Affiliations: Department of Psychology, Washington University, Saint
Louis, MO, USA | Program in Occupational Therapy, Washington University
School of Medicine, Saint Louis, MO, USA | Department of Neurology, Washington University School
of Medicine, Saint Louis, MO, USA | Department of Radiology, Washington University School
of Medicine, Saint Louis, MO, USA
Note: [] Corresponding author: Elaine Tamez, Department of Psychology,
Washington University, One Brookings Drive, Box 1125, St. Louis, MO 63130, USA.
E-mail: [email protected]. Or: Lisa Tabor Connor, Program in Occupational
Therapy and Departments of Neurology and Radiology, Washington University
School of Medicine, Saint Louis, MO 63108, USA. E-mail: [email protected]
Abstract: The Trail Making Test and Digit Span are neuropsychological tests
widely used to assess executive abilities following stroke. The Trails B and
Digits Backward conditions of these tests are thought to be more sensitive to
executive impairment related to frontal lobe dysfunction than the Trails A and
Digits Forward conditions. Trails B and Digits Backward are also thought to be
more sensitive to brain damage in general. Data from the Stroke and Lesion
Registry maintained by the Washington University Cognitive Rehabilitation
Research Group were analyzed to compare the effects of frontal versus
nonfrontal strokes and to assess the effects of stroke severity. Results showed
that the performance of patients with frontal and nonfrontal strokes was
comparable in each condition of both the Trail Making Test and Digit Span,
providing no support for the widely held belief that Trails B and Digits
Backward are more sensitive to frontal lobe damage. Further, Trails A was as
strongly correlated with stroke severity as Trails B, whereas Digits Backward
was more strongly correlated with stroke severity than Digits Forward. Overall,
the Trail Making Test and Digit Span are sensitive to brain damage but do not
differentiate between patients with frontal versus nonfrontal stroke.
Keywords: Digit span, trail making test, stroke, executive function
