Trail Making Test

The Trail Making Test is a neuropsychological test of visual attention and task switching. It consists of two parts in which the subject is instructed to connect a set of 25 dots as quickly as possible while still maintaining accuracy.[1] The test can provide information about visual search speed, scanning, speed of processing, mental flexibility, as well as executive functioning.[1] It is sensitive to detecting cognitive impairment associated with dementia, for example, Alzheimer's disease.[2]

Trail Making Test
Part A Sample
MeSHD014145

History

The test was created by Ralph Reitan, an American neuropsychologist considered one of the fathers of clinical neuropsychology. The test was used in 1944 for assessing general intelligence, and was part of the Army Individual Test of General Ability.[3] In the 1950s[4][5] researchers began using the test to assess cognitive dysfunction stemming from brain damage, and it has since been incorporated into the Halstead-Reitan battery.[3] The Trail Making Test is now commonly used as a diagnostic tool in clinical settings. Poor performance is known to be associated with many types of brain impairment, in particular frontal lobe lesion.

Method and interpretation

The task requires a subject to connect a sequence of 25 consecutive targets on a sheet of paper or computer screen, in a similar manner to a child's connect-the-dots puzzle. There are two parts to the test: in the first, the targets are all numbers from 1 al 25 and the test taker needs to connect them in sequential order; in the second part, the dots go from 1 to 13 and include letters from A to L. As in the first part, the patient must connect the dots in order while alternating letters and numbers, as in 1-A-2-B-3-C..., in the shortest time possible without lifting the pen from the paper. .[6] If the subject makes an error, the test administrator corrects them before the subject moves on to the next dot.[6]

The goal of the test is for the subject to finish both parts as quickly as possible, with the time taken to complete the test being used as the primary performance metric. The error rate is not recorded in the paper and pencil version of the test, however, it is assumed that if errors are made it will be reflected in the completion time. If the patient makes a mistake, the person administering the test tells them immediately and the patient is allowed to correct it. These mistakes affect scoring only if the time taken to correct them occurs within the time it takes to complete the task as a whole. [3] The second part of the test, in which the subject alternates between numbers and letters, is used to examine executive functioning.[3] The first part is used primarily to examine cognitive processing speed.[3]

Puntuación

Su puntuación será el tiempo que haya tardado en realizarlo, siendo una puntuación de 35 si ha tardado 35 segundos en realizarlo, por lo que cuanta mayor puntuación mayor discapacidad.

Time to complete

The entire test takes between 10 and 30 minutes. The average times to complete part A and B are 29 and 75 seconds, respectively. A patient is considered impaired if part A takes more than 78 seconds, and part B takes more than 273 seconds. It is not necessary to continue the test if a patient cannot complete parts A and B within 5 minutes.

Población y utilidad

La población que se evalúa comprende a los adolescentes, adultos y ancianos.

La utilidad que tiene esta prueba en el año 1944 fue para evaluar la inteligencia general pero en la década de los 50 los investigadores la empezaron a usar para evaluar la disfunción cognitiva derivada del daño cerebral. Actualmente se usa como instrumento para diagnósticos en ámbitos clínicos. Puede proporcionar información sobre la velocidad de búsqueda visual, la velocidad de procesamiento, el escaneo, el funcionamiento ejecutivo y la flexibilidad mental. Asimismo permite detectar el deterioro cognitivo asociado con la demencia.

References
  1. Arnett, James A.; Seth S. Labovitz (1995). "Effect of physical layout in performance of the Trail Making Test". Psychological Assessment. 7 (2): 220–221. doi:10.1037/1040-3590.7.2.220. ProQuest 614331919.
  2. Cahn, D. A.; et al. (1995). "Detection of dementia of the Alzheimer type in a population-based sample: Neuropsychological test performance". Journal of the International Neuropsychological Society. 1 (3): 252–260. doi:10.1017/s1355617700000242. PMID 9375219.
  3. Tombaugh, T.N.T.N (2004). "Trail Making test A and B: Normative Data Stratified by Age and Education". Archives of Clinical Neuropsychology. 19 (2): 203–214. doi:10.1016/s0887-6177(03)00039-8. PMID 15010086. ProQuest 71715116.
  4. R. M. Reitan, R. M. (1955). The relation of the trail making test to organic brain damage. Journal of Consulting Psychology
  5. Reitan, R. M. (1958). "Validity of the Trail Making test as an indicator of organic brain damage". Percept. Mot Skills. 8 (3): 271–276. doi:10.2466/pms.1958.8.3.271.
  6. Bowie, C.R.C.R; P.D.P.D Harvey (2006). "Administration and interpretation of the trail making test". Nature Protocols. 1 (5): 2277–2281. doi:10.1038/nprot.2006.390. PMID 17406468. ProQuest 68327018.

Further reading
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