{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:32:13Z","timestamp":1793406733832,"version":"4.5.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Digital neuropsychological tests reliably capture real-time, process-based behavior that traditional paper\/pencil tests cannot detect, enabling earlier detection of neurodegenerative illness. We assessed relations between informant-based subtle and mild functional decline and process-based features extracted from the digital Trail Making Test-Part B (dTMT-B).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 321 community-dwelling participants (56.0% female) were assessed with the Functional Activities Questionnaire (FAQ) and the dTMT-B. Three FAQ groups were constructed: FAQ = 0 (unimpaired); FAQ = 1\u20134 (subtle impairment); FAQ = 5\u20138 (mild impairment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to the FAQ-unimpaired group, other groups required longer pauses inside target circles (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.050) and produced more total pen strokes to complete the test (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.016). FAQ-subtle participants required more time to complete the entire test (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.002) and drew individual lines connecting successive target circles slower (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) than FAQ-unimpaired participants. Lines connecting successive circle targets were less straight among FAQ-mild, compared to FAQ-unimpaired participants (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.044). Using stepwise nominal regression (reference group = FAQ-unimpaired), pauses inside target circles classified other participants into their respective groups (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.015, respectively). Factor analysis using six dTMT-B variables (oblique rotation) yielded a two-factor solution related to impaired motor\/cognitive operations (48.96% variance explained) and faster more efficient motor\/cognitive operations (28.88% variance explained).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Digital assessment technology elegantly quantifies occult, nuanced behavior not previously appreciated, operationally defines critical underlying neurocognitive constructs related to functional abilities, and yields selected process-based scores that outperform traditional paper\/pencil test scores for participant classification. When brought to scale, the dTMT-B test could be a sensitive tool to detect subtle-to-mild functional deficits in emergent neurodegenerative illnesses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2024.1354647","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T01:12:29Z","timestamp":1712106749000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Dysexecutive difficulty and subtle everyday functional disabilities: the digital Trail Making Test"],"prefix":"10.3389","volume":"15","author":[{"given":"David J.","family":"Libon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod","family":"Swenson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Tobyne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Jannati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Schulman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine 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