Moll Jorge, de Oliveira-Souza Ricardo, Moll Fernanda Tovar, Bramati Ivanei Edson, Andreiuolo Pedro Angelo
LABS-Rede D'Or, Grupo de Neuroimagem e Neurologia do Comportamento, D'Or Hospital, RJ Rio de Janeiro, Brazil.
Arq Neuropsiquiatr. 2002 Dec;60(4):900-5. doi: 10.1590/s0004-282x2002000600002. Epub 2003 Jan 15.
The trail making test (TMT) pertains to a family of tests that tap the ability to alternate between cognitive categories. However, the value of the TMT as a localizing instrument remains elusive. Here we report the results of a functional magnetic resonance imaging (fMRI) study of a verbal adaptation of the TMT (vTMT). The vTMT takes advantage of the set-shifting properties of the TMT and, at the same time, minimizes the visuospatial and visuomotor components of the written TMT. Whole brain BOLD fMRI was performed during the alternating execution of vTMTA and vTMTB in seven normal adults with more than 12 years of formal education. Brain activation related to the set-shifting component of vTMTB was investigated by comparing performance on vTMTB with vTMTA, a simple counting task. There was a marked asymmetry of activation in favor of the left hemisphere, most notably in dorsolateral prefrontal cortex (BA 6 lateral, 44 and 46) and supplementary motor area/cingulate sulcus (BA 6 medial and 32). The intraparietal sulcus (BA 7 and 39) was bilaterally activated. These findings are in line with clinico-anatomic and functional neuroimaging data that point to a critical role of the dorsolateral and medial prefrontal cortices as well as the intraparietal sulci in the regulation of cognitive flexibility, intention, and the covert execution of saccades/anti-saccades. Many commonly used neuropsychological paradigms, such as the Stroop, Wisconsin Card Sorting, and go - no go tasks, share some patterns of cerebral activation with the TMT.
连线测验（TMT）属于一类用于测试在不同认知类别之间进行转换能力的测验。然而，TMT作为一种定位工具的价值仍不明确。在此，我们报告一项对TMT言语适应性版本（vTMT）的功能磁共振成像（fMRI）研究结果。vTMT利用了TMT的转换特性，同时将书面TMT中的视觉空间和视觉运动成分降至最低。对7名接受过12年以上正规教育的正常成年人在交替执行vTMTA和vTMTB过程中进行了全脑BOLD fMRI检查。通过比较vTMTB与简单计数任务vTMTA的表现，研究了与vTMTB转换成分相关的脑激活情况。激活存在明显的不对称性，偏向于左半球，最显著的是在背外侧前额叶皮质（BA 6外侧、44和46）以及辅助运动区/扣带沟（BA 6内侧和32）。顶内沟（BA 7和39）双侧激活。这些发现与临床解剖学和功能性神经影像学数据一致，这些数据表明背外侧和内侧前额叶皮质以及顶内沟在认知灵活性、意图以及扫视/反扫视的隐蔽执行调节中起关键作用。许多常用的神经心理学范式，如斯特鲁普测验、威斯康星卡片分类测验和停止信号任务，与TMT有一些共同的脑激活模式。
