Trail Making Test

Trail Making Test is a neuropsychological method, the main task of which is to study the visual form of a person’s attention and ability to switch between several tasks. TMT includes 2 parts of 25 cards and is organized by analogy with the children's puzzle "Connect all the points in a certain sequence".

Trail Making Test helps determine:

• The speed of visual search.
• The development of selective attention to certain incentives.
• The speed of recognition of information.
• The method and pace of processing the received information.
• Level of programming activity.
• Ability to make choices.
• The ability to switch attention.
• The rate of sensorimotor reactions.
• Ability to plan actions in accordance with the goal.
• The likelihood of cognitive impairment (for example, the development of Alzheimer's disease).
• The presence of frontal dysfunction.

Brief historical background

For the first time, the Trail Making Test was applied in 1944 and assessed the general intelligence of a person as part of a large block of individual tests to determine the general abilities of military personnel. In 1956, Reitan tried to use the test to identify cognitive impairment provoked by cerebrovascular diseases. The study showed high performance, and therefore in the late 1950s, TMT was included in the Halstead-Reitan battery Neuropsychological Battery of Tests.

Today, the Trail Making Test is widely used in clinical practice as a diagnostic method for identifying abnormal brain functions.

Conduct and interpretation

The essence of TMT: a serial connection of 25 goals on paper or on a monitor screen.

TMT's task: the subject must finish connecting the indicated points as soon as possible — it is time that is the main indicator of performance.

The structure of TMT: two subtests — A and B. Subtest A reveals the speed of cognitive processing of information by the subjects, subtest B examines cognitive processes (flexibility of thinking, working memory, control of attention and inhibition).

Features of subtest A:

• On the form (monitor) the numbers from 1 to 25 are located in a chaotic order.
• The object connects the lines of numbers in direct sequence.
• Proper execution means no line intersection.
• Exceeding the standard time indicates a slowdown in the rate of mental development, significant difficulties in concentration.
• Multiple errors and corrections of the controller indicate a disorder of selective attention.
• Misunderstanding of the task indicates a lack of flexibility of thinking.

Features of subtest B:

• On the form (monitor) the numbers from 1 to 13 and the letters from A to M are randomly arranged.
• The subject in order connects the lines of numbers with letters.
• Exceeding time standards indicates the difficulty of switching active attention.
• The error, consisting in the serial connection of numbers and letters separately indicates the passivity of cognitive processes.

The results of the study are based on the age of the test object. For the most objective diagnosis of TMT is used in combination with other neuropsychological techniques.