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PROTOCOL
Administration and interpretation of the Trail Making Test
Christopher R Bowie & Philip D Harvey
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Department of Psychiatry, Mount Sinai School of Medicine, 1425 Madison Ave., Box 1230, New York, New York 10029, USA. Correspondence should be addressed to P.D.H. (philipdharvey1@cs.com).
Published online 21 December 2006; doi:10.1038/nprot.2006.390
Measurement of cognitive functions is an increasingly important goal for clinicians and researchers. Many neuropsychological test batteries are comprehensive and require specialized training to administer and interpret. The Trail Making Test is an accessible neuropsychological instrument that provides the examiner with information on a wide range of cognitive skills and can be completed in 510 min. Its background, psychometric properties, administration procedures and interpretive guidelines are provided in this protocol.
INTRODUCTIONThe Trail Making Tests (TMTs) are popular neuropsychological instruments used either alone as a screening instrument for detecting neurological disease and neuropsychological impairment or as part of a larger battery of tests. The tests are believed to measure the cognitive domains of processing speed, sequencing, mental exibility and visualmotor skills. The most commonly used version of the test, the TMT, was developed from the Taylor number series test, which required the subject to connect numbers sequentially from 1 to 50. It was revised by Partington and Leiter and included in the Army Individual Test Battery1 as well as the HalsteadReitan Neuropsychological Battery2 in its current form3.
The most widely used version of the TMT comprises parts A andl B. In part A, the subject uses a pencil to connect a series of 25 encircled numbers in numerical order. In part B, the subject connects 25 encircled numbers and letters in numerical and alphabetical order, alternating between the numbers and letters.For example, the rst number 1 is followed by the rst letter A, followed by the second number 2 then second letter B and so on. The numbers and letters are placed in a semi-random xed order, in such a manner as to avoid overlapping lines being drawn by the examinee. The primary variables of interest are the total time to completion for parts A and B....