Estimating the Diagnostic Value of the Trail Making Test for Suboptimal Effort in Acquired Brain Injury Rehabilitation Patients

Powell, Matthew R.; Locke, Dona E.C.; Smigielski, Jeffrey S.; McCrea, Michael

doi:10.1080/13854046.2010.532912

Cited by 17 publications

(9 citation statements)

References 34 publications

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“…As in previous reports [28, 39, 40, 42, 47], malingering effects were greater on Trails A than Trails B, as reflected in significant reductions in C-TMT-B versus C-TMT-A difference measures, ratios, and movement velocities, a pattern opposite that seen in the majority of patients with brain injury [8]. Indeed, even among malingering subjects with abnormal performance on the C-TMT-B, 89% showed greater z-score abnormalities on the C-TMT-A, whereas none of the control subjects with abnormal C-TMT-B completion times showed greater C-TMT-A abnormalities.…”

Section: Experiments 3: Effects Of Malingeringsupporting

confidence: 54%

The Effects of Aging, Malingering, and Traumatic Brain Injury on Computerized Trail-Making Test Performance

et al. 2015

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The trail making test (TMT) is widely used to assess speed of processing and executive function. However, normative data sets gathered at different sites show significant inconsistencies. Here, we describe a computerized version of the TMT (C-TMT) that increases the precision and replicability of the TMT by permitting a segment-by-segment analysis of performance and separate analyses of dwell-time, move-time, and error time. Experiment 1 examined 165 subjects of various ages and found that completion times on both the C-TMT-A (where subjects connect successively numbered circles) and the C-TMT-B (where subjects connect circles containing alternating letters and numbers) were strongly influenced by age. Experiment 2 examined 50 subjects who underwent three test sessions. The results of the first test session were well fit by the normative data gathered in Experiment 1. Sessions 2 and 3 demonstrated significant learning effects, particularly on the C-TMT-B, and showed good test-retest reliability. Experiment 3 examined performance in subjects instructed to feign symptoms of traumatic brain injury: 44% of subjects produced abnormal completion times on the C-TMT-A, and 18% on the C-TMT-B. Malingering subjects could be distinguished from abnormally slow controls based on (1) disproportionate increases in dwell-time on the C-TMT-A, and (2) greater deficits on the C-TMT-A than on the C-TMT-B. Experiment 4 examined the performance of 28 patients with traumatic brain injury: C-TMT-B completion times were slowed, and TBI patients showed reduced movement velocities on both tests. The C-TMT improves the reliability and sensitivity of the trail making test of processing speed and executive function.

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Section: Experiments 3: Effects Of Malingeringsupporting

confidence: 54%

The Effects of Aging, Malingering, and Traumatic Brain Injury on Computerized Trail-Making Test Performance

et al. 2015

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“…Attention resources, simple motor and spatial skills, visual searching and sequencing abilities are all needed to complete both Trail A and B in the TMT. Additionally, Trail B requires extra cognitive effort due to the need for mental flexibility and divided attention [33,52]. Subjects with SCA3 exhibited apparent disturbance in TMT-B with the percentage of impaired subjects up to about 90%.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Native Chinese with Spinocerebellar Ataxia Type 3

Chen

Hou

et al. 2014

Eur Neurol

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Background: Previous studies have shown cognitive impairment in patients with spinocerebellar ataxia type 3 (SCA3). However, there is a lack of data on Chinese patients with SCA3. Method: We investigated 22 native Chinese with SCA3 and 18 controls matched for age, education as well as mental status. Cognitive assessments were carefully carried out to measure verbal fluency, memory, attention, executive function, visuospatial and visuoconstructive functions. Results: The most common impairments of cognition in native Chinese with SCA3 were disruption of phonemic verbal fluency and frontal executive dysfunction. Deficits in semantic fluency were detected in about 31.8% patients. Impaired visuospatial function and verbal memory were also found in native Chinese with SCA3. The degree of ataxia, CAG repeat length and education were found to correlate with cognitive performance. Multivariate binary logistic regression suggested that an oculomotor disorder and depression are predictors of cognitive impairment. Conclusion: Native Chinese with SCA3 had cognitive impairment of frontal executive function, temporal and parietal functions. An oculomotor disorder might be an index of cognitive dysfunction.

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“…A variety of SVT methods are now available (Larrabee, 2007). While contemporary neuropsychological test development has begun to more directly incorporate SVT indicators embedded within the primary neuropsychological instrument (Bender, Martin Garcia, & Barr, 2010; Miller et al, 2011; Powell, Locke, Smigielski, & McCrea, 2011), traditional neuropsychological test construction and the vast majority of standardized tests currently in use do not. Current practice has been to use what are referred to as “stand-alone” SVT measures that are separately administered during the neuropsychological examination (Sollman & Berry, 2011).…”

mentioning

confidence: 99%

Symptom Validity Testing, Effort, and Neuropsychological Assessment

Bigler

2012

J Int Neuropsychol Soc

112

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AbstractSymptom validity testing (SVT) has become a major theme of contemporary neuropsychological research. However, many issues about the meaning and interpretation of SVT findings will require the best in research design and methods to more precisely characterize what SVT tasks measure and how SVT test findings are to be used in neuropsychological assessment. Major clinical and research issues are overviewed including the use of the “effort” term to connote validity of SVT performance, the use of cut-scores, the absence of lesion-localization studies in SVT research, neuropsychiatric status and SVT performance and the rigor of SVT research designs. Case studies that demonstrate critical issues involving SVT interpretation are presented. (JINS, 2012,18, 1–11)

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Estimating the Diagnostic Value of the Trail Making Test for Suboptimal Effort in Acquired Brain Injury Rehabilitation Patients

Cited by 17 publications

References 34 publications

The Effects of Aging, Malingering, and Traumatic Brain Injury on Computerized Trail-Making Test Performance

The Effects of Aging, Malingering, and Traumatic Brain Injury on Computerized Trail-Making Test Performance

Cognitive Impairment in Native Chinese with Spinocerebellar Ataxia Type 3

Symptom Validity Testing, Effort, and Neuropsychological Assessment

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