Assessing Executive Abilities Following Acute Stroke with the Trail Making Test and Digit Span

Abstract

The Trail Making Test and Digit Span are neuropsychological tests widely used to assess executive abilities following stroke. The Trails B and Digits Backward conditions of these tests are thought to be more sensitive to executive impairment related to frontal lobe dysfunction than the Trails A and Digits Forward conditions. Trails B and Digits Backward are also thought to be more sensitive to brain damage in general. Data from the Stroke and Lesion Registry maintained by the Washington University Cognitive Rehabilitation Research Group were analyzed to compare the effects of frontal versus nonfrontal strokes and to assess the effects of stroke severity. Results showed that the performance of patients with frontal and nonfrontal strokes was comparable in each condition of both the Trail Making Test and Digit Span, providing no support for the widely held belief that Trails B and Digits Backward are more sensitive to frontal lobe damage. Further, Trails A was as strongly correlated with stroke severity as Trails B, whereas Digits Backward was more strongly correlated with stroke severity than Digits Forward. Overall, the Trail Making Test and Digit Span are sensitive to brain damage but do not differentiate between patients with frontal versus nonfrontal stroke.

Forced Aerobic Exercise Enhances Motor Recovery After Stroke: A Case Report

“…Outcomes used to measure UE motor function were the Wolf Motor Function Test (Morris, Uswatte, Crago, Cook, & Taub, 2001), including the Functional Ability and Performance Time scales; the Fugl-Meyer Assessment (FMA; Gladstone, Danells, & Black, 2002); and the Nine-Hole Peg Test (Chen, Chen, Hsueh, Huang, & Hsieh, 2009). Nonmotor function was assessed using the Center for Epidemiologic Studies Depression Scale (Shinar et al, 1986), the Stroke Impact Scale (SIS; Duncan et al, 1999), and the Trail Making Test Parts A and B (Tamez et al, 2011). Outcomes for cardiopulmonary function were a CPX test and the Six-Minute Walk Test (6MWT; Fulk, Echternach, Nof, & O'Sullivan, 2008).…”

Impaired Executive Function by Interictal Epileptiform Discharges in Patients with Idiopathic Generalized Epilepsy

“…Two trials were presented at each length. The test was halted when the participant failed to recall both sequences at a single sequence length [27].…”

Current Perspectives in Post-stroke Cognitive Impairment

“…34 In addition, the Trail Making Test A and B and the Digit-Span Forward and Backward Test can be rapidly completed and are helpful in diagnosing and monitoring cognitive decline. 35 Following the onset of a stroke there is a delay before cognitive impairment becomes apparent. The dynamic properties and molecular development of this process are not well understood and this creates difficulties for practitioners regarding diagnosis and treatment.…”