Stamelou M, Diehl-Schmid J, Hapfelmeier A, Kontaxopoulou D, Stefanis L, Oertel W H, Bhatia K P, Papageorgiou S G, Höglinger G U
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.
Department of Psychiatry, Technische Universität München, Munich, Germany.
Parkinsonism Relat Disord. 2015 Oct;21(10):1264-8. doi: 10.1016/j.parkreldis.2015.08.006. Epub 2015 Aug 11.
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.
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.
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).
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.
额叶评估量表（FAB）被认为是用于鉴别进行性核上性麻痹（PSP）与帕金森病（PD）及帕金森综合征型多系统萎缩（MSA-P）的有用工具。然而，FAB在鉴别PSP与额颞叶痴呆（FTD）各表型中的作用仍在研究中。
我们在一个多中心队列中对70例PSP、103例FTD（84例行为变异型FTD、10例语义性痴呆、9例进行性非流利性失语）、26例PD和11例MSA-P患者进行了FAB评估，这些患者均根据既定标准诊断。患者还接受了简易精神状态检查和运动量表评分。
作为一个整体，PSP和FTD组之间FAB总分的鉴别力较差[曲线下面积（AUC）=0.523]。此外，FAB评分在PSP组（r=0.05）或FTD组（r=0.04）中与病程均无相关性。相比之下，我们证实FAB在临床上有助于鉴别PSP与PD及MSA-P（AUC=0.927）。实际上，FAB两个子评分（语言流畅性和鲁利亚运动序列）之和在鉴别PSP与PD及MSA-P方面与总分效果相当（AUC=0.957）。
FAB可能不是鉴别PSP与FTD的有用工具，且在这些疾病中与病程无相关性。另一方面，鉴别PSP与PD及MSA-P的关键信息仅包含在FAB的两个子评分之和中。这在临床实践和临床试验规划中均应予以考虑。
