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Frontal Behavioral Inventory: Diagnostic Criteria for Frontal Lobe Dementi

Published online by Cambridge University Press:  18 September 2015

Andrew Kertesz ,
Wilda Davidson  and
Hannah Fox
Andrew Kertesz*
Affiliation:
Department of Clinical Neurological Sciences, St. Joseph's Health Centre, University of Western Ontario, London.
Wilda Davidson
Affiliation:
Department of Clinical Neurological Sciences, St. Joseph's Health Centre, University of Western Ontario, London.
Hannah Fox
Affiliation:
Department of Clinical Neurological Sciences, St. Joseph's Health Centre, University of Western Ontario, London.
*
Division of Neurology, St. Joseph's Health Centre, 268 Grosvenor Street, London, Ontario, Canada N6A 4V2
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Abstract:

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Objective:

To utilize the diagnostic criteria of frontal lobe dementia (FLD).

Methods:

We studied 12 patients with FLD diagnosed clinically, with radiological confirmation in 10 and autopsy confirmation in 2; sixteen patients with Alzheimer's disease matched for stage and severity to FLD and 11 patients with depressive dementia were used as control groups. A 24-item Frontal Behavioral Inventory (FBI) using the most relevant behavioral manifestations of FLD was administered in these populations.

Results:

FLD patient scores on the FBI were much higher compared with control groups (AD and DD). Item analysis showed loss of insight, indifference, distractibility, personal neglect and apathy as the most frequent negative symptoms. Perseveration, disinhibition, inappropriateness, impulsivity, and irresponsibility were the most significant positive symptoms. An operational definition of FLD included a minimum FBI score of 27. Only one false positive was shown in the depressive group and none among the AD group, indicating little overlap between patient groups, and a high discriminating value of the FBI.

Conclusions:

The FBI appears to be a useful diagnostic instrument and a method to operate the behavioral criteria of FLD. Further prospective studies are warranted to establish validity.

Résumé:

RÉSUMÉ:Objectif:

De rendre opérationnels les critères diagnostiques de la démence frontale (DF).

Méthodes:

Nous avons étudié 12 patients atteints de DF diagnostiquée cliniquement, avec confirmation radiologique du diagnostic chez 10 et autopsique chez 2; 16 patients atteints de la maladie d'Alzheimer (MA) appariés pour le stade et la sévérité de la DF et 11 patients atteints d'une démence dépressive (DD) ont servi de contrôles. Une grille d'évaluation du comportement frontal (ÉCF) comportant 24 items ciblant les manifestations du comportement les plus pertinentes a la DF à été administrée à ces patients.

Résultats:

Les scores des patients atteints de DF à l'ÉCF étaient beaucoup plus élevés comparés à ceux des groupes contrôles (MA et DD). L'analyse par item a monté' une perte de la capacité d'introspection, de l'indifférence, de la distractivité, de la négligence de leur personne et de l'apathie comme symptômes négatifs les plus fréquents. La persévération, la désinhibition, l'inopportunité, l'impulsivité et l'irresponsabilité étaient les symptômes positifs les plus significatifs. Une définition opérationelle de la DF incluait un score minimun de 27 à l'ÉCF. On a constaté un seul faux positif dans le groupe DD et aucun dans le groupe MA, ce qui indique qu'il y a peu de chevauchement entre les groupes de patients et que la valeur discriminante de l'ÉCF est élévee.

Conclusions:

L'ÉCF semble être un outil diagnostique utile et une méthode pour rendre opérationnels les critères comportementaux de la DF. Des études prospectives sont justifiées pour en établir la validité.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 24 , Issue 1 , February 1997 , pp. 29 - 36
Copyright
Copyright © Canadian Neurological Sciences Federation 1997

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