Nishimura Ayako, Sutoko Stephanie, Kiguchi Masashi, Atsumori Hirokazu, Obata Akiko, Funane Tsukasa, Kandori Akihiko, Mizuguchi Tomohiko, Shimonaga Koji, Hama Seiji, Tsuji Toshio
Center for Exploratory Research, Research & Development Group, Hitachi. Ltd., Kokubunji, Japan.
Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan.
Front Neurol. 2022 Jun 2;13:853942. doi: 10.3389/fneur.2022.853942. eCollection 2022.
The Trail Making Test Part-B (TMT-B) is an attention functional test to investigate cognitive dysfunction. It requires the ability to recognize not only numbers but also letters. We analyzed the relationship between brain lesions in stroke patients and their TMT-B performance.
From the TMT-B, two parameters (score and completion time) were obtained. The subjects were classified into several relevant groups by their scores and completion times through a data-driven analysis (-means clustering). The score-classified groups were characterized by low (≤10), moderate (10 < score < 25), and high (25) scores. In terms of the completion time, the subjects were classified into four groups. The lesion degree in the brain was calculated for each of the 116 regions classified by automated anatomical labeling (AAL). For each group, brain sites with a significant difference (corrected < 0.1) between each of the 116 regions were determined by a Wilcoxon Rank-Sum significant difference test.
Lesions at the cuneus and the superior occipital gyrus, which are mostly involved in visual processing, were significant (corrected < 0.1) in the low-score group. Furthermore, the moderate-score group showed more-severe lesion degrees (corrected < 0.05) in the regions responsible for the linguistic functions, such as the superior temporal gyrus and the supramarginal gyrus. As for the completion times, lesions in the calcarine, the cuneus, and related regions were significant (corrected < 0.1) in the fastest group as compared to the slowest group. These regions are also involved in visual processing.
The TMT-B results revealed that the subjects in the low-score group or the slowest- group mainly had damage in the visual area, whereas the subjects in the moderate-score group mainly had damage in the language area. These results suggest the potential utility of TMT-B performance in the lesion site.
连线测验B部分（TMT - B）是一项用于研究认知功能障碍的注意力功能测试。它不仅需要识别数字的能力，还需要识别字母的能力。我们分析了中风患者脑损伤与其TMT - B表现之间的关系。
从TMT - B中获取两个参数（得分和完成时间）。通过数据驱动分析（K均值聚类），根据受试者的得分和完成时间将其分为几个相关组。得分分类组的特征为低分（≤10）、中等（10＜得分＜25）和高分（≥25）。就完成时间而言，受试者被分为四组。通过自动解剖标记（AAL）将大脑分为116个区域，计算每个区域的脑损伤程度。对于每组，通过Wilcoxon秩和显著性差异检验确定116个区域中每个区域之间存在显著差异（校正P＜0.1）的脑区。
在低分患者组中，主要参与视觉处理的楔叶和枕上回的损伤具有显著性（校正P＜0.1）。此外，中等分数组在负责语言功能的区域，如颞上回和缘上回，显示出更严重的损伤程度（校正P＜0.05）。至于完成时间，与最慢组相比，最快组在距状裂、楔叶及相关区域的损伤具有显著性（校正P＜0.1）。这些区域也参与视觉处理。
TMT - B结果显示，低分患者组或最慢组的受试者主要在视觉区域受损，而中等分数组的受试者主要在语言区域受损。这些结果表明TMT - B表现对于损伤部位具有潜在的应用价值。
