Several studies have appeared recently indicating that persons with brain damage tend to perform significantly more poorly on the Trail Making Test than d o control Ss without brain damage (1, 4, 1 0 ) . This paper is based on larger groups than have been used previously and provides preliminary norms for evaluating the performance of adult Ss.
PROCEDUREThe Trail Making Test was administered individually to 200 patients with verified brain damage and 84 persons without anamnescic or clinical evidence of brain damage. The brain-damaged group was heterogeneous with respect to the types of lesions involved, including the following: multiple sclerosis, 39; traumatic head injury, 33; diffuse cerebrovascular disease, 25; cerebrovascular accident, 20; intrinsic brain tumor, 20; cerebral atrophy, 11; epilepsy following head trauma, 8; extrinsic brain tumor, 7; cerebral abscess, 7; epilepsy (idiopathic), 6; epilepsy (surgically treated ) , 5; subdural hematoma, 5; nvo each with congenical brain anomaly, cerebellar degenerative disease, dementia paralytics, encephalitis, and acoustic neuroma; and one each with porencephalic cyst, optic nerve adhesions, barbiturate intoxication, and thalamic tumor. Testing of the brain-damaged pacients was performed after maximal benefits of hospitalization had been realized and the patients were ready for discharge, although many had acute symptoms at the time of admission to the hospital. The group was probably characreristic of patients generally seen at a university medical center rather than representative of the long standing, chronic, brain-damaged patients often seen at state institutions or domiciliary hospitals.All but eight of the 84 control Ss were hospitalized at the time of testing. Diagnoses included the following: neurological complaincs ( a complete history, neurological examination, and observation of the course during hospicalizntion failed to reveal satisfactory evidence of brain damage), 25; paraplegia, 21; neurosis, 15; surgery not involving the brain, 8; normal, 8; carcinoma, 1. A deliberate attempc was made to include a large proportion of patients who had entered the hospital with neurological complaints but for whom no evidence of brain damage was found, since differentiation of such patients from those with brain damage represents an important clinical problem. The other control patients were selected to include factors such as chronic illness of both 'This study was s u p p o r t e d -b~~l~-~s e a r c h Grant B-808 from the National lnstirute of Neurological Diseases and Blindness. 'The author is indebted to Miss Elaine Tarshes for assistance with test administration and statistical analysis.
