DIGITAL NEUROPSYCHOLOGICAL BATTERY
SPAIn-MO
Verbal and spatial working memory with N-Back tasks
Four N-Back tasks that assess working memory — verbal and spatial — under different levels of cognitive load, measuring the ability to maintain, update and manipulate information in real time with millisecond precision.
4
BRIEF TESTS
≈ 10′
DURATION
18–80
AGE RANGE
ms
PRECISION
· Development: UCM · UNED · NeuronUP | Authors: Periáñez, Lubrini, Ríos-Lago
· Reference data: by age, sex and education level | Clinical groups: brain injury, multiple sclerosis, Parkinson’s
THE PROBLEM
Why measure working memory?
When working memory fails, daily life suffers: difficulty retaining instructions, following conversations, managing several tasks at once, or solving problems that require holding information in mind.
These failures often go unnoticed in traditional paper-and-pencil tests. SPAIn-MO is designed precisely to detect them, quantify them and explain what is causing them.
INSTRUMENT FEATURES
A standardised digital platform
SPAIn combines classic reaction time tests, recording each response automatically and generating a report with multiple indicators ready to interpret.
01
Millisecond precision
The system measures each response with far greater accuracy than a manual stopwatch. It detects very small changes that would go unnoticed with other tests, making it especially useful for clinical follow-up.
02
Problem identification
The tasks isolate, one by one, the different phases of processing: perceiving, deciding, moving, remembering, controlling impulses. Comparing results pinpoints exactly where the difficulty appears.
03
Standardised administration
All tests follow the same format: initial questionnaire, practice trials, the actual test and a final questionnaire on fatigue and perceived performance. The clinician also adds qualitative observations.
CLINICAL BENEFITS
Practical information for clinical decisions
Beyond a single number, SPAIn gives the clinician information that translates directly into concrete decisions.
Identifies subtle changes not yet visible in conventional tests. Enables earlier action in mild cognitive impairment, early stages of neurodegenerative conditions, or after brain injury.
Differential diagnosis
Helps determine whether the difficulty is due to general slowing, attention deficit, memory failure or a motor problem. Essential when symptoms are ambiguous or overlap between conditions.
Tailored rehabilitation
Knowing which component is affected allows rehabilitation to be designed around the real problem. Training pure speed is not the same as training attention under pressure or the ability to inhibit responses.
Progress monitoring
Tests can be repeated without the patient “learning” the correct response. Ideal for checking whether a treatment is working, whether the condition is progressing, or whether the person is recovering after an acute episode.
Communicable results
Numerical data and comparative charts against the reference population make it possible to explain to the patient and their family what is happening and why. This improves understanding, adherence and motivation.
Support for daily life
Objective information to assess the suitability of activities such as driving, returning to work, managing finances, or any task requiring quick reactions and sustained attention.
SCIENTIFIC BASIS
Consolidated theoretical foundations
Attention, working memory, executive functions and processing speed are closely connected: when one fails, the others are usually affected. SPAIn integrates models by Diamond, Miyake, Posner and Baddeley.
Reaction time tasks are among the most sensitive tools for detecting cognitive changes, even when better-known tests appear to give normal results.
Numerous studies show that much of what appears to be “memory failure” or “attention failure” is, in fact, explained by an underlying slowing of processing.
| Attention | The ability to stay alert, orient and focus on what matters. |
| Working memory | The ability to hold information “in mind” and manipulate it while performing a task. |
| Executive functions | The ability to inhibit impulses, switch plans, organise and make decisions. |
| Processing speed | The speed at which the brain understands, decides and responds to incoming information. |
THE FOUR TESTS
From low load to high load
The N-Back paradigm assesses the ability to maintain, update and manipulate information in real time. The battery includes verbal (numbers) and spatial (positions) versions, under low-load (1-Back) and high-load (2-Back) conditions, to examine separately the phonological and visuospatial components of working memory.
▍ Working memory · Tests 1–4 · N-Back tasks
01 · 1-Back Num
Memory with numbers (low load)
The patient must press when the number shown matches the one shown immediately before.
What it measures: ability to retain brief information and compare it with the next item.
Clinical use: assessing short-term memory under simple conditions.
02 · 2-Back Num
Memory with numbers (high load)
The patient must respond when the current number matches the one shown two positions earlier.
What it measures: holding several things in mind simultaneously and updating them.
Clinical use: detecting difficulties following conversations, complex instructions or demanding intellectual work.
03 · 1-Back Spat
Spatial memory (low load)
The patient must respond when the circle appears in the same position as in the previous screen. There are nine possible positions in a 3 × 3 grid.
What it measures: remembering where things were a moment ago.
Clinical use: assessing visual and spatial memory, useful for orientation.
04 · 2-Back Spat
Spatial memory (high load)
The patient must respond when the current position of the circle matches the position it had two screens earlier.
What it measures: managing several locations simultaneously in the mind.
Clinical use: sensitive to alterations after traumatic brain injury or in pathological ageing.
REPORT
What the report provides
Each test generates direct and derived results, automatically compared against people of the same age, sex and education level.
Basic results
- Mean response time (ms)
- Correct responses and errors per condition
- Missed responses and premature responses
- Response consistency (variability)
- Comparison with the reference population (percentiles)
Profile indicators
- Balance between speed and accuracy
- Update rate, hits and missed responses
- Load effect (1-Back vs 2-Back)
- Reaction after making an error (self-correction)
- Differences between verbal and spatial memory
Behaviour
- Onset of fatigue during the task
- Learning curve
- Practice effect between conditions
- How the patient feels before and after
- Clinician’s notes
CONFIGURATIONS
Available configurations
Use the full battery or shorter groupings depending on what you need to assess.
| Configuration | Composition | Purpose | Duration |
|---|---|---|---|
| SPAIn | All 10 tests | Comprehensive cognitive profile | ≈ 30 min |
| SPAIn-VPM | Finger Tapping Simple reaction time Choice reaction time | Basic speed to see, decide and move the hand | ≈ 7 min |
| SPAIn-MO | 1-Back and 2-Back numerical 1-Back and 2-Back spatial | Verbal and spatial working memory | ≈ 10 min |
CLINICAL APPLICATION
Clinical application by condition
SPAIn-MO shows how increasing load (1-Back vs 2-Back) affects verbal and spatial working memory, revealing subtle impairments that go unnoticed under simple conditions.
| Condition | What is usually affected | Typical pattern in working memory |
|---|---|---|
| Mild cognitive impairment Useros-Olmo, 2015; 2020 | Performance on 2-Back (high load) | Marked decline as load increases; possible early warning sign |
| Traumatic brain injury | Updating and manipulation under load | More errors and missed responses on 2-Back |
| Frontal lesions | Updating and manipulation of information | Executive difficulty under high load |
| Schizophrenia | Verbal and spatial working memory | Generalised deficit |
| Ageing | Efficiency under high load | Load-dependent slowing |
PATIENT PROFILE
Patients who may benefit
SPAIn-MO is useful in conditions where working memory, information updating or sensitivity to cognitive load are part of the problem.
Mild cognitive impairment
Detects subtle drops in working memory as load increases — a possible early warning sign.
Traumatic brain injury
Sensitive to difficulties in updating and manipulating information following brain damage.
Schizophrenia
An objective measure of working memory deficit, independent of the most visible symptoms.
Ageing
Distinguishes the expected age-related working memory decline from what might indicate pathology.
ADHD and similar conditions
Quantifies difficulties maintaining and updating information under attentional load.
Treatment monitoring
Objectively verifies whether an intervention is improving working memory performance.
HOW IT IS ADMINISTERED
Practical administration
SPAIn is designed to be administered rigorously in clinical settings. These are the technical and administration requirements.
| Duration | Approximately 10 min (SPAIn-MO) |
| Devices | Computer or tablet in landscape orientation. Not mobile phones or small tablets |
| Posture | Seated ~50 cm from the screen, arms supported, index fingers |
| Clinician | Supervised by a neuropsychologist or equivalent |
| Environment | Quiet room, free from distractions |
| Practice trials | Practice run before each test |
| Prior data | Diagnosis, sex, date of birth, education, country, language, dominant hand |
| Questionnaires | Mood, sleep, fatigue and perceived performance (1–7), before and after |
REFERENCE DATA
Validity, reliability and norms
SPAIn is based on extensively validated reaction time tests. Its reference data is updated periodically to ensure fair comparisons.
Age
18 – 80 years
Comparisons by
Age, sex and education level
Clinical groups
Brain injury, multiple sclerosis and Parkinson’s
Updates
Periodic, as new data are incorporated
Patient data
Sex, date of birth, education, country, native language and dominant hand
CLINICAL OBSERVATION
Observations recorded by the clinician
Beyond the numbers, the clinician can record what happens during the test.
- General state and arousal level of the patient
- Understanding of instructions and need to repeat them
- Dominant hand and use of the other hand
- Awareness of errors and attempts to correct them
- Hesitations and repeated responses
- Awareness of own difficulties
- Signs of low effort or lack of motivation
- Self-talk or self-encouragement during the task
- Changes in breathing or posture during the test
- Left-right confusion, especially in older patients
- Environmental distractions (calls, interruptions)
- Mood and attitude towards the assessment
- Visual or motor difficulties affecting the test
- Personal style (more cautious or more risk-prone)
- Breaks during the session and reasons for them
RESEARCH TEAM
Authors
Prof. José A. Periáñez
PRINCIPAL INVESTIGATOR
Dept. of Basic Psychology II
Universidad Complutense de Madrid
Prof. Genny Lubrini
CO-AUTHOR
Dept. of Basic Psychology II
UNED
Prof. Marcos Ríos-Lago
CO-AUTHOR
Dept. of Basic Psychology II, UNED
Dept. of Neuropsychology, NeuronUP
FAQ
Frequently asked questions
1. What ages can it be used for?
SPAIn is validated for people aged 18 to 80, with comparison groups by age, sex and level of education. Results for those under 18 or over 80 should be interpreted with caution.
2. On which devices can it be administered?
The recommended device is a computer or a tablet placed horizontally on a table. It should not be used on mobile phones or small tablets, as the patient must respond with their index fingers, not their thumbs.
3. Can the patient take the test on their own?
No. The test must be supervised by a qualified professional, who ensures the patient understands the instructions, takes useful notes, and correctly interprets the results.
4. What is the difference between the full battery and the short versions?
The full SPAIn battery (10 tests, approximately 30 minutes) provides a comprehensive cognitive profile. SPAIn-VPM groups three tests focused on basic speed of seeing, deciding and moving the hand. SPAIn-MO includes the four working memory tasks (with numbers and with positions, under easier and harder conditions).
5. What information does the report provide?
Mean response time, correct responses and errors, missed responses, premature responses, response consistency and comparison with the reference population. It also includes profile indicators that help interpret the results: balance between speed and accuracy, ability to distinguish between similar stimuli, task-switching cost, self-correction after an error, and differences between hands.
6. Can the test be repeated for follow-up?
Yes. Each assessment is saved in the patient’s file and can be compared with previous ones. This makes it possible to track whether the patient is improving with rehabilitation, whether the condition is progressing, or whether a treatment is working.
7. Can it provide a diagnosis by itself?
No. SPAIn is not a medical device within the meaning of Regulation (EU) 2017/745. Its purpose is for guidance, as part of a broader neuropsychological assessment conducted by a qualified professional.
8. How is the patient compared with the general population?
When starting the assessment, some patient data is entered (sex, date of birth, education level, country, language and dominant hand). The system automatically assigns them to the closest reference group and displays results in relation to similar people.
Would you like to see SPAIn in action?
Request a personalised demonstration with one of our neuropsychologists and discover how to integrate the battery into your practice.
