Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients.
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.
Cognitive Neurology, Technische Universität Braunschweig, Salzdahlumer Str, 90, Braunschweig 38126, Germany. k.wessel@klinikum-braunschweig.de.
Bruno
B
Kopp
Nina
N
Rösser
Sandra
S
Tabeling
Hans Jörg
HJ
Stürenburg
Bianca
B
de Haan
Hans-Otto
HO
Karnath
Karl
K
Wessel
D000368:Aged; D001930:Brain Injuries / Q000209:etiology / Q000473:pathology*; D032882:Comprehension; D003210:Concept Formation; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications*; D014057:Tomography, X-Ray Computed