Test-retest reliability of eye tracking measures in a Trail Test

The Trail Making Test (TMT) is a frequently applied neuropsychological test that evaluates participants' executive functions based on their time to connect a sequence of numbers (TMT-A) or alternating numbers and letters (TMT-B). Test performance is associated with various cognitive functions ranging from visuomotor speed to working memory capabilities. However, although the test can screen for impaired executive functioning in a variety of neuropsychiatric disorders, it provides only little information about which specific cognitive impairments underlie performance detriments. To resolve this lack of specificity, recent cognitive research combined the TMT with eye tracking so that eye movements could help uncover reasons for performance impairments. However, using eye-tracking-based test scores to examine differences between persons, and ultimately apply the scores for diagnostics, presupposes that the reliability of the scores is established. Therefore, we investigated the test-retest reliabilities of scores in an eye-tracking version of the TMT recently introduced by Recker et al. (2022). We examined two healthy samples performing an initial test and then a retest 3 days (n = 31) or 10 to 30 days (n = 34) later. Results reveal that, although reliabilities of classic completion times were overall good, comparable with earlier versions, reliabilities of eye-tracking-based scores ranged from excellent (e.g., durations of fixations) to poor (e.g., number of fixations guiding manual responses). These findings indicate that some eye-tracking measures offer a strong basis for assessing interindividual differences beyond classic behavioral measures when examining processes related to information accumulation processes but are less suitable to diagnose differences in eye-hand coordination.