Trail Making Test Performance Using a Touch-Sensitive Tablet: Behavioral Kinematics and Electroencephalography

Zhongmin Lin; Fred Tam; Nathan W Churchill; Fa-Hsuan Lin; Bradley J MacIntosh; Tom A Schweizer; Simon J Graham

doi:10.3389/fnhum.2021.663463

Trail Making Test Performance Using a Touch-Sensitive Tablet: Behavioral Kinematics and Electroencephalography

Front Hum Neurosci. 2021 Jul 1:15:663463. doi: 10.3389/fnhum.2021.663463. eCollection 2021.

Authors

Zhongmin Lin¹, Fred Tam², Nathan W Churchill³, Fa-Hsuan Lin^{1

2}, Bradley J MacIntosh^{1

2}, Tom A Schweizer^{3

4}, Simon J Graham^{1

2}

Affiliations

¹ Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
³ Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.
⁴ Division of Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.

Abstract

The Trail Making Test (TMT) is widely used to probe brain function and is performed with pen and paper, involving Parts A (linking numbers) and B (alternating between linking numbers and letters). The relationship between TMT performance and the underlying brain activity remains to be characterized in detail. Accordingly, sixteen healthy young adults performed the TMT using a touch-sensitive tablet to capture enhanced performance metrics, such as the speed of linking movements, during simultaneous electroencephalography (EEG). Linking and non-linking periods were derived as estimates of the time spent executing and preparing movements, respectively. The seconds per link (SPL) was also used to quantify TMT performance. A strong effect of TMT Part A and B was observed on the SPL value as expected (Part B showing increased SPL value); whereas the EEG results indicated robust effects of linking and non-linking periods in multiple frequency bands, and effects consistent with the underlying cognitive demands of the test.

Keywords: EEG; Trail Making Test; computerized tablet; neuropsychological tests; partial least squares; time-frequency analysis.