Trail making and cognitive set-shifting

Abstract

, FÁTIMA AZEVEDO IGNÁCIO 7 , ROGÉRIO PAYSANO MARROCOS 8 ABSTRACT -We tested the hypothesis that Part B of the Trail Making Test (TMT) is a measure of cognitive setshifting ability in 55 normal subjects with the conventional (written) TMT and a verbal adaptation, the "verbal TMT" (vTMT). The finding of a significant association between Parts B of TMT and vTMT (r = 0,59, p < 0,001), after correcting for age and education, supports the view that Part B of TMT is a valid measure of the ability to alternate between cognitive categories.KEY WORDS: trail making test, verbal trail making test, set-shifting cognition. . In Part A, the circles are numbered from 1 to 25, whereas in Part B numbers from 1 to 13 and letters from A to M must be connected in alternating fashion, beginning at 1-A and ending at M-13. Total score is given by time spent to complete each part. Factor analysis has shown that the TMT loads on both a rapid visual search and a visuospatial sequencing factor 3 . Whether it also superimposes on a third, "cognitive set-shifting", factor has been debated [4][5][6] . If true, however, this would be an important attribute of the test, as the ability to switch between categories is one of the most reliable indexes of normal neurobehavioral functioning 7 .In this study we administered a verbal adaptation of TMT-the "verbal Trail Making Test" (vTMT)-to normal individuals to see whether Part B of Trail Making Test (TMTB) also gauges the ability to shift between cognitive sets. Since in vTMT the visuospatial and visuomotor factors intrinsic to the conventional (written) TMT are reduced to a minimum, a lack of correlation between Parts B

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“…The Digit Span and Trails B tests are sensitive to subtle cognitive deficits and participants fell within 'normal' parameters for the Digit Span task and their performance on the verbal trails B task was similar to the norms derived from an unimpaired sample of 55 who were of younger mean age but similar mean education levels to the present participants [46]. These results indicate that participants were unimpaired in their ability to complete the questionnaire measures.…”

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“…The difference score commonly is used to provide information about cognitive control relative to motor factors (Anderson, 1998;Arbuthnott & Frank, 2000;van der Sluis, de Jong, & van der Leij, 2007). Trails has been used as an index of shifting in previous research (Anderson, 1998;Arbuthnott & Frank, 2000;de Olivera-Souza, Moll, Passman, Cunha, Paes, Adriano et al, 2000;Lehto et al, 2003).…”

The cerebral correlates of set-shifting: an fMRI study of the trail making test

“…In view of the low localizing and lateralizing value of the TMT 4,5 , the cerebral areas that are critical for its execution have been difficult to define on the basis of clinico-anatomic data alone 6 . A verbal adaptation of the TMT (vTMT) has been increasingly employed in normal individuals as well as in mixed clinical samples 7,8 . The vTMT is more suited for probing the ability to switch between cognitive sets because it reduces to a minimum the visuospatial and visuomotor factors of the written format 9 .…”