Quantitative electroencephalographic and neuropsychological investigation of an alternative measure of frontal lobe executive functions: the Figure Trail Making Test.

Paul S Foster,Valeria Drago,Brad J Ferguson,Patti Kelly Harrison,David W Harrison

doi:10.1007/s40708-015-0025-z

Abstract

The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning. Relatively little is known about right frontal lobe contributions to executive functioning given the paucity of measures sensitive to right frontal functioning. The present investigation reports the development and initial validation of a new measure designed to be sensitive to right frontal lobe functioning, the Figure Trail Making Test (FTMT). The FTMT, the classic Trial Making Test, and the Ruff Figural Fluency Test (RFFT) were administered to 42 right-handed men. The results indicated a significant relationship between the FTMT and both the TMT and the RFFT. Performance on the FTMT was also related to high beta EEG over the right frontal lobe. Thus, the FTMT appears to be an equivalent measure of executive functioning that may be sensitive to right frontal lobe functioning. Applications for use in frontotemporal dementia, Alzheimer’s disease, and other patient populations are discussed.

Highlights

The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning
The raw time required completing each part of the Trail Making Test (TMT) and the Figure Trail Making Test (FTMT) was used in the correlational analyses
Additive scores were obtained by summing the times required to complete the two separate parts of the TMT and the FTMT

Summary

Introduction

The most frequently used measures of executive functioning are either sensitive to left frontal lobe functioning or bilateral frontal functioning. The frequent use of the TMT, WCST, and the SCWT, as well as the assumption that they are measures of executive functioning, led Demakis (2003–2004) to conduct a series of meta-analyses to determine the sensitivity of these test to detect frontal lobe dysfunction, lateralized frontal lobe dysfunction. Patients with left frontal lobe lesions are known to exhibit impaired performance on lexical fluency to confrontation tasks, relative to either patients with right frontal lesions [12, 19, 20] or controls [21]. A recent meta-analysis indicated that the largest deficits in performance on measures of lexical fluency are associated with left frontal lobe lesions [22]. Performance on lexical fluency tasks varies as a function of lateral frontal lobe asymmetry, as assessed by electroencephalography [28]

Methods

Results

Conclusion