Fastball responses compared to non‐amnestic MCI patients (p = .002) and healthy older adult controls (p = .005). Fastball scores correlated with the ACE‐III memory subscale (r(46) = .44, p = 0.002) and no other ACE‐III subscale, demonstrating sensitivity and specificity to memory dysfunction. Fastball scores also correlated with performance on the Delayed Match to Sample 48 subscale (r(46) = .37, p = .011). 12 month follow up is underway and data will be presented at AAIC 2023. Conclusion Fastball is a passive, rapid measure of memory dysfunction in Alzheimer’s disease that we have now demonstrated to be sensitive to early memory dysfunction in Mild Cognitive Impairment. Fastball data can be reliably collected in patients' homes using low‐cost portable EEG, and the approach holds great potential as a future diagnostic tool.