Original article
An analysis of performance in the Trail Making Test by subjects after a stroke with different lesion locations

Introduction: Executive dysfunctions are common neuropsychological symptoms in patients after a stroke. These disorders may present with impairment of cognitive flexibility, ability to plan behavior and decision-making skills. From the perspective of clinical practice, early detection of these disorders is essential.

The aim of the study was to compare the level of executive functions in patients after stroke, depending on the location of the damage. The Trail Making Test (TMT) was used for this purpose.

Material and methods: The study included 43 patients with diagnosed ischemic cerebral stroke. Patients were divided into three groups: a) damage of frontal cerebral lobes, b) damage of the cortex of the posterior parts of the cerebral hemispheres, c) damage of subcortical structures of the brain. The analysis takes into account the results of Part A and B of the test and the ratio B/A.

Results: The results showed that the patients with damage to the frontal lobes have a lower level of cognitive flexibility than patients with damage to subcortical structures (p = 0.037).

Conclusions: Patients with damage of the frontal cerebral lobes demonstrated a significantly lower level of executive dysfunctions. However, only taking into account the ratio B/A, TMT enables one to more precisely assess the efficiency of executive functions and eliminate the psychomotor component. The presence of executive dysfunction hampers the functioning of the patient and, consequently, leads to a reduction of independence. Therefore, it is important to take into account the appropriate procedure in the neuropsychological diagnosis of patients after stroke.