To develop and validate a mobile version of the Trail Making Test(mTMT) that enables rapid, self-administered assessment of executive function, quantifies information processing speed, allows frequent remote testing without clinical supervision, demonstrates sensitivity to performance differences (particularly reaction times) between Parts A and B, and correlates with traditional TMT measures.The goal is to enhance accessibility and frequency of cognitive assessments, potentially improving patient monitoring and clinical decision-making worldwide.

Executive function assessments are essential for monitoring cognition but currently face significant challenges.Traditional Trail Making Test administration requires in-person appointments with neuropsychologists and is often time-consuming. Logistical barriers, limited availability of trained professionals, and restricted access to specialized testing environments (e.g., difficulty scheduling clinic appointments) create further obstacles. Infrequent assessments hinder the ability to track cognitive changes over time and may delay detection of cognitive decline. These limitations highlight the need for an innovative approach to executive function testing that is accessible, feasible, efficient, and allows frequent monitoring of cognitive health.

We used Qualtrics platform and enrolled 53 healthy participants. The TMT is consisted of two parts:Part A(20) and Part B(24) multiple-choice questions (five options each) with randomized choices, distributed via QR codes.Mean reaction times, standard deviations, and variances were analyzed using paired t-tests.

Full dataset:Part A(Mean=2.92, SD=1.35, Variance=1.83); Part B(Mean=2.66, SD=1.09, Variance=1.18); t=1.36, p=0.18. Excluding the first eight questions:Part A(Mean=2.16, SD=0.94, Variance=0.89); Part B(Mean=2.82, SD=1.40, Variance=1.96); t=–3.42, p=0.001.A statistically significant difference in reaction times between Parts A and B was observed after exclusion.

Our findings demonstrate the feasibility of self-administered remote testing, sensitivity to set-switching effects between Parts A and B, and the importance of accounting for practice effects.The mobile version shows promise as a practical tool for frequent, accessible cognitive assessments, enabling earlier detection of cognitive changes and timely intervention.There is a need to test mTMT with patient population.