title: Clinico-Pathological Correlations of the Frontal Lobe Syndrome: Results of a Large Brain Bank Study.
abstract: OBJECTIVE
  A clinical frontal lobe syndrome (FLS) is generally attributed to functional or structural disturbances within frontal-subcortical circuits. We studied the distribution of pathological brain changes in FLS. Additionally, the prevalence of FLS among various disorders was studied.
  
  
  METHODS
  We systematically screened clinical files of donors to the Netherlands Brain Bank (n = 2,814) for FLS. A total of 262 FLS cases were identified, and the distribution of postmortem pathological changes within the frontal-subcortical circuits was extracted from their neuropathological reports.
  
  
  RESULTS
  In 244 out of 262 patients (93%), pathological changes within the frontal-subcortical circuits were found: 90 subjects (34%) with frontal cortical pathology and 18 (7%) with pathology restricted to subcortical grey matter nuclei, whereas 136 subjects (52%) showed both cortical and subcortical pathology. In 18 subjects (7%), no pathology was found in the examined areas. The prevalence of FLS was highest in frontal-temporal lobar degeneration, followed by progressive supranuclear palsy and vascular dementia [χ(2)(6, n = 1,561) = 222.64, p < 0.01].
  
  
  CONCLUSIONS
  In this large brain bank study, the distribution of pathological changes in subjects with FLS was shown to be frontal-subcortical for the first time. A minority of FLS cases had pathology in the subcortical regions only or no frontal pathology at all.
authors.affiliation: Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Welmoed A
authors.initials: WA
authors.lastname: Krudop
authors.forename: Sjanne
authors.initials: S
authors.lastname: Bosman
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: Geurts
authors.forename: Sietske A M
authors.initials: SA
authors.lastname: Sikkes
authors.forename: Nicolaas A
authors.initials: NA
authors.lastname: Verwey
authors.forename: Max L
authors.initials: ML
authors.lastname: Stek
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Annemieke J M
authors.initials: AJ
authors.lastname: Rozemuller
authors.forename: Yolande A L
authors.initials: YA
authors.lastname: Pijnenburg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology; D001344:Autopsy; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D057180:Frontotemporal Dementia / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D019636:Neurodegenerative Diseases / Q000473:pathology; D012189:Retrospective Studies; D014015:Tissue Banks