Examining Relationship Of Brain Injury, Anxiety And Workload On Trail Making Test Performances

Abstract Objective Both anxiety and traumatic brain injury (TBI) are both related to poorer Trail Making Test (TMT) performances. TBI survivors exhibit a greater incidence of anxiety in contrast to the general population. We evaluated the relationship between TBI and anxiety on TMT and perceived workload ratings. Method The sample consisted of 39 moderate-to-severe TBI [(21 with normal symptoms of anxiety (NSA) and 18 with abnormal symptoms of anxiety (ASA)] and 51 healthy comparison (HC; 26 NSA and 25 ASA) participants. Results ANCOVA’s, controlling for age, revealed the HC group outperformed the TBI group on TMT part A and TMT part B (TMT-B). An interaction emerged on TMT-B, with TBI-ASA participants outperformed TBI-NSA participants and HC-NSA participants outperformed their counterparts with ASA. Ratings of physical demand and frustration were reported higher in TBI participants compared to the HC participants. Moreover, TBI and anxiety symptoms had interactive effects on NASA-TLX temporal demand and frustration ratings, were TBI-ASA participants reported higher scores in contrast to TBI-NSA. Lastly, an interaction emerged with HC participants with ASA reporting better performances in contrast to HC-NSA. Conclusions As expected, TBI participants did worse on both TMT tasks. Next, we found that TBI-ASA participants impacted their TMT-B performance and their perceived workload (i.e., frustration, temporal demand) more than TBI-NSA participants. In the future, studies with a larger sample size should examine if anxiety influences TMT performance and perceived workload in person with mild TBI.