Recent progress has been made using fMRI as a clinical assessment tool, often employing analogues of traditional “paper and pencil” tests. The Trail Making Test (TMT), popular for years as a neuropsychological exam, has been largely ignored in the realm of neuroimaging, most likely because its physical format and administration does not lend itself to straightforward adaptation as an fMRI paradigm. Likewise, there is relatively more ambiguity about the neural systems associated with this test than many other tests of comparable clinical use. In this study, we describe an fMRI version of Trail Making Test-B (TMTB) that maintains the core functionality of the TMT while optimizing its use for both research and clinical settings. Subjects (N = 32) were administered the Functional Trail Making Test-B (f-TMTB). Brain region activations elicited by the f-TMTB were consistent with expectations given by prior TMT neurophysiological studies, including significant activations in the ventral and dorsal visual pathways and the medial pre-supplementary motor area. The f-TMTB was further evaluated for concurrent validity with the traditional TMTB using an additional sample of control subjects (N = 100). Together, these results support the f-TMTB as a viable neuroimaging adaptation of the TMT that is optimized to evoke maximally robust fMRI activation with minimal time and equipment requirements.

中文翻译：

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Trail Making Test-B 的功能神经影像学分析：对临床应用的影响。

最近使用 fMRI 作为临床评估工具取得了进展，通常使用传统“纸笔”测试的类似物。多年来一直作为神经心理学考试流行的 Trail Making Test (TMT) 在神经影像学领域一直被忽视，很可能是因为它的物理格式和管理不适合作为 fMRI 范式的直接适应。同样，与可比临床使用的许多其他测试相比，与此测试相关的神经系统相对更模糊。在本研究中，我们描述了 Trail Making Test-B (TMTB) 的 fMRI 版本，该版本保持了 TMT 的核心功能，同时优化了其在研究和临床环境中的使用。科目 ( N= 32) 进行了功能性路径制作测试-B (f-TMTB)。f-TMTB 引起的大脑区域激活与先前 TMT 神经生理学研究给出的预期一致，包括腹侧和背侧视觉通路以及内侧前补充运动区的显着激活。使用额外的对照受试者样本 ( N = 100)进一步评估了 f-TMTB 与传统 TMTB 的并发有效性。总之，这些结果支持 f-TMTB 作为 TMT 的可行神经成像适应，经过优化，以最少的时间和设备要求唤起最大程度的强大 fMRI 激活。