Multicomponent analysis of a digital Trail Making Test

Abstract

Objective The purpose of the current study was to use a newly developed digital tablet-based variant of the TMT to isolate component cognitive processes underlying TMT performance. Method Similar to the paper-based trail making test, this digital variant consists of two conditions, Part A and Part B. However, this digital version automatically collects additional data to create component subtest scores to isolate cognitive abilities. Specifically, in addition to the total time to completion and number of errors, the digital Trail Making Test (dTMT) records several unique components including the number of pauses, pause duration, lifts, lift duration, time inside each circle, and time between circles. Participants were community-dwelling older adults who completed a neuropsychological evaluation including measures of processing speed, inhibitory control, visual working memory/sequencing, and set-switching. The abilities underlying TMT performance were assessed through regression analyses of component scores from the dTMT with traditional neuropsychological measures. Results Results revealed significant correlations between paper and digital variants of Part A (rs = .541, p < .001) and paper and digital versions of Part B (rs = .799, p < .001). Regression analyses with traditional neuropsychological measures revealed that Part A components were best predicted by speeded processing, while inhibitory control and visual/spatial sequencing were predictors of specific components of Part B. Exploratory analyses revealed that specific dTMT-B components were associated with a performance-based medication management task. Conclusions Taken together, these results elucidate specific cognitive abilities underlying TMT performance, as well as the utility of isolating digital components.

A new device-aided cognitive function test, User eXperience-Trail Making Test (UX-TMT), sensitively detects neuropsychological performance in patients with dementia and Parkinson’s disease

“…The UX-TMT showed significant correlations with the MMSE-J ( r = .77) and the trail making test part B of the MoCA-J ( r = .56). Fellows et al reported that the digital trail making test (dTMT) showed significant correlation with paper version of trail making test part A ( r s = .541) and part B ( r s = .799), respectively, in 68 participants comprised of the elderly controls and patients including PD and MCI [ 26 ]. They administrated the test by using a stylus instead of pencil and used 26 encircled numbers and letters in paper version and 20 or 19 encircled numbers and letters in tablet version TMT, respectively.…”

“…Recently, the next generation applications take advantage of touch sensors and mobile technology [ 25 , 30 ]. They have been applied to exploring behavioral indices and quantitative measurements of perturbed cognitive processes [ 25 , 26 , 30 , 47 ]. Other possibility includes real-time and remote behavioral monitoring of cognitive and motor function in the elderly [ 26 , 47 ].…”

“…It has been unclear thought whether these assessments can be completely self-administered by any person [ 20 – 24 ]. Some studies have investigated a novel model or isolated components of cognitive processes [ 25 , 26 ]. Better assessment strategies would be beneficial both to patients and physicians, potentially minimizing sample size needed in randomized controlled trials (RCTs) by capturing subtler changes during asymptomatic disease stages [ 27 ].…”

Perceiving the evil eye: Investigating hostile interpretation of ambiguous facial emotional expression in violent and non-violent offenders

“…Cognitive flexibility and divided attention were assessed with the Trail Making Test (TMT) [ 37 ]. It requires speed and good visual scanning skills, as well as inhibitory control and visual/spatial sequencing [ 36 , 38 ]. In condition A, participants are instructed to draw lines between numbers as fast as possible (1-2-3-4-…), while in condition B, the instruction is to draw lines between numbers and letters and switch between those (1-A-2-B-3-C-…).…”

Weighing up the Effects of Working Memory and Cognitive Abilities in CLIL Learning

“…Other authors calculate derived scores based on the B/A ratio and the B-A difference, arguing that the switch cost between the primary scores reflect "the additional cognitive control required to switch between sequencial numbers and letters" (Arbuthnott & Frank, 2000, p. 519). However, this type of score is "best conceptualized as reflecting a combination of several cognitive functions" (Kortte et al, 2002), which complicates the identification and isolation of specific executive functions (see also Fellows et al, 2017). Naturally, both the primary and the derived scores are valid measurements in the TMT, and the choice of one or another may be driven by the particular needs of each study.…”