The FAB - A frontal assessment battery at bedside

Objective: To devise a short bedside cognitive and behavioral battery to as sess frontal lobe functions. Methods: The designed battery consists of six subtests exploring the following: conceptualization, mental flexibility, mo tor programming, sensitivity to interference, inhibitory control, and envir onmental autonomy. It takes approximately 10 minutes to administer. The aut hors studied 42 normal subjects and 121 patients with various degrees of fr ontal lobe dysfunction (PD, n = 24; multiple system atrophy, n = 6; cortico basal degeneration, n = 21; progressive supranuclear palsy, n = 47; frontot emporal dementia, n = 25). Results: The Frontal Assessment Battery scores c orrelated with the Mattis Dementia Rating Scale scores (rho = 0.82, p < 0.0 1) and with the number of criteria (rho = 0.77, p < 0.01) and perseverative errors (rho = 0.68, p < 0.01) of the Wisconsin Card Sorting Test. These va riables accounted for 79% of the variance in a stepwise multiple regression , whereas age or Mini-Mental State Examination scores had no significant in fluence. There was good interrater reliability (<kappa> = 0.87, p < 0.001), internal consistency (Cronbach's coefficient alpha 0.78), and discriminant validity (89.1% of eases correctly identified in a discriminant analysis o f patients and controls). Conclusion: The Frontal Assessment Battery is eas y to administer at bedside and is sensitive to frontal lobe dysfunction.