Trail Making Test: Training Cognitive Flexibility and Processing Speed

What is the Trail Making Test?

The Trail Making Test (TMT) is a neuropsychological test that has been used since the 1940s. It measures visual attention, processing speed, and cognitive flexibility.

The Principle

You connect dots in a specific order - either numerically (1-2-3...) or alternating between numbers and letters (1-A-2-B-3-C...).

Two Versions

TMT-A (Trail Making Test Part A)

• Connect numbers in ascending order
• 1 → 2 → 3 → 4 → 5 → ...
• Primarily measures processing speed

TMT-B (Trail Making Test Part B)

• Alternately connect numbers and letters
• 1 → A → 2 → B → 3 → C → ...
• Additionally measures cognitive flexibility

Why is the TMT So Valuable?

Scientific Relevance

The TMT is one of the most commonly used tests in clinical neuropsychology:

• Standard test for cognitive impairments
• Sensitive to many neurological conditions
• Well researched with normative data for all age groups

What Does the TMT Train?

1. Visual search - Quick scanning and finding targets
2. Sequential thinking - Maintaining sequences
3. Motor speed - Fast hand-eye coordination
4. Task-switching - Switching between rules (in TMT-B)
5. Working memory - Remembering where you are and what comes next

Applications of the TMT

Clinical Diagnosis

• Dementia screening - Early detection of cognitive deficits
• ADHD diagnosis - Detecting attention deficits
• Traumatic brain injury - Assessing brain injuries

Daily Relevance

The skills from the TMT are used daily:

• Cooking: Following recipes, monitoring multiple pots simultaneously
• Driving: Looking for traffic signs, planning routes
• Working: Processing task lists, setting priorities
• Organizing: Sorting documents, coordinating appointments

TMT-B and Cognitive Flexibility

What is Cognitive Flexibility?

Cognitive flexibility is the ability to switch between different concepts, perspectives, or strategies. It's part of executive functions and crucial for:

• Problem-solving - Finding alternative approaches
• Creativity - Making new connections
• Adaptability - Responding to changes

Why is TMT-B Harder?

In TMT-B, you must switch between two rule systems (numbers and letters). This switching requires:

• Inhibition of the currently irrelevant rule
• Activation of the new rule
• Monitoring to ensure correct switching

How to Improve at the TMT

Strategy for TMT-A

1. Scan systematically - Left to right, top to bottom
2. Plan ahead - Look for the next number while connecting
3. Keep your finger close - Minimize movement time

Strategy for TMT-B

1. Anticipate the switch - Always think: "Number then letter"
2. Develop a rhythm - 1-A-2-B becomes like a mantra
3. Stay calm - Stress worsens switching

Training Recommendations

• Frequency: 3-4 times per week
• Duration: 5-10 minutes per session
• Progression: Start with TMT-A, then TMT-B, then under time pressure

Trail Making in SynapseGym

SynapseGym offers an interactive Trail Making Test:

Features

• Touch-optimized - Perfect for smartphones
• Various difficulties - From easy to expert
• Time measurement - Precise tracking of your speed
• Error tracking - See where you make mistakes
• Progress history - Track your improvement over time

Modes

Classic (TMT-A)

• Connect numbers only
• Ideal for beginners and warm-up

Extended (TMT-B)

• Alternating numbers and letters
• Trains cognitive flexibility

Challenge

• Time limit for extra challenge
• Increases processing speed under pressure

Normative Values

TMT-A (Numbers Only)

Age Group	Good Time	Average	Slow
18-24 years	< 22s	22-29s	> 29s
25-54 years	< 25s	25-35s	> 35s
55-64 years	< 30s	30-42s	> 42s
65+ years	< 40s	40-58s	> 58s

TMT-B (Numbers + Letters)

Age Group	Good Time	Average	Slow
18-24 years	< 48s	48-64s	> 64s
25-54 years	< 55s	55-75s	> 75s
55-64 years	< 70s	70-100s	> 100s
65+ years	< 90s	90-132s	> 132s

Tips for Better Results

1. Warm Up

Do a few easy runs before going for time.

2. Optimize Your Setup

• Screen at eye level
• Comfortable sitting position
• No time pressure when practicing (add later)

3. Analyze Your Errors

• Where do most errors occur?
• During searching or switching?
• Work specifically on weaknesses

4. Practice Switching Separately

Count aloud: 1-A-2-B-3-C... without the visual test. This improves automation.

Frequently Asked Questions

Why is TMT-B So Much Harder Than TMT-A?

TMT-B requires cognitive switching between two rule systems. This "switch cost" adds up with each switch and makes the test significantly more demanding.

Does TMT Training Really Improve Daily Skills?

Yes! Studies show transfer effects to other tasks requiring cognitive flexibility. The trained visual search and sequential thinking are universally applicable.

How Often Should I Practice the TMT?

3-4 times per week for 5-10 minutes each is optimal. More training leads to faster improvement, but even daily short training shows effects.

Conclusion

The Trail Making Test is an effective exercise for:

• Faster visual processing - Find information more quickly
• Better cognitive flexibility - Switch between tasks more easily
• Higher processing speed - Think and act faster

Train the Trail Making Test in SynapseGym and improve these important cognitive abilities!

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Sources: Reitan (1958), Tombaugh (2004), Arbuthnott & Frank (2000)