The CANTAB Paired Associates Learning task as a pre-screening tool for clinical trials

Enriching participant eligibility for clinical trials through pre-screening for cognitive deficit.

Alzheimer’s disease (AD) trials require participants with a specific biomarker and cognitive profile, targeting a particular disease severity: from pre-clinical to severe AD. Finding participants for clinical trials in the ‘pre-clinical’ or ‘prodromal’ stage of AD prior to the onset of cognitive and functional decline can be challenging, time-consuming and expensive. Episodic memory tasks such as CANTAB Paired Associates Learning (PAL), are associated with AD biomarkers, hippocampal and temporal-frontal network function (de Rover 2011, Nathan 2017) and may therefore be useful for pre-screening.

This study synthesised data to assess the utility of PAL to (i) differentiate patients from controls, (ii) enrich samples for biomarker positive subjects, and (iii) identify deficits in other commonly used cognitive tasks.

The study concluded that PAL can be used to (i) pre-screen subjects and identify those with episodic memory deficits early in the recruitment process, and (ii) enrich samples for amyloid positive participants.

PAL is a promising AD screening task as it can be used at home, as a web-based assessment, as well as in-clinic. By targeting subjects with a high probability of meeting screening criteria: trial costs, screen failure rates, site and patient burden, could potentially be reduced.

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Poster by Kenton Zavitz and colleagues