Intermanual and alternate-form equivalence on the trail making tests

Area of Science:

• Neuropsychology
• Cognitive Psychology
• Psychometrics

Background:

• The Trail Making Test (TMT) is a widely used neuropsychological assessment.
• Understanding intermanual performance differences and alternate-form reliability is crucial for accurate TMT interpretation.
• Hand preference and task complexity may influence TMT performance.

Purpose of the Study:

• To investigate intermanual discrepancies in Trail Making Test performance.
• To evaluate the alternate-form equivalence between Trail Making Test Part B (TMT-B) and Trail Making Test Part D (TMT-D).
• To examine the influence of hand preference and task complexity on TMT performance.

Main Methods:

• A mixed-model analysis of variance was employed.
• Participants included 80 healthy adults (40 left-hand-preferred, 40 right-hand-preferred).
• Performance was assessed using both hands on numeric (TMT-B) and numeric/lexical (TMT-D) tasks.

Main Results:

• No clinically meaningful score differences were found when administering the TMT to the non-dominant hand.
• Hand preference and task complexity did not significantly alter the magnitude of intermanual discrepancies.
• A significant interaction revealed TMT-D to be slightly more difficult than TMT-B.

Conclusions:

• The TMT can be administered to the non-preferred hand without significant clinical implications.
• While not perfectly equivalent, TMT-D can serve as a suitable alternate form for TMT-B retesting, with considerations for its slightly higher difficulty.
• Understanding form difficulty is key for accurate longitudinal assessment with TMT alternate forms.