The frontal assessment battery is not useful to discriminate progressive supranuclear palsy from frontotemporal dementias.
BACKGROUND
The frontal assessment battery (FAB) has been suggested as a useful tool in the differential diagnosis of progressive supranuclear palsy (PSP) from Parkinson's disease (PD) and multiple system atrophy with parkinsonism (MSA-P). However, the utility of the FAB in the differential diagnosis of PSP from frontotemporal dementia (FTD) phenotypes is still under research.


METHODS
We performed the FAB, in a multi-centre cohort of 70 PSP, 103 FTD (N = 84 behavioral variant FTD, N = 10 semantic dementia, N = 9 progressive non-fluent aphasia), 26 PD and 11 MSA-P patients, diagnosed according to established criteria. Patients were also rated with the mini mental state examination and motor scales.


RESULTS
The FAB total score showed a poor discriminatory power between PSP and FTD as a group [area under the curve (AUC) = 0.523]. Moreover, the FAB score showed no correlation with disease duration in PSP (r = 0.05) or FTD group (r = 0.04). In contrast, we confirmed that the FAB is clinically useful to differentiate PSP from PD and MSA-P (AUC = 0.927). In fact, the sum of two FAB subscores together (verbal fluency and Luria motor series) were as good as the total score in differentiating PSP from PD and MSA-P (AUC = 0.957).


CONCLUSIONS
The FAB may not be a useful tool to differentiate PSP from FTDs, and shows no correlation with disease duration in these disorders. On the other hand, the essential information to differentiate PSP from PD and MSA-P is contained in the sum of only two FAB subscores. This should be taken into consideration in both clinical practice and the planning of clinical trials.
Department of Neurology, Philipps Universität, Marburg, Germany; Second Department of Neurology, Attikon University Hospital, University of Athens, Greece; Movement Disorders Department, Hygeia Hospital, Athens, Greece. Electronic address: mariastamelou@gmail.com.
M
M
Stamelou
Department of Psychiatry, Technische Universität München, Munich, Germany.
J
J
Diehl-Schmid
Department of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany.
A
A
Hapfelmeier
Second Department of Neurology, Attikon University Hospital, University of Athens, Greece.
D
D
Kontaxopoulou
Second Department of Neurology, Attikon University Hospital, University of Athens, Greece.
L
L
Stefanis
Department of Neurology, Philipps Universität, Marburg, Germany.
W H
WH
Oertel
Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom.
K P
KP
Bhatia
Second Department of Neurology, Attikon University Hospital, University of Athens, Greece; First Department of Neurology, Eginition University General Hospital, University of Athens, Greece.
S G
SG
Papageorgiou
Department of Neurology, Philipps Universität, Marburg, Germany; Department of Neurology, Technische Universität München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), München, Germany.
G U
GU
Höglinger
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D057180:Frontotemporal Dementia / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis*
Frontal assessment battery; Frontotemporal dementia; Multiple system atrophy; Parkinson's disease; Progressive supranuclear palsy