Frontotemporal Assessment
(Added post DOMS 2007)
Frontal Executive Function
These instruments assess frontal lobe function and identify a dysexecutive syndrome. Such an assessment is helpful in the diagnosis and prognosis of brain diseases such as frontotemporal dementias and for the evaluation of the severity of brain injuries. It can also help to identify deficits in vascular dementias and parkinsonian disorders, particularly progressive supranuclear palsy (PSP), in which the presence of frontal lobe dysfunction supports the diagnosis. It may also be useful for differentiating between degenerative disorders involving subcortical structures for evaluating the progression of these disorders over time. (Dubois, B., Slachervsky, A., Litvan, Il, and Pillon, B. (2000), The FAB: A frontal assessment battery at bedside, Neurology, 55, p1621)
- Frontal Assessment Battery (FAB)
Purpose: Provides an objective measure to distinguish FTD from AD in mildly demented people. A bedside battery to assess the presence and severity of a dysexecutive syndrome affecting both cognition and motor behaviour.
Admin Time: <10 min
User Friendly: High
Administered by: Clinician structured interview with person being assessed.
Most appropriate: Clinician at bedside. Poor performance on the FAB in conjunction with the presence of behavioural abnormalities could be an important factor in the diagnosis of FTD
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- EXIT 25
Purpose: Assesses executive cognitive function at bedside.
Admin Time: Approx 15 min
User Friendly: Medium
Administered by: Administered and scored by any clinician.
Most appropriate: Higher EXIT 25 scores indicate greaterexecutive dyscontrol. EXIT25 scores have been specifically associated with left frontal system structural lesions by magnetic resonance imaging and with left mesiofrontal cerebral blood flow by single photon emission computed tomography (spect).
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- ACE-R Cognitive Functions
Purpose: A brief cognitive test that assesses five cognitive domains, namely attention/orientation, memory, verbal fluency, language, and visoospatial abilities.
Admin Time: 15 min
User Friendly: High
Administered by: Interviewer with the person being assessed.
Most appropriate: A brief test sensitive to the early stages of dementia and capable of differentiating subtypes of dementia including Alzhheimer’s disease, Frontotemporal dementia, progressive supranulear palsy and other parkinsonian syndromes.
Scoring using the subscales: V= verbal fluency, L = Language, O=Orientation, M= Recall Memory, Ratio (V+L)/(O+M), VLOM Ratio >3.2 differentiates AD from non-AD and a ratio of <2.2 differentiates FTD from non-FTD
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Frontal Neuropsychiatric (behaviour)
The frontal assessments in this category assesses behaviour related to frontal lobe dysfunction. At autopsy, frontotemporal dementias (FTD), FTDs are under recognised in memory clinics, FTDs are confused with Alzheimer’s disease (AD) or vascular dementia (VaD). These misdiagnoses may affect the results of AD pharmacological trials. The first manifestations of FTD are often behavioural abnormalities.
(Lebret, F., Pasquier, F., Souliez, and Petit, H., (1998) Frontotemporal Behavioral Scale, Alzheimer Disease and Associated Disorder, 12:4, p335)
Go Frontal Assessments, Frontal Neuropsychiatric (behaviour)
- Frontal Behavioural Inventory (FBI)
Purpose: Measures major positive and negative behaviours and personality change. Personality and behavioural changes are important and defining features of frontal degeneration . The diagnosis usually depends on the progressive development of various behavioural symptoms rather than a set of neuropsychological measures.(Kertesz, A. et al (2000) p. 460)
The FBI is useful not only to differentiate the behavioural variant of FTD, but also to diagnose and quantify the behavioural abnormality in aphasic presentations of FTD. The FBI could also potentially be useful to diagnose and quantify behavioural abnormalities in other frontal lobe syndromes such as head injuries. (Marczinki, C. A et al (2004)
Admin Time: 15-30 min
User Friendly: High
Administered by: Skilled interviewer with primary caregiver.
Most appropriate: On the FBI, the cutoff of 30 distinguishes FTD from other degenerative dementias.
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- Frontotemporal Behaviour Scale (FBS)
Purpose: Measures behavioural changes related to frontal lobe dysfunction, distinguishing between people with frontal lobe dysfunction and early cutoff to diagnose frontotemoral dementia (FTD) from those with Alzheimer’s disease (AD). Highly sensitive with high diagnostic accuracy.
Admin Time: 20 min to admin & 5 min to score
User Friendly:
Administered by: Experienced interviewer with principal caregiver (at least daily contact with person assessed). Caregiver asked whether behaviour has changed since the onset of symptoms.
Most appropriate: For assessing the following: Self-monitoring dyscontrol, self-neglect, self-centred behaviour, and affective disorders. Cut-off scores for distinguishing FTD from probable AD is 3.
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