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An fMRI study of the Trail Making Test

Zakzanis, Konstantine K., Mraz, Richard, Graham, Simon J.·2005·Neuropsychologia

DOI 10.1016/j.neuropsychologia.2005.03.013

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Abstract

This study investigated the cerebral correlates of the Trail Making Test (TMT), used commonly as a measure of frontal lobe function. Such work sheds additional light on the known shortcomings of the TMT as a localizing instrument, as indicated, for example, by studies of patients with focal brain lesions. Functional magnetic resonance imaging (fMRI) was used to record brain activity while participants performed the TMT using a custom-built, fiber-optic fMRI-compatible writing device, the "virtual stylus". Unlike in a previous fMRI study that used a verbal adaptation of the TMT, the virtual stylus enabled a closer depiction of the brain regions engaged by the actual paper-and-pencil task. Twelve, right-handed healthy young adults participated. In Part A of the task, participants were required to link in ascending order numbers (1-2-3 ...) that were randomly distributed on a computer screen. In Part B, participants were required to link alternately between numbers and letters (1-A-2-B ...). Although behavioral performance was somewhat less than typically obtained with the TMT due to use of the virtual stylus, distinct left-sided dorsolateral and medial frontal activity was revealed when comparing Part B versus Part A. These findings agree with existing literature showing sensitivity of the TMT to frontal regions in the left hemisphere. However, other activity was also observed (left middle and superior temporal gyrus) reinforcing that the brain-behavior correlations for the TMT are multifaceted and not restricted to the frontal lobe.

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Authors: Zakzanis, K. K., Mraz, R., & Graham, S. J.
Affiliations: University of Toronto (CA)
Sunnybrook Health Science Centre (CA)
Corresponding author: Mraz, Richard
ORCID: Zakzanis, Konstantine K.
Graham, Simon J.
Venue: Neuropsychologia
Publisher: Elsevier BV
Published: 2005-01
Volume: 43
Issue: 13
Pages: 1878-1886
ISSN: 0028-3932 (ISSN-L)
DOI: 10.1016/j.neuropsychologia.2005.03.013
OpenAlex: W2051410142
Cited by: 408
References: 37
Citations by year: 2026: 2 · 2025: 7 · 2024: 13 · 2023: 14 · 2022: 19 · 2021: 27 · 2020: 13 · 2019: 13 · 2018: 20 · 2017: 24 · 2016: 25 · 2015: 27 · 2014: 26 · 2013: 35 · 2012: 34
FWCI: 5.11
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Neuropsychologia (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
Keywords: Trail Making Test, frontal lobe function, brain-behavior relationship, dorsolateral prefrontal cortex, medial frontal cortex, left hemisphere, executive function, temporal lobe activation, neuropsychological assessment validity
MeSH terms: Adult, Brain Mapping, Cerebral Cortex, Dominance, Cerebral, Female, Frontal Lobe, Hand, Humans, Magnetic Resonance Imaging, Male, Movement, Psychomotor Performance, Reference Values, Serial Learning, Trail Making Test

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An fMRI study of the Trail Making Test

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