Illustration with two panels, left panel showing a computer screen with an image of a cognitive assessment, and right panel showing a person coughing.
Design by Arunika Shee

While past research has suggested that being stressed or not sleeping enough could make you more vulnerable to infection, a recent study conducted by researchers at Duke University and the University of Virginia in collaboration with researchers at the University of Michigan suggests that the resilience of your immune system is related to cognitive performance.

The study, which was published in the journal Scientific Reports on Dec. 31, 2022, is the first study suggesting that a person’s cognitive performance at different times — including their ability to focus and their memory skills — can predict how severe a viral respiratory infection might be.

The study, which began in September 2015, tracked the cognitive behavior of 18 participants who lived normally while biomarkers, such as viral and contagion levels, along with symptoms and cognitive performance data were tracked three times per day. The study started with a three-day pre-exposure period. On day four, participants were exposed to human rhinovirus, known as the common cold.  

In an interview with The Michigan Daily, Alfred Hero, U-M professor of electrical engineering and computer science and one of the authors of the study, said the research team sought to understand how a person’s susceptibility to infection could be linked to various aspects of their physical and mental health before exposure.

“The most intriguing dimension to us was the cognitive dimension,” Hero said. “Since every system in the human body is linked, brain health could also be associated with immune health.”

Following the participants’ exposure to the virus, researchers continued to collect biomarker data for four days to look at the connection between cognitive processing and the participants’ susceptibility to the virus. Hero said the correlation between susceptibility to illness and the biomarkers that marked cognitive performance was surprising.

“We were very surprised by the principal finding, which was that among all the biomarkers, a cognitive biomarker was one of the most highly associated with one’s susceptibility to getting severe symptoms and severe shedding,” Hero said. 

Researchers measured the degree of consistency of each subject’s performance on various cognitive tests. They found that when there is more variability in performance, the participants were more susceptible to severe infection. 

The cognitive performance data for the study was collected by the Neurocognitive Performance Test, an online neuropsychological test developed by Lumosity for research purposes. The test involved a 15-minute cognitive assessment designed to measure changes in how well participants could perform different cognitive activities, including memory and attention-related ones.

Murali Doraiswamy, professor of psychiatry and behavioral sciences at the Duke University School of Medicine and co-author, said computerized tests, like the Lumosity’s, have advantages over traditional paper-and-pencil tests, such as measures of validity and reliability and briefness of tests. In addition, computerized tests are scored correctly and automatically, giving researchers quick and reliable data.

“It’s basically a computerized, automated, web-based series of video games,” Doraiswamy said. “Every video game is equivalent to a traditional paper and pencil test except that these are just done (digitally) so that they can be scored automatically. This is the future of cognitive testing.”

According to Hero, computerized cognitive tests could be used to measure cognitive health for data collection in future studies as well. The web-based tests could help physicians and public health authorities assess the susceptibility of a particular population to respiratory infections.

“(It’s) a passive measurement, passive collection,” Hero said. “Say people are interacting either with their cell phones and you’re collecting data in that way, where they’re not constantly aware that they’re trying to do a brain game. We’re just collecting data on the fly.” 

Engineering junior Jill Pollon, who read the study, said she believes the study presents interesting opportunities for real-world application in the field of health care.

“(The study) is super interesting and I think the possibilities (of the study’s results) are amazing,” Pollon said. “It could be helpful for those in the healthcare field or those who interact with a ton of people daily.”

Updated 2/1: The study was originally published in the journal Scientific Reports.

Daily Staff Reporter Jingqi Zhu can be reached at