Trail making test in chronic toxic encephalopathy: performance and discriminative potential

Area of Science:

• Neuroscience
• Neurology
• Toxicology

Background:

• Chronic toxic encephalopathy (CTE) is a neurological condition affecting cognitive function.
• The Trail Making Test (TMT) is a neuropsychological tool used to assess cognitive processing speed, visual-spatial processing, and executive functions.
• Understanding the TMT's utility in diagnosing CTE is crucial for clinical practice.

Purpose of the Study:

• To investigate the impact of chronic toxic encephalopathy (CTE) on Trail Making Test (TMT) performance.
• To evaluate the discriminative capability of the TMT in identifying CTE.
• To explore the influence of age on TMT performance in different groups.

Main Methods:

• Assessed TMT performance in three groups: diagnosed CTE patients, patients with similar symptoms but no CTE diagnosis, and healthy controls.
• Compared TMT scores across groups.
• Analyzed the effect of age on TMT performance within each group, particularly focusing on TMT-B.

Main Results:

• Patients with CTE exhibited poorer TMT performance compared to healthy participants.
• Increasing age negatively affected TMT performance exclusively in the CTE group, most notably on TMT-B.
• The TMT demonstrated low sensitivity for identifying CTE but high specificity, correctly classifying all healthy individuals.

Conclusions:

• The TMT has limited ability to detect CTE, especially in mild to moderate cases.
• Normal TMT performance can be observed in individuals with mild to moderate brain syndromes like CTE.
• Poor TMT performance is unlikely in healthy individuals, making it a reliable indicator of normality.