Affiliations: Psychology Department, Brigham Young University,
Provo, UT, USA | Neuroscience Center, Brigham Young University, Provo,
UT, USA | Rehabilitation Unit, Neuropsychology, Utah Valley
Regional Medical Center, Provo, UT, USA
Note: [] Corresponding author: Mark D. Allen, Department of Psychology,
1022 SWKT, Brigham Young University, Provo, UT 84602, USA. Tel.: +1 801 422
6481; Fax: +1 801 422 0602; E-mail. m_allen@byu.edu
Abstract: Recent progress has been made using fMRI as a clinical assessment
tool, often employing analogues of traditional "paper and pencil" tests. The
Trail Making Test (TMT), popular for years as a neuropsychological exam, has
been largely ignored in the realm of neuroimaging, most likely because its
physical format and administration does not lend itself to straightforward
adaptation as an fMRI paradigm. Likewise, there is relatively more ambiguity
about the neural systems associated with this test than many other tests of
comparable clinical use. In this study, we describe an fMRI version of Trail
Making Test-B (TMTB) that maintains the core functionality of the TMT while
optimizing its use for both research and clinical settings. Subjects
(N=32) were administered the Functional Trail Making
Test-B (f-TMTB). Brain region activations elicited by the f-TMTB were
consistent with expectations given by prior TMT neurophysiological studies,
including significant activations in the ventral and dorsal visual pathways and
the medial pre-supplementary motor area. The f-TMTB was further evaluated for
concurrent validity with the traditional TMTB using an additional sample of
control subjects (N=100). Together, these results support
the f-TMTB as a viable neuroimaging adaptation of the TMT that is optimized to
evoke maximally robust fMRI activation with minimal time and equipment requirements.
Keywords: fMRI, clinical fMRI, cognitive assessment, neuropsychological assessment, Trail Making
