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Originalartikel

Eine Normierungsstudie eines modifizierten Trail Making Tests im deutschsprachigen Raum

Published Online:February 24, 2012https://doi.org/10.1024/1016-264X/a000060

Abstract

Der Trail Making Test (TMT) ist ein international weit verbreitetes Verfahren, das z. B. zur Untersuchung von Patienten mit erworbenen Hirnschädigungen eingesetzt wird. Die Performanz im TMT wird mit unterschiedlichen neuropsychologischen Domänen, wie z. B. Aufmerksamkeit und Exekutivfunktionen, in Verbindung gebracht. Trotz der häufigen Anwendung im klinischen Alltag liegen bisher keine deutschsprachigen Normen für einen umfassenden Altersrange vor. Die vorliegende Untersuchung hat daher den Einfluss von Alter und Bildung auf die Bearbeitungszeit im TMT bei deutschsprachigen Erwachsenen im Alter zwischen 18 und 85 Jahren erfasst und analysiert. Ausschlusskriterien bildeten neurologische oder psychiatrische Erkrankungen, die Beeinträchtigung des Blickfeldes bzw. der Sehfähigkeit, die motorische Beeinträchtigung der Arme und Hände sowie Drogen- oder Alkoholmissbrauch. Die Stichprobe ist in vier Altersgruppen aufgeteilt: 18 – 34 Jahre (n = 148), 35 – 49 Jahre (n = 111), 50 – 64 Jahre (n = 93) und 65 – 84 Jahre (n = 53). Hinsichtlich der Bildung wurden zwei Gruppen gebildet: niedriges bis mittleres Bildungsniveau ( ≤ 12 Jahre formale Bildung) und höheres Bildungsniveau ( ≥ 12 Jahre formale Bildung). Signifikante Korrelationen zwischen den demografischen Variablen und den Bearbeitungszeiten im TMT-A bzw. TMT-B zeigen, dass sowohl Alter als auch Bildung mit der Leistung im TMT korrelieren (p < .01). Post hoc Analysen machen deutlich, dass sich dabei alle Altersgruppen voneinander unterscheiden. Die Ergebnisse für die Bearbeitungszeit stehen in Einklang mit früheren Normierungsstudien, die ebenfalls Alter und Bildung als die bedeutsamsten Moderatoren für die Leistung im TMT identifiziert hatten.


A Normative Study of a Modified Trail Making Test in a German Speaking Population

The Trail Making Test (TMT) is an internationally used method for examining subject with brain damage. TMT involves different neuropsychological domains such as attention and executive functions. Despite the wide use in clinical practice, no German normative data for a wide age range exist until now. This study analyzes the influence of age and education on processing time in the TMT in German speaking adults aged between 18 and 85 years. Exclusion criteria are neurological or psychiatric disease, impairment of visual field or unsufficient visual acuity, motor impairment of arms and hands and finally drugs- or alcohol abuse. The sample is divided into four age groups: very young (n = 148; 18 – 34 years), young (n = 111; 35 – 49 years), middle aged (n = 93; 50 – 64 years) and old aged (n = 53, 65 – 84 years). Depending upon the education level, they were divided into two groups: low to medium level of education ( ≤ 12 years) and higher ( > 12 years). TMT-A and TMT-B processing time correlates significantly with age and education (p < .01). Post hoc analysis show that all age groups differ from each other. The results are consistent with previous normative studies showing that age and education are the most significant variables that influence the performance in TMT.

Literatur

  • Abe, M. , Suzuki, K. , Okada, K. , Miura, R. , Fujii, T. , Etsurou, M. et al. (2004). Normative data on tests for frontal lobe functions: Trail Making Test, verbal fluency, Wisconsin Card Sorting Test. No To Shinkei, 56, 567 – 574. First citation in articleGoogle Scholar

  • Ananda, M. M. A. , Weerahandi, S. (1997). Two-way ANOVA with unequal cell frequencies and unequal variances. Statistica Sinica, 7, 631 – 646. First citation in articleGoogle Scholar

  • Arbuthnott, K. , Frank, J. (2000). Trail making test, part B as a measure of executive Control: Validation using a set-switching paradigm. Journal of Clinical and Experimental Neuropsychology, 22, 4. First citation in articleCrossref, Google Scholar

  • Arnett, J. , Labovitz, S. (1995). Effect of physical layout in performance of the Trail Making Test. Psychological Assessment, 7, 220 – 221. First citation in articleCrossref, Google Scholar

  • Arnold, B. R. , Montgomery, G. T. , Castaneda, I. , Longoria, R. (1994). Acculturation and performance of Hispanics on selected Halstead-Reitan neuropsychological tests. Assessment, 1, 239 – 248. First citation in articleCrossref, Google Scholar

  • Ashendorf, L. , Jefferson, A. L. , O’Connor, M. K. , Chaisson, C. , Green, R. C. , Stern, R. A. (2008). Trail Making Test errors in normal aging, mild cognitive impairment, and dementia. Archives of Clinical Neuropsychology, 23, 129 – 137. First citation in articleGoogle Scholar

  • Atkinson, T. M. , Ryan, J. P. (2008). The use of variants of the Trail Making Test in serial assessment: A construct validity study. Journal of Psychoeducational Assessment, 26, 42 – 53. First citation in articleCrossref, Google Scholar

  • Axelrod, B. , Aharon-Peretz, J. , Tomer, R. , Fisher, T. (2000). Creating interpretations guidelines for the Hebrew Trail Making Test. Applied Neuropsychology, 7, 186 – 188. First citation in articleCrossref, Google Scholar

  • Backmann, L. , Wahlin, A. , Small, J. J. , Herlitz, A. , Winblad, B. , Fratiglioni, L. (2004). Cognitive functioning in aging and dementia: The Kungsholmen Project. Aging, Neuropsychology and Cognition, 11, 212 – 244. First citation in articleCrossref, Google Scholar

  • Basso, M. R. , Bornstein, R. A. , Lang, J. M. (1999). Practice effects on commonly used measures of executive function across twelve months. The Clinical Neuropsychologist, 13, 283 – 292. First citation in articleCrossref, Google Scholar

  • Bates, M. E. , Voelbel, G. T. , Buckmann, J. F. , Labouvie, E. W. , Barry, D. (2005). Short-term neuropsychological recovery in clients with substance use disorders. Alcoholism: Clinical and Experimental Research, 29, 367 – 377. First citation in articleCrossref, Google Scholar

  • Bowie, C. R. , Harvey, P. (2006). Administration and interpretation of the Trail Making Test. Nature Protocols, 1, 2277 – 2281. First citation in articleCrossref, Google Scholar

  • Bugg, J. M. , Zook, N. A. , DeLosh, E. L. , Davalos, D. B. , Davis, H. P. (2006). Age Differences in Fluid Intelligence: Contributions of General Slowing and Frontal Decline. Brain and Cognition, 62, 9 – 16. First citation in articleCrossref, Google Scholar

  • Cahn-Weiner, D. A. , Boyle, P. A. , Malloy, P. F. (2002). Tests of executive function predict instrumental activities of daily living in community-dwelling older individuals. Applied Neuropsychology, 9, 187 – 191. First citation in articleCrossref, Google Scholar

  • Charlton, R. A. , Barrick, T. R. , McIntyre, D. J. , Shen, Y. , O’Sullivan, M. , Howe, F. A. et al. (2006). White matter damage on diffusion tensor imaging correlates with age-related cognitive decline. Neurology, 66, 217 – 222. First citation in articleCrossref, Google Scholar

  • Craddick, R. A. , Stern, M. R. (1963). Practice effects on the trail making test. Perceptual and Motor Skills, 17, 651 – 653. First citation in articleCrossref, Google Scholar

  • Diaz-Asper, C. M. , Schretlen, D. J. , Pearlson, G. D. (2004). How well does IQ predict neuropsychological test performance in normal adults? Journal of International Neuropsychology Society, 10, 82 – 90. First citation in articleCrossref, Google Scholar

  • Dodrill, C. B. (Ed.). (1987). What’s normal? Seattle, WA: Northwest Neuropsychological Association. First citation in articleGoogle Scholar

  • Drane, D. I. , Yuspeh, R. L. , Huthwaite, J. S. , Klingler, L. K. (2002). Demographic characteristics and normative observations for derived Trail Making indices. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 15, 39 – 43. First citation in articleGoogle Scholar

  • Dye, O. A. (1979). Effects of Pratice on Trail Making performance. Perceptual and Motor Skills, 48, 296. First citation in articleGoogle Scholar

  • Eckert, M. A. (2011). Slowing down: age-related neurobiological predictors of processing speed. Frontiers in Neuroscience, 5: 25. doi: 10.3389fnins.201.00025 First citation in articleGoogle Scholar

  • Elderkin-Thompson, V. , Kumar, A. , Bilker, W. B. , Dunkin, J. J. , Mintz, J. , Moberg, P. J. et al. (2003). Neuropsychological deficits among patients with late-onset minor and major depression. Archives of Clinical Neuropsychology, 18, 529 – 549. First citation in articleCrossref, Google Scholar

  • Etienne, V. , Marin-Lamellet, C. , Laurent, B. (2009). Executive functioning in normal aging. Revue Neurologique, 164, 1010 – 1017. First citation in articleCrossref, Google Scholar

  • Fernandez, A. L. , Marcopulo, B. A. (2008). A comparison of normative data for the Trail Making Test from several countries: Equivalence of norms and considerations for interpretation. Scandinavian Journal of Psychology, 49, 239 – 246. First citation in articleCrossref, Google Scholar

  • Gaudino, E. A. , Geisler, M. W. , Squires, N. K. (1995). Construct validity in the Trail Making Test: What makes part B harder? Journal of Clinical and Experimental Neuropsychology, 17, 529 – 535. First citation in articleCrossref, Google Scholar

  • Giovagnoli, A. , Del Pesce, M. , Mscheroni, S. , Simoncelli, M. , Laiacona, M. , Capitani, E. (1996). Trail Making Test: normative values from 287 normal adult controls. Italian Journal of Neurological Science, 17, 305 – 309. First citation in articleCrossref, Google Scholar

  • Goul, W. R. , Brown, M. (1970). Effects of age and intelligence on trail making test performance and validity. Perceptual and Motor Skills, 30, 319 – 326. First citation in articleCrossref, Google Scholar

  • Grissom, R. J. (2000). Heterogeneity of Variance in Clinical Data. Journal of Consulting and Clinical Psychology, 68, 155 – 165. First citation in articleCrossref, Google Scholar

  • Hamdan, A. C. , Hamdan, E. M. (2009). Effects of age and education level on the Trail Making Test in a healthy Brazilian sample. Psychology and Neuroscience, 2, 199 – 203. First citation in articleCrossref, Google Scholar

  • Hashimoto, R. , Meguro, K. , Lee, E. , Kasai, M. , Ishii, H. , Yamaguchi, S. (2006). Effect of age and education on the Trail Making Test and determination of normative data for Japanese elderly people: The Tajiri Project. Psychiatry and Clinical Neurosciences, 60, 422 – 428. First citation in articleCrossref, Google Scholar

  • Heaton, R. K. , Miller, S. W. , Taylor, M. J. , Grant, I. (Eds.). (2004). Revised comprehensive norms for an expanded Halstead-Reitan battery: Demographically adjusted neuropsychological norms for African American and Caucasian adults. Lutz, Fla: PAR. ((ist Lutz, Fla: PAR Ort und Verlag?)) First citation in articleGoogle Scholar

  • Hellmchen, H. , Reischies, F. M. (1998). Normales und pathologisches Altern. Nervenarzt, 69, 369 – 378. First citation in articleCrossref, Google Scholar

  • Hester, R. L. , Kinsella, G. J. , Ong, B. , McGregor, J. (2005). Demographic influences on baseline and derived scores from the Trail Making Test in healthy older Australian adults. The Clinical Neuropsychologist, 19, 45 – 54. First citation in articleCrossref, Google Scholar

  • Horton, A. M. , Roberts, C. (2003). Demographic effects on the Trail Making Test in a drug-abuse treatment sample. Archives of Clinical Neuropsychology, 18, 49 – 56. First citation in articleCrossref, Google Scholar

  • Hsiung, T. , Olejnik, S. (1994). Power of pairwise multiple comparisons on the unequal variance case. . Communications in Statistics – Simulation and Computation, 23, 355 – 371. First citation in articleCrossref, Google Scholar

  • Jacobs, C. , Tischler, L. , Petermann, F. (2009). Typische klinische Problemkonstellationen bei Patienten der Psychologischen Kinderambulanz der Universität Bremen. Verhaltenstherapie, 19, 22 – 27. First citation in articleCrossref, Google Scholar

  • Jacobs, H. I. , Leritz, E. C. , Williams, V. J. , Van Boxtel, M. P. , Elst, W. V. , Jolles, J. et al. (2011). Association between white matter microstructure, executive functions, and processing speed in older adults: The impact of vascular health. Human Brain Mapping. doi: 10.1002/nbm.21412 First citation in articleGoogle Scholar

  • Lamberty, G. J. , Putnam, S. H. , Chatel, D. M. , Beliauskas, L. A. , Adams, K. S. (1994). Derived Trail Making Test indices: a prelimary report. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 7, 230 – 234. First citation in articleGoogle Scholar

  • Lannoo, E. , Vingerhoets, G. (1997). Flemish normative data on common neuropsychological tests: Influence of age, education and gender. Psychologica Belgica, 37, 141 – 155. First citation in articleGoogle Scholar

  • Lemiere, J. , Decruyenaere, M. , Evers-Kiebooms, G. , Vandenbussche, E. , Dom, R. (2004). Cognitive changes in patients with Huntington’s disease (HD) and asymptomatic carriers of th HD mutation-a longitudinal follow-up study. Journal of Neurology, 251, 935 – 942. First citation in articleCrossref, Google Scholar

  • Lima, S. D. , Hale, S. , Myerson, J. (1991). How general is general slowing? Evidence from the lexical domain. Psychology and Aging, 6, 416 – 425. First citation in articleCrossref, Google Scholar

  • Lu, L. , Bigler, E. D. (2000). Performance on original and on a Chinese version of Trail Making Test B: A normative bilingual sample. Applied Neuropsychology, 7, 243 – 246. First citation in articleCrossref, Google Scholar

  • Lucas, J. A. , Ivnik, R. J. , Smith, G. E. , Ferman, T. J. , Willis, F. B. , Petersen, R. C. et al. (2005). Mayo’s older African Americans normative studies: Norms for Boston Naming Test, Controlled Oral Word Association, Category Fluencs, Animal Naming, Token Test, WRAT-3 reading, Trail Making Test, Stroop Test, and Judgment of Line Orientation. The Clinical Neuropsychologist, 19, 243 – 269. First citation in articleCrossref, Google Scholar

  • Luck, T. , Riedel-Heller, S. G. , Wiese, B. , Stein, J. , Weyerer, S. , Werle, J. et al. (2009). CERAD-NP-Testbatterie: Alters-, geschlechts- und bildungs-spezifische Normen ausgewählter Subtests Ergebnisse der German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Zeitschrift für Gerontologie und Geriatrie, 42, 372 – 384. First citation in articleCrossref, Google Scholar

  • Mahurin, R. K. , Velligan, D. I. , Hazleton, B. , Davis, J. M. , Eckert, S. , Miller, A. L. (2006). Trail Making Test erros and executive function in schizophrenia and depression. The Clinical Neuropsychologist, 20, 271 – 288. First citation in articleCrossref, Google Scholar

  • Mayr, U. (2006). Normales kognitives Altern. In H. O. Karnath & P. Thier (Hrsg.), Neuropsychologie. Berlin: Springer. First citation in articleGoogle Scholar

  • McCaffrey, R. J. , Ortega, A. , Haase, R. F. (1993). Effects of repeated neuropsychological assessments. Archives of Clinical Neuropsychology, 8, 519 – 524. First citation in articleCrossref, Google Scholar

  • McGrath, J. , Scheldt, S. , Welham, J. , Clair, A. (1997). Performance on tests sensitive to impaired executive ability in schizophrenia, mania and well controls: acute and subacute phases. Schizophrenia Research, 26, 127 – 137. First citation in articleCrossref, Google Scholar

  • Miller, E. M. (1994). Intelligence and brain myelination: a hypothesis. Personality and Individual Differences, 17, 803 – 832. First citation in articleCrossref, Google Scholar

  • Mitrushina, M. N. , Boone, K. B. , Razani, J. , D’Elia, L. F. (Eds.). (2005). Handbook of normative data for neuropsychological assessment (2nd ed.). New York: Oxford University Press. First citation in articleGoogle Scholar

  • Moritz, S. , Birkner, C. , Kloss, M. , Jahn, H. , Hand, I. , Haasen, C. et al. (2002). Executive functioning in obsessive-compulsice disorder, unipolar depression, and schizophrenia. Archives of Clinical Neuropsychology, 17, 477 – 483. First citation in articleGoogle Scholar

  • Morris, J. C. , McManus, D. Q. (1991). The neurology of aging: normal versus pathologic change. Geriatrics, 46, 47 – 54. First citation in articleGoogle Scholar

  • Myerson, J. , Lawrence, B. , Hale, S. , Jenkins, L. , Chen, J. (1998). General Slowing of Lexical and Nonlexical Information Processing in Dementia of the Alzheimer Type. Aging, Neuropsychology, and Cognition, 5, 182 – 193. First citation in articleCrossref, Google Scholar

  • Nielsen, H. , Knudsen, L. , Daugbjerg, O. (1989). Normative data for eight neuropsychological tests based on a danish sample. Scandinavian Journal of Psychology, 30, 37 – 45. First citation in articleCrossref, Google Scholar

  • Nielsen, H. , Lolk, A. , Kragh-sorensen, P. (1995). Normative data for eightychological tests, gathered from a random sample of Danes aged 64 to 83 years. Nordisk Psykologi, 47, 241 – 255. First citation in articleGoogle Scholar

  • Oldfield, R. C. (1971). The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia, 9, 97 – 113. First citation in articleCrossref, Google Scholar

  • Palmer, B. W. , Heaton, R. K. , Jeste, D. V. (1999). Extrapyramidal symptoms and neuropsychological deficits in schizophrenia. Biological Psychiatry, 45, 791 – 794. First citation in articleCrossref, Google Scholar

  • Partington, J. E. , Leiter, R. G. (1949). Partington’s Pathway Test. The Psychological Service Center Bulletin, 1, 9 – 20. First citation in articleGoogle Scholar

  • Periánez, J. A. , Ríos-Lago, M. , Rodríguez-Sánchez, J. M. , Adriver-Roig, D. , Sánchez-Cubillo, I. , Crespo-Facorro, B. et al. (2007). Trail Making Test in traumatic brain injury, schizophrenia, and normal ageing: Sample comparisons and normative data. Archives of Clinical Neuropsychology, 22, 433 – 447. First citation in articleCrossref, Google Scholar

  • Reitan, R. M. (1955). The relationship of the Trail Making Test to organic brain damage. Journal of Consulting Psychology, 19, 393 – 394. First citation in articleCrossref, Google Scholar

  • Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271 – 276. First citation in articleCrossref, Google Scholar

  • Reitan, R. M. (Ed.). (1992). Trail Making Test. Tucson, AZ: Reitan Neuropsychology Laboratory. First citation in articleGoogle Scholar

  • Roberts, C. , Horton, A. M. (2001). Demographic effects on the Trail Making Test in marijuana abusers. International Journal of Neuroscience, 110, 173 – 180. First citation in articleCrossref, Google Scholar

  • Sanchez-Cubillo, I. , Perianez, J. A. , Adrover.Roig, D. , Rodriguez-Sanchez, J. , Rios-Lago, M. , Tirapu, J. et al. (2009). Construct Validity of the Trail Making Test: rile of task-switching, working memory, inhibition/interference and visuo-motor abilities. Journal of International Neuropsychological Society, 15, 438 – 450. First citation in articleCrossref, Google Scholar

  • Siegert, R. , Cavana, C. (1997). Norms for older new zealanders on the Trail Making Test. New Zealand Journal of Psycholgy, 26, 25 – 31. First citation in articleGoogle Scholar

  • Solana, E. , Poca, M. A. , Sahuquillo, J. , Benejam, B. , Junque, C. , Dronavalli, M. (2010). Cognitive and motor improvement after retesting in normal-pressure hydrocephalus: a real change or merely a learning effect? Journal of Neurosurgery, 112, 399 – 409. First citation in articleCrossref, Google Scholar

  • Spreen, O. , Strauss, E. (1998). A compendium of neuropsychological tests: administration, norms, and commentary. New York: Oxford University Press. First citation in articleGoogle Scholar

  • Stewart, R. , Richards, M. , Brayne, C. , Mann, A. (2001). Cognitive function in UK community-dwelling African Caribbean elders: Normative daa for a test battery. International Journal of Geriatric Psychiatry, 16, 518 – 527. First citation in articleCrossref, Google Scholar

  • Strauss, E. , Sherman, E. M. S. , Spreen, O. (Eds.). (2006). A Compendium of Neuropsychological Tests (3rd ed.). New York: Oxford University Press. First citation in articleGoogle Scholar

  • Stuss, D. T. , Bisschop, S. M. , Alexander, M. P. , Katz, D. , Izukawa, D. (2001). The Trail Making Test: A study in focal lesion patients. Psychological Assessment, 13, 230 – 239. First citation in articleCrossref, Google Scholar

  • Tischler, L. , Petermann, F. (2010). Testbesprechung Trail Making Test. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 58, 79 – 81. First citation in articleLink, Google Scholar

  • Tombaugh, T. N. (2004). Trail Making Test A and B: Normative data stratified by age and education. Archives of Clinical Neuropsychology, 19, 203 – 214. First citation in articleCrossref, Google Scholar

  • Vernooij, M. W. , de Groot, M. , van der Lugt, A. , Ikram, M. A. , Krestin, G. P. , Hofman, A. et al. (2008). White matter atrophy and lesion formation explain the loss of structural integrity of white matter in aging. Neuroimage, 43, 470 – 477. First citation in articleCrossref, Google Scholar

  • Vivell, S. (2011). Differenzierbarkeit des Trail Making Test und seiner Indizes nach Anpassung des Layouts des TMT-B an den TMT-A. Unveröffentlichte Diplomarbeit, Universität Mannheim. First citation in articleGoogle Scholar

  • Wölwer, W. , Falkai, P. , Streit, M. , Gaebel, W. (2003). Trait characteristic of impaired visuomotor integration during trail-making test B performance in schizophrenia. Neuropsychology, 48, 59 – 67. First citation in articleGoogle Scholar

  • Wölwer, W. , Gaebel, W. (2002). Impaired Trail Making Test-B performance in patients with acute schizophrenia is related to inefficient sequencing of planning and acting. Journal of Psychiatric Research, 36, 407 – 416. First citation in articleCrossref, Google Scholar

  • Woodruff, G. R. , Mendoza, J. E. , Dickson, A. L. , Blanchard, E. , Christenberry, L. B. (1995). The effects of configural differences on the Trail Making Test. Archives of Clinical Neuropsychology, 10, 408. First citation in articleCrossref, Google Scholar

  • Zakzanis, K. K. , Mraz, R. , Graham, S. J. (2005). An fMRI study of the Trail Making Test. Neuropsychologia, 43, 1878 – 1886. First citation in articleCrossref, Google Scholar

  • Zalonis, I. , Christidi, F. , Kararizou, E. , Triantafyllou, N. I. , Kapaki, E. , Paraskevas, G. et al. (2010). Reference data from derived Trail Making Test scores in Greek healthy population. Annals of General Psychiatry, 9, 145. First citation in articleCrossref, Google Scholar

  • Zalonis, I. , Kararizou, E. , Traintafyllou, N. I. , Kapaki, E. , Papageorgiou, S. , Sgouropoulos, P. et al. (2008). A normative study of the Trail Making Test A and B in Greek adults. The Clinical Neuropsychologist, 22, 842 – 850. First citation in articleCrossref, Google Scholar

  • Ziegler, G. , Dahnke, R. , Jancke, L. , Yotter, R. A. , May, A. , Gaser, C. (2011). Brain structural trajectories over the adult lifespan. Human Brain Mapping. doi: 10.1002/hbm.21374 First citation in articleGoogle Scholar