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Frontal assessment battery for detecting executive dysfunction in amyotrophic lateral sclerosis without dementia: a retrospective observational study.

Barulli MR, Fontana A, Panza F, Copetti M, Bruno S, Tursi M, Iurillo A, Tortelli R, Capozzo R, Simone IL, Logroscino G - BMJ Open (2015)

Bottom Line: Different levels of respiratory function, duration of disease and depressive symptoms did not affect the FAB validity.In patients with ALS without dementia, a high prevalence of executive dysfunction was present.The FAB showed good validity as a screening instrument to detect executive dysfunction in these patients and may be used when a complete neuropsychological assessment is not possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Research in Neurology, Neurodegenerative Disease Unit, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.

No MeSH data available.


Related in: MedlinePlus

ROC curve for the frontal assessment battery index to detect patients with executive dysfunction evaluated in the whole sample (AUC, Area Under the receiver operating characteristic Curve; ROC, receiver-operating characteristic).
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BMJOPEN2014007069F2: ROC curve for the frontal assessment battery index to detect patients with executive dysfunction evaluated in the whole sample (AUC, Area Under the receiver operating characteristic Curve; ROC, receiver-operating characteristic).

Mentions: Results of the RECPAM analysis are shown in figure 1. The algorithm identified four homogeneous subgroups of patients in terms of EI means (classes 1–4). Class 1 represented the patient subgroup with the lowest standardised mean EI (and thus with the highest executive cognitive impairment), whereas class 4 represented the patient subgroup with the highest standardised mean EI (and thus with the lowest executive cognitive impairment). Specifically, the algorithm found that patients with an education level ≤8, age >58 years and FVC ≤86.4 represented the class (class 1) with the lowest standardised mean EI (ie, −2.92±2.67, N=20 patients). Patients with an education level ≤8, age >58 years and FVC >86.4 represented the class (class 2) with a quite lower standardised mean EI (ie, −1.45±1.17, N=20 patients). Patients with an education level ≤8 and age ≤58 years represented the class (class 3) with a higher standardised mean EI (ie, −0.87±1.24, N=20 patients), and finally patients with an education level >8 represented the class (class 4) with the highest standardised mean EI (ie; −0.14±0.71, N=35 patients). Furthermore, using the EI standardised cut-off to identify patients with cognitive impairment (gold standard), the optimal cut-off for the FAB (total score) was detected both in the whole sample and within each identified RECPAM class. The receiver-operating characteristic (ROC) curve showed that the optimal cut-off for the FAB in the whole sample was 16 (figure 2). Such a cut-off achieved a high sensitivity of 0.889 (95% CI 0.545 to 1.000), a low specificity of 0.593 (95% CI 0.450 to 0.907), a positive predictive value (PPV) of 0.571 (95% CI 0.446 to 0.698) and a negative predictive value (NPV) of 0.897 (95% CI 0.794 to 0.977). The overall discriminatory power (AUC) for the FAB was 0.809. The optimal cut-off for the FAB in patients within each RECPAM class was also assessed. Results are reported in online supplementary figure S1 and in the appendix.


Frontal assessment battery for detecting executive dysfunction in amyotrophic lateral sclerosis without dementia: a retrospective observational study.

Barulli MR, Fontana A, Panza F, Copetti M, Bruno S, Tursi M, Iurillo A, Tortelli R, Capozzo R, Simone IL, Logroscino G - BMJ Open (2015)

ROC curve for the frontal assessment battery index to detect patients with executive dysfunction evaluated in the whole sample (AUC, Area Under the receiver operating characteristic Curve; ROC, receiver-operating characteristic).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563243&req=5

BMJOPEN2014007069F2: ROC curve for the frontal assessment battery index to detect patients with executive dysfunction evaluated in the whole sample (AUC, Area Under the receiver operating characteristic Curve; ROC, receiver-operating characteristic).
Mentions: Results of the RECPAM analysis are shown in figure 1. The algorithm identified four homogeneous subgroups of patients in terms of EI means (classes 1–4). Class 1 represented the patient subgroup with the lowest standardised mean EI (and thus with the highest executive cognitive impairment), whereas class 4 represented the patient subgroup with the highest standardised mean EI (and thus with the lowest executive cognitive impairment). Specifically, the algorithm found that patients with an education level ≤8, age >58 years and FVC ≤86.4 represented the class (class 1) with the lowest standardised mean EI (ie, −2.92±2.67, N=20 patients). Patients with an education level ≤8, age >58 years and FVC >86.4 represented the class (class 2) with a quite lower standardised mean EI (ie, −1.45±1.17, N=20 patients). Patients with an education level ≤8 and age ≤58 years represented the class (class 3) with a higher standardised mean EI (ie, −0.87±1.24, N=20 patients), and finally patients with an education level >8 represented the class (class 4) with the highest standardised mean EI (ie; −0.14±0.71, N=35 patients). Furthermore, using the EI standardised cut-off to identify patients with cognitive impairment (gold standard), the optimal cut-off for the FAB (total score) was detected both in the whole sample and within each identified RECPAM class. The receiver-operating characteristic (ROC) curve showed that the optimal cut-off for the FAB in the whole sample was 16 (figure 2). Such a cut-off achieved a high sensitivity of 0.889 (95% CI 0.545 to 1.000), a low specificity of 0.593 (95% CI 0.450 to 0.907), a positive predictive value (PPV) of 0.571 (95% CI 0.446 to 0.698) and a negative predictive value (NPV) of 0.897 (95% CI 0.794 to 0.977). The overall discriminatory power (AUC) for the FAB was 0.809. The optimal cut-off for the FAB in patients within each RECPAM class was also assessed. Results are reported in online supplementary figure S1 and in the appendix.

Bottom Line: Different levels of respiratory function, duration of disease and depressive symptoms did not affect the FAB validity.In patients with ALS without dementia, a high prevalence of executive dysfunction was present.The FAB showed good validity as a screening instrument to detect executive dysfunction in these patients and may be used when a complete neuropsychological assessment is not possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Research in Neurology, Neurodegenerative Disease Unit, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.

No MeSH data available.


Related in: MedlinePlus