Clinical utility of the 64-card version of the Wisconsin Card Sorting Test in patients with traumatic brain injury

Aims. To analyze the validity of the single deck 64-card Wisconsin Card Sorting Test (WCST-64) compared to the standard version (WCST-128), and to study the sensibility of both versions to identify changes over time in patients with traumatic brain injury (TBI). Patients and methods. The WCST was administered twice across a 6-month period to a sample of 50 patients with TBI. Pearson correlation coefficients were calculated to examine bivariate associations between WCST-128 scores and the corresponding WCST-64 scores at inclusion and at follow-up. Agreement in classification of impairment (z = -1) or normal performance was calculated for the two tests (kappa). Significant change over time was also analyzed for both versions of the test (paired-samples t test). Results. The results revealed positive and significant correlations between both measures as well as a significant agreement in the classification of patients as having deficits or not. Moreover the WCST-128 and the WCST-64 showed similar ability to identify changes over time. Conclusions. Our findings showed strong associations between scores derived from the two test and support the comparability of both versions when analyzing cross-sectional or longitudinal data. The findings support the use of the WCST-64 in evaluations of executive deficits of patients with moderate and severe TBI.