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PubMed2000

Performance on original and a Chinese version of Trail Making Test Part B: a normative bilingual sample.

This study examined an equivalent of Trail Making Test Part B for native Chinese speakers. Digit Symbol Coding and Trail Making Test Parts A and B were administered to American and Chinese students from an American university. The Chinese group also took a modified Trails B test where numbers in Chinese characters replaced English letters. Independent-samples t tests showed no difference between American and Chinese groups on the Digit Symbol Coding and Trails A, but a difference on Trails B (p < .05). The Chinese group's modified Trails B performance showed no difference from the American group's original Trails B performance. These findings suggest equivalence of Digit Symbol Coding and Trails A for American and Chinese groups, but a longer Trails B completion time for the Chinese group. This finding indicates a language bias of Trails B for Chinese-English bilinguals. Thus, the Chinese version of Trails B is preferable for native Chinese speakers.

Adult↗
PubMed2001

Demographic effects on the Trail Making test in alcohol abusers.

Demographic effects on the Trail Making Test (TMT), a test often used for screening for cognitive impairment, are examined in a sample of alcohol abusers in drug abuse treatment programs. A sample was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of alcohol abuser's scores available for analysis was 1000. Data were analyzed to determine the effects of gender, ethnicity, age and education variables on the two parts of the TMT in this large treatment sample of alcohol abusers. The variables of age, ethnicity and education were statistically significant for both parts A and B of the TMT. R-Square values for overall models were quite weak (A = .12, B = .14) suggesting that demographic effects on the TMT, while clearly present, account for relatively little overall variance in terms of alcohol abuser's TMT performance. These results are consistent with earlier research using a more heterogenous drug abuse treatment sample.

Adult↗
PubMed1978

The Trail Making Test and Bender Background Interference Procedure as screening devices.

The Trail Making Test and Bender Background Interference Procedure were evaluated with 598 Ss against both external neurologic criteria and against psychological opinion derived from a more complete evaluation. For Trails, highly significant differences in mean scores were seen when preselected neurologic patients and patients without neurologic stigmata were compared. Similarly, the distribution of classification of these patients by Bender is significantly different from chance. Application of these measures in a screening paradigm, however, yielded large numbers of false negatives against both neurological and psychological criteria. It was not possible to establish an optimal cutting score to justify application of these measures as screening devices, either alone or in concert.

Adult↗
PubMed1977

Assessment of cognitive recovery in alcoholics by use of the trail-making test.

Cognitive recovery among male alcoholics and controls was investigated with the Trail-Making Test as an index of cognitive impairment. The test was administered twice to all Ss with an interval of approximately 1 year between testings. A reported measures analysis of variance showed that the controls performed significantly better than the alcoholics at both administrations, although the alcoholics did improve between the pre-and posttests. Reported drinking episodes that occurred between the pre-and posttests appeared to have no effect on cognitive recovery in the alcoholic group when relapsed and abstinent subgroups were compared.

Adult↗
PubMed1996

Trail making test: normative values from 287 normal adult controls.

The Trail Making Test (TMT), which explores visual-conceptual and visual-motor tracking, is a frequently used neuropsychological test because of its ease of administration and sensitivity to brain damage. In this paper, norms are provided for the time scores derived from parts A and B, and for the (B-A) difference. The data were collected from 287 adult Italian subjects stratified by gender, schooling and age (from 20 to 79 years). The test scores were affected by age, education and general intelligence (as expressed by Raven's Coloured Progressive Matrices). Only for part A did females have longer time scores than males. Test-retest reliability was high for each score.

Adolescent↗
PubMed2001

Demographic effects on the Trail Making Test in narcotic/other opiate abusers.

Demographic effects on the Trail Making Test (TMT), a test often used to screen for cognitive impairments, were examined in a sample of narcotic/other opiate abusers in drug abuse treatment programs. A sample was drawn from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991 through 1993 in 96 programs within 11 cities in the United States. The number of narcotic/other opiate abusers' scores available for analysis was 191. Data were analyzed to determine the effects of sex, ethnicity, age, and education on the two parts of the TMT in this sample of narcotic/other opiate abusers. The variables of age and education level were statistically significantly related to TMT parts A and B, and ethnicity was statistically significant for part B of the TMT. R-square values for overall models were moderate (A = .34, B = .24), suggesting that demographic effects on the TMT are moderate.

Adult↗
PubMed2001

The symbol trail making test: test development and utility as a measure of cognitive impairment.

Although the Trail Making Test (TMT) has proven to be an exceptional clinical tool, its applications have been limited by the instrument's use of the Arabic numeral system and Latin alphabet. Clearly an instrument not limited by a specific alphabet or numerical system could fill this void. This study presents the development and validation of an alternative to the TMT that offers modestly similar psychometric properties and can be used with populations that have no familiarity with the Arabic numerical system or a specific alphabet. The Symbol Trail Making Test (STMT), which employs symbols that are not language or numerically based was administered to a normative sample of 210 participants, including 54 individuals whose first language was not English, for the purpose of collecting normative data. Reliability, assessed through an alternate form administration, and convergent validity, assessed through correlation with the TMT in a nonpatient sample, was deemed acceptable. Significant discriminant validity was obtained comparing non-brain-injured patients to brain-injured patients, particularly on time measures. An analysis of variance found no significant difference between native English speakers and individuals speaking English as a second language on performance on the STMT. This preliminary study provides evidence that the STMT is a clinically useful instrument for discriminating brain-injured from non-brain-injured participants without employing a specific culture-bound symbol system.

Adult↗
PubMed1994

The Trail Making Test A and B: a technical note on structural nonequivalence.

The major structural aspect of the Trail Making Test, length of drawn lines needed to complete the tests, was measured and compared for the adult and school-aged child versions. Trail Making B is a markedly longer test than Trail Making A, 32% for adults and 27% for school-aged children. The interpretive assumptions that Trail Making B differs from Trail Making A only in terms of the cognitive skills needed to complete the test and the implicit interpretive bias toward minimizing the motor component of the tests were challenged in this technical note.

Adult↗
PubMed1998

Trail making test performance in Vietnam combat veterans with and without posttraumatic stress disorder.

The present study investigated variables associated with performance on the Trail Making Test from the Halstead-Reitan neuropsychological test battery in Vietnam combat veterans. There was a significant difference in performance between veterans with and without PTSD on both parts of the Trail Making Test. In subgroup analyses excluding participants on medications (antianxiety, antidepressant, and cardiac), comorbid diagnoses (history of alcohol or substance abuse, history of major depression and comorbid anxiety disorder) and compensation-seeking status, the group difference on Trails B remained significant. However, subgroup analyses suggested that poorer performance on Trails A was influenced by antianxiety and cardiac medications, as well as heavy combat exposure status.

Brain↗
PubMed2000

Trail making test, part B as a measure of executive control: validation using a set-switching paradigm.

Recent controversy surrounds the use of the Trail Making Test as a measure of cognitive flexibility, given that the Trail Making Test, Part B (TMT-B) also differs from Part A (TMT-A) in factors of motor control and perceptual complexity. The present study compared performance in the TMT and a set-switching task in order to test the assumption that cognitive flexibility is captured in TMT-B performance. Set-switching tasks have low motor and perceptual selection demands, and therefore provide a clearer index of executive function. In this study, participants made category judgments for digits, letters, or symbols across a series of trials, and performance for consecutive same-task trials was compared with task-switch trials. Results of the set-switching task indicated significant switch cost, but only for the situation of task alternation (e.g., an ABA series), suggesting that task-set inhibition may play a role in this effect. Alternating-switch cost was significantly correlated with TMT-B performance, especially with the TMT-B to TMT-A ratio (B/A). Cost for alternating switches was especially large for participants with B/A ratio > 3. These results provide direct evidence that the B/A ratio of performance in the TMT provides an index of executive function.

Adult↗
PubMed1978

Diagnostic efficiency of the Trail Making Test as a function of cut-off score, diagnosis, and age.

This study is a reinvestigation of the effectiveness of the Trail Making Test in discriminating between brain-damaged (n = 51) and pseudoneurologic (n = 72) subjects. All subjects were hospitalized male veterans at the Allen Park Veterans Administration Hospital. An analysis of covariance showed that the pseudoneurologic subjects performed at a significantly higher level than the brain-damaged subjects. Further analysis with two different cut-off scores exhibited unequal discriminatory power throughout the whole range of Trail Making Test scores. These results suggested diagnosing only when the scores were 9 or lower and 13 or higher. This use of extreme scores resulted in an over-all hit rate of 87% in the study. Comparisons with five major subgroupings of the pseudoneurologic subjects yielded only one significant difference: more accurate discrimination with the 12 cut-off score between 10 general-medical and peripheral nerve-damaged subjects (100% correct) and 18 psychotic subjects (39% accuracy).

Adolescent↗
PubMed1990

Neuropsychological false positives in litigation: trail making test findings.

100 workers' compensation claimants with no known history of brain injury and no claim for neuropsychological impairment were administered a generally accepted neuropsychological screening instrument, the Trail Making Test, to consider the possibility that the presence of litigation may be reflected in neuropsychological test scores. On Trails A and B, respectively, 40% and 36% of subjects scored in the impaired range. Clinicians are urged to interpret the results of the Trail Making Test cautiously when a patient is in litigation. Suggestions for research are offered.

Adult↗
PubMed2001

Using the Trail Making test to screen for cognitive impairment in a drug abuse treatment sample.

The Trail Making test (TMT) is a brief paper and pencil neuropsychological test often used for screening for cognitive impairment. The value of the TMT is examined in a sample of 5619 males and 2902 females was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS), a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of specific drugs of abuse on parts A and B of the TMT in this large sample of patients in drug abuse treatment programs. Most subjects, regardless of type of drug abused, on TMT parts A and B appeared to fall within normal limits relative to commonly accepted cutoff scores. These results suggest that the TMT parts A and B would have great value as screening measures for cognitive impairment in a drug abuse treatment population.

Adult↗
PubMed1996

The geometric structure, construction, and interpretation of path-following (trail-making) tests.

Diagnostic comparisons of performance on parts A and B of the Trail Making Test (TMT) assume that path structure in the two parts is equivalent but that task complexity is greater for B. The two parts are shown to differ with respect to length and angular variability. However, measures of fractal dimension show no difference in structural complexity between paths A and B. This analysis suggests a principled method for generating alternative pathways, varying in complexity, and opens the way for a systematic study of path-following. It also suggests that path-following may be interpretable within a general approach, in which perceptual, linguistic, reasoning and motor processes are seen as related through different groups of geometric transformations.

Adult↗
PubMed1990

Emotional impact on trail making test performance.

This study assessed the effect of emotional factors on Trail Making Test Part B performance for a sample of 105 neuropsychological referrals for whom there was no neurodiagnostic evidence of brain damage. Trails B scores declined in relation to elevated MMPI scores on Scales 6, 7, and 8, though only nine patients performed within the impaired range. The results suggest that (a) Trails B performance is resilient to a variety of emotional influences, (b) psychotic symptoms and severe anxiety impede Trails B performance, though rarely to the extent caused by brain damage, and (c) the MMPI provides objective criteria that help rule out emotional effects on Trails B performance.

Adult↗
PubMed1997

Trail Making Test in assessing children with reading disabilities: a test of executive functions or content information.

The speed of performance on Part A, Part B, and on an experimental version containing alphabetical series (Part A Alphabetic) of the Trail Making Test was studied with 19 children with reading disabilities and 34 controls from Grades 4 to 6. When the test was used in discriminant profile fashion, children with reading disabilities showed a deficit compared with control children on Part B relative to part A but did not relative to the new Part A Alphabetic. The results indicate that the performance of the children with reading disabilities on Part B is likely to be affected by their slowness on the alphabetical series. Based on these results we recommend that the speed of following the alphabetical series be assessed when using Part B of the Trail Making Test.

Child↗
PubMed2001

Derived trail making test indices in a sample of substance abusers: demographic effects.

Derived indices on the Trail Making Test (TMT), a test often used to screen for cognitive impairments, were examined in a sample of substance abusers in drug abuse treatment programs. A mixed race sample was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991 through 1993 within 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of demographic variables on derived indices created by adding, subtracting, multiplying, and dividing parts A and B of the TMT in this large treatment sample of substance abusers. The variables of sex, age, ethnicity, and education were statistically significant for selected derived indices of the TMT.

Adult↗