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Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients.

Kopp B, Rösser N, Tabeling S, Stürenburg HJ, de Haan B, Karnath HO, Wessel K - BMC Neurol (2013)

Bottom Line: Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score.Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9).These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cognitive Neurology, Technische Universität Braunschweig, Salzdahlumer Str, 90, Braunschweig 38126, Germany. k.wessel@klinikum-braunschweig.de.

ABSTRACT

Background: The Frontal Assessment Battery (FAB) is a brief battery of six neuropsychological tasks designed to assess frontal lobe function at bedside [Neurology 55:1621-1626, 2000]. The six FAB tasks explore cognitive and behavioral domains that are thought to be under the control of the frontal lobes, most notably conceptualization and abstract reasoning, lexical verbal fluency and mental flexibility, motor programming and executive control of action, self-regulation and resistance to interference, inhibitory control, and environmental autonomy.

Methods: We examined the sensitivity of performance on the FAB to frontal lobe damage in right-hemisphere-damaged first-ever stroke patients based on voxel-based lesion-behavior mapping.

Results: Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score. Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9). Finally, the FAB inhibitory control score was sensitive to damage of the right inferior frontal gyrus (IFG; BA44/45).

Conclusions: These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.

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Anatomical results obtained from the lesion subtraction analysis on the FAB global composite score. A. Overlay lesion plots for those patients who achieved a FAB global composite score below the median (Mdn = 16; N = 15). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 15). B. Overlay lesion plots for those patients who achieved a FAB global composite score equal to or above the median (Mdn = 16; N = 16). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 16). C. Overlay plots of the subtracted superimposed lesions of the patients who achieved a FAB global composite score below the median minus patients who achieved a FAB global composite score equal to or above the median. Colours code increasing frequencies from dark red (difference 1% to 20%) to white-yellow (difference 81% to 100%), indicating regions damaged more frequently in patients who achieved a FAB global composite score below the median. The colours from dark blue (difference -1 to -20%) to light green (difference -81 to -100%) indicate regions damaged more frequently in patients who achieved a FAB global composite score equal to or above the median.
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Figure 2: Anatomical results obtained from the lesion subtraction analysis on the FAB global composite score. A. Overlay lesion plots for those patients who achieved a FAB global composite score below the median (Mdn = 16; N = 15). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 15). B. Overlay lesion plots for those patients who achieved a FAB global composite score equal to or above the median (Mdn = 16; N = 16). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 16). C. Overlay plots of the subtracted superimposed lesions of the patients who achieved a FAB global composite score below the median minus patients who achieved a FAB global composite score equal to or above the median. Colours code increasing frequencies from dark red (difference 1% to 20%) to white-yellow (difference 81% to 100%), indicating regions damaged more frequently in patients who achieved a FAB global composite score below the median. The colours from dark blue (difference -1 to -20%) to light green (difference -81 to -100%) indicate regions damaged more frequently in patients who achieved a FAB global composite score equal to or above the median.

Mentions: Figure 2 displays the results of a lesion subtraction analysis for global composite score. Figure 2A shows the overlay lesion plot of those patients who achieved a FAB global composite score below the median (Mdn = 16). The overlay lesion plot of those patients who achieved a FAB global composite score equal to or above the median is presented in Figure 2B. Figure 2C displays the results of a lesion subtraction analysis (patients below the median vs. patients equal to or above the median). The right frontal lobe was more frequently damaged in the group of patients who achieved low FAB global composite scores.


Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients.

Kopp B, Rösser N, Tabeling S, Stürenburg HJ, de Haan B, Karnath HO, Wessel K - BMC Neurol (2013)

Anatomical results obtained from the lesion subtraction analysis on the FAB global composite score. A. Overlay lesion plots for those patients who achieved a FAB global composite score below the median (Mdn = 16; N = 15). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 15). B. Overlay lesion plots for those patients who achieved a FAB global composite score equal to or above the median (Mdn = 16; N = 16). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 16). C. Overlay plots of the subtracted superimposed lesions of the patients who achieved a FAB global composite score below the median minus patients who achieved a FAB global composite score equal to or above the median. Colours code increasing frequencies from dark red (difference 1% to 20%) to white-yellow (difference 81% to 100%), indicating regions damaged more frequently in patients who achieved a FAB global composite score below the median. The colours from dark blue (difference -1 to -20%) to light green (difference -81 to -100%) indicate regions damaged more frequently in patients who achieved a FAB global composite score equal to or above the median.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4225667&req=5

Figure 2: Anatomical results obtained from the lesion subtraction analysis on the FAB global composite score. A. Overlay lesion plots for those patients who achieved a FAB global composite score below the median (Mdn = 16; N = 15). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 15). B. Overlay lesion plots for those patients who achieved a FAB global composite score equal to or above the median (Mdn = 16; N = 16). The number of overlapping lesions is illustrated by colour, from violet (N = 1) to red (N = 16). C. Overlay plots of the subtracted superimposed lesions of the patients who achieved a FAB global composite score below the median minus patients who achieved a FAB global composite score equal to or above the median. Colours code increasing frequencies from dark red (difference 1% to 20%) to white-yellow (difference 81% to 100%), indicating regions damaged more frequently in patients who achieved a FAB global composite score below the median. The colours from dark blue (difference -1 to -20%) to light green (difference -81 to -100%) indicate regions damaged more frequently in patients who achieved a FAB global composite score equal to or above the median.
Mentions: Figure 2 displays the results of a lesion subtraction analysis for global composite score. Figure 2A shows the overlay lesion plot of those patients who achieved a FAB global composite score below the median (Mdn = 16). The overlay lesion plot of those patients who achieved a FAB global composite score equal to or above the median is presented in Figure 2B. Figure 2C displays the results of a lesion subtraction analysis (patients below the median vs. patients equal to or above the median). The right frontal lobe was more frequently damaged in the group of patients who achieved low FAB global composite scores.

Bottom Line: Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score.Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9).These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.

View Article: PubMed Central - HTML - PubMed

Affiliation: Cognitive Neurology, Technische Universität Braunschweig, Salzdahlumer Str, 90, Braunschweig 38126, Germany. k.wessel@klinikum-braunschweig.de.

ABSTRACT

Background: The Frontal Assessment Battery (FAB) is a brief battery of six neuropsychological tasks designed to assess frontal lobe function at bedside [Neurology 55:1621-1626, 2000]. The six FAB tasks explore cognitive and behavioral domains that are thought to be under the control of the frontal lobes, most notably conceptualization and abstract reasoning, lexical verbal fluency and mental flexibility, motor programming and executive control of action, self-regulation and resistance to interference, inhibitory control, and environmental autonomy.

Methods: We examined the sensitivity of performance on the FAB to frontal lobe damage in right-hemisphere-damaged first-ever stroke patients based on voxel-based lesion-behavior mapping.

Results: Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score. Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9). Finally, the FAB inhibitory control score was sensitive to damage of the right inferior frontal gyrus (IFG; BA44/45).

Conclusions: These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.

Show MeSH
Related in: MedlinePlus