The Frontal Lobe Score: part II: evaluation of its clinical validity

Objective: To evaluate the ability of the Frontal Lobe Score (FLS) to diffe rentiate patients with frontal lobe lesions from those with nonfrontal lesi ons and normal controls. D esign: In a prospective, blind setup, the sensitivity and specificity of th e Frontal Lobe Score was compared with the Wisconsin Card Sorting Test (WCS T) and the Stroop Test. Patients: A sample of 108 subjects (26 patients with cerebral lesions confi ned to the frontal lobes, 28 patients with cerebral lesions without involve ment of the frontal lobes, 31 patients with mixed frontal/nonfrontal lesion s, 23 controls without cerebral lesions) was examined. Measures: Frontal Lobe Score, Wisconsin Card Sorting Test, Stroop Test. Results: The Frontal Lobe Score detected pure frontal lesions with a sensit ivity of 92.3%. It discriminated patients with frontal lesions from normal controls with a specificity of 100%; differentiation from patients with non frontal lesions was obtained with a specificity of 75.0%. For the WCST, sen sitivity for detection of pure frontal lesions was 65.4%, while specificity was 60.9% compared with normal controls and 53.6% compared with nonfrontal lesions. The Stroop Test showed a sensitivity of 30.8%, a specificity comp ared with normal controls of 95.7% and compared with nonfrontal lesions of 92.9%. Conclusion: The Frontal Lobe Score has clinical usefulness for screening of effects of frontal lobe damage superior to that of the WCST and the Stroop Test.