NeuroTrax Science Team and Glen M. Doniger, PhD
Mental rotation may sound like a simple spatial exercise, but it actually represents a fundamental cognitive ability that allows us to mentally transform information, anticipate outcomes, and interact effectively with the world.
In fact, tasks including rotation, perspective taking, and transformation are not isolated abilities. Instead, they represent different aspects of a broader cognitive process. In a 2024 study by Bar-Hen-Schweiger and Henik, the authors describe these operations as forms of “mental manipulation… the cognitive process of mentally transforming, or operating on, perceived or imagined objects” [1].
This capacity, mental manipulation, may be one of the fundamental building blocks of intelligence. Humans constantly manipulate objects physically, such as turning a tool, assembling furniture, or fitting luggage into a car trunk. These physical manipulations are accompanied by something more sophisticated: the ability to perform those transformations internally.
As described by the researchers, intelligence involves “the transition from object manipulation to mental manipulation,” allowing individuals to operate on imagined objects without physically interacting with them. Mental rotation is one of the clearest examples of this ability. When we imagine rotating a 3D shape, visualizing the view from a different angle, or predicting how parts of an object fit together, we are performing mental manipulation. Thus visual spatial thinking is not just relevant to cognitive testing. It plays a role in many aspects of daily life and professional performance. Mental rotation and spatial abilities are essential for everyday tasks like reading a map, packing objects efficiently, assembling equipment, and navigating unfamiliar environments. Further, visual spatial skills are key indicators of performance in STEM fields, supporting navigation and environmental awareness, engineering and architectural design, aviation and surgical planning, mathematical reasoning, and complex problem solving.
Bar-Hen-Schweiger and Henik examined the structure of visual spatial ability and found it best explained by three interacting components: rotation, perspective taking, and transformation. Together, these processes form the foundation of spatial reasoning. Additionally, the study showed that these abilities are not isolated skills but are connected via a higher-order cognitive process. In their structural modeling, tasks traditionally labeled “spatial” and tasks involving lexical-semantic reasoning both loaded onto the same underlying factor. This finding reinforces the notion that mental manipulation is a general cognitive capacity rather than a narrow spatial skill.
While the theory of mental manipulation provides a conceptual framework, its clinical value depends on the ability to measure these processes reliably and objectively. This is where digital neuromarkers like NeuroTrax play an essential role.
The NeuroTrax Visual Spatial Processing test is designed to assess abstract spatial ability and orientation. Using a 3D imagery paradigm, everyday scenes containing a reference point (a red pillar) are presented, and the task is to determine how the scene would appear from that vantage point. The test has demonstrated test-retest reliability [2] and construct validity relative to traditional neuropsychological measures like Judgment of Line Orientation [3] and the Rey-Osterrieth Complex Figure Test [4].
Lower NeuroTrax visual spatial scores have been found in people with such conditions as mild cognitive impairment (MCI) [5,6] and attention-deficit hyperactivity disorder (ADHD) [4,7]. Performance on the test also predicts real-world outcomes, including fall risk and driving ability. More specifically, reduced visual spatial ability has been linked to increased gait variability [8], as well as poorer driving ability even after accounting for physical disability [9].
Findings like these demonstrate how a digital neuromarker like NeuroTrax can facilitate clinically actionable insights even in a conceptually abstract domain. Rather than treating spatial tasks as isolated measures, digital neuromarkers allow clinicians to quantify the underlying processes of mental manipulation and track them over time. This enables earlier detection of cognitive decline, more precise monitoring of disease progression, and better alignment between cognitive testing and routine function. Test performance ultimately reflects how the brain plans, predicts, and interacts with the world, offering a practical and scalable approach to maintaining cognitive health.
References:
[1] Bar-Hen-Schweiger, M., and Henik, A. (2024). Looking beyond seeing: Components of visual-spatial ability as an overarching process. Acta Psychologica, 251:104577. DOI: 10.1016/j.actpsy.2024.104577
[2] Schweiger, A., Doniger, G.M., Dwolatzky, T., Jaffe, D., and Simon, E.S. (2003). Reliability of a novel computerized neuropsychological battery for mild cognitive impairment. Acta Neuropsychologica, 1(4), 407–413. GICID: 01.3001.0001.0603
[3] Fernandez, H. H., Doniger, G., Simon, E. S., Jacobson, C. E., Weiss, D., Rosado, C., and Okun, M. S. (2006). Construct validity of a computerized neuropsychological assessment in patients with movement disorders. Movement Disorders, 21 (S15), S656–S657. DOI: 10.1002/mds.21249
[4] Abramovitch, A., Dar, R., Hermesh, H., and Schweiger, A. (2012). Comparative neuropsychology of adult obsessive-compulsive disorder and attention deficit/hyperactivity disorder. Journal of Neuropsychology, 6(2), 161–191. DOI: 10.1111/j.1748-6653.2011.02021.x
[5] Dwolatzky, T., Whitehead, V., Doniger, G.M., Simon, E.S., Schweiger, A., Jaffe, D., and Chertkow, H. (2003). Validity of a novel computerized cognitive battery for mild cognitive impairment. BMC Geriatrics, 3:4. DOI: 10.1186/1471-2318-3-4.
[6] Doniger, G.M., Dwolatzky, T., Zucker, D.M., Chertkow, H., Crystal, H., Schweiger, A., and Simon, E.S. (2005). Towards practical cognitive assessment for detection of early dementia: A 30-minute computerized battery discriminates as well as longer testing. Current Alzheimer Research, 2(2), 117–124. DOI: 10.2174/1567205053585792
[7] Leitner, Y., Doniger, G.M., Barak R., Simon, E.S., and Hausdorff, J.M. (2007). Attention deficit hyperactivity disorder: Evidence for widespread and circumscribed deficits. Journal of Child Neurology, 22(3), 264–276. DOI: 10.1177/0883073807299859
[8] Ofori, E., Delgado, F., James, D.L., Wilken, J., Hancock, L.M., Doniger, G.M., and Gudesblatt, M. (2024). Impact of distinct cognitive domains on gait variability in individuals with mild cognitive impairment and dementia. Experimental Brain Research, 242(6), 1573–1581. DOI:10.1007/s00221-024-06832-9
[9] Gudesblatt, M., Zarif, M., Bumstead, B., Buhse, M., Smitha, T., Fafard, L., Kalina, J., Sullivan, C., Wilken, J., and Doniger, G. (2014). Multiple sclerosis and driving: Cognitive profile correlation to patient self-reported driving. Neurology, 82(S10), P4.173. DOI: 10.1212/WNL.82.10_supplement.P4.173
