Ann Rehabil Med.  2020 Aug;44(4):261-272. 10.5535/arm.19111.

Value of the Frontal Assessment Battery Tool for Assessing the Frontal Lobe Function in Stroke Patients

• Han M
• Kim DY
• Leigh JH
• Kim MW

• KMID: 2505386
• DOI: http://doi.org/10.5535/arm.19111

Abstract

Objective
To examine the correlation between the Frontal Assessment Battery (FAB) test, which is used to assess the frontal lobe function, and anatomical lesions as well as the ability of the test to detect frontal lobe dysfunction.
Methods
Records of stroke patients undergoing a FAB test and Mini-Mental State Examination (MMSE) were retrospectively reviewed. The patients were divided into three groups according to the lesions determined by an imaging study: frontal lobe cortex lesions, frontal subcortical circuit lesions, and other lesions. The FAB scores of the three groups were compared using the Kruskal-Wallis test. The validity of the FAB test to detect frontal lobe dysfunction was assessed by a comparison with the Computerized Neuropsychological Function Test (CNT) using the Spearman correlation coefficient. The correlation coefficients between the FAB test and MMSE were analyzed further based on the MMSE cutoff score.
Results
Patients with frontal cortex lesions had significantly lower total and subtest scores according to the FAB test than the other patients. The FAB test correlated better with the CNT than the MMSE, particularly in the executive function and memory domains. A high MMSE score (r=0.435) indicated a lower correlation with the FAB test score than a low MMSE score (r=0.714).
Conclusion
The FAB test could differentiate frontal lobe lesions from others in stroke patients and showed a good correlation with the CNT. Moreover, the FAB test can be used in patients with high MMSE scores to detect frontal lobe dysfunction and determine the treatment strategies for stroke patients.

Keyword

Stroke; Executive function; Neuropsychological tests; Mental status and dementia tests

Figure

• 

  Fig. 1. Frontal Assessment Battery (FAB) and Mini-Mental State Examination (MMSE) scores of patients according to brain lesions. (A) The mean FAB scores were significantly different in the FL group (7.3±5.0), SC group (9.5±5.3), and OL group (10.5±4.8). (B) The mean MMSE scores were significantly different in the FL group (16.94±9.04), SC group (20.68±8.38), and OL group (23.36±6.67). FL group, with lesions involving the frontal lobe cortex; SC group, with lesions related to the frontal subcortical circuit without frontal cortex involvement; OL group, with other lesions that were unrelated to the frontal subcortical circuit. *p<0.05 indicate a significant difference among three groups.

• 

  Fig. 2. Scatterplots for the Frontal Assessment Battery (FAB) and Mini-Mental State Examination (MMSE) scores of patients according to brain lesions. Scatterplots showed a positive correlation between the FAB and MMSE tests when divided among the three lesion groups (FL group: r=0.839, p<0.001; SC group: r=0.864, p<0.001; OL group: r=0.765, p<0.001). When the MMSE scores were divided according to the cutoff value that (MMSE=24), a high MMSE score (r=0.488, p<0.001) had a lower correlation with the FAB score than did a low MMSE score (r=0.704, p<0.001). FL group, with lesions involving the frontal lobe cortex; SC group, with lesions related to the frontal subcortical circuit without frontal cortex involvement; OL group, with other lesions that were unrelated to the frontal subcortical circuit.

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