Department of Pathology and Surgery, Miguel Hernandez University, San Juan de Alicante, Spain.
Department of Health Psychology, Miguel Hernandez University, San Juan de Alicante, Spain.
PLoS One. 2018 Nov 19;13(11):e0207698. doi: 10.1371/journal.pone.0207698. eCollection 2018.
Deficits in executive functions (EFs) are frequently detected in patients with Parkinson's disease (PD). The Frontal Assessment Battery (FAB) is a screening test for assessing EFs although it has not been so far adapted and validated in Spain. We evaluated the reliability and validity of the Spanish version of the FAB (FAB-E) in PD patients.
Our study included 54 healthy subjects and 67 PD patients. Cognitive assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE), Trail Making Test (TMT), Revised-Barcelona Test (RBT) and Executive Interview (EXIT-25). Internal consistency, intra- and test-retest reliabilities, concurrent and discriminant validity of the FAB-E were examined. To evaluate the influence of cognitive dysfunction in PD on the performance of the FAB-E, we also classified the PD patients into groups according to their cognitive status as measured by the MMSE using published criteria to identify cognitive deficits in PD.
The FAB-E showed good internal consistency (α = 0.751). The intraclass correlation coefficients (ranging from 0.559 to 0.891) and Spearman correlations (from 0.494 to 0.864) of the FAB-E subtests indicated a good-strong reliability. The total and subtest scores generally showed a good concurrent validity, except for the prehension behaviour item of the FAB-E and the Interference and Go/no-go tasks of the EXIT-25 that presented low estimates. Excluding the prehension behaviour subtest, the performance of the FAB-E was higher in the control group than in PD patients. Cognitive dysfunction in PD patients also indicated significant poorer FAB-E scores excepting the motor and prehension behaviour subtests. Discriminant analysis determined a cut-off of 14.5 was optimal to differentiate healthy subjects from PD patients. Moreover, a cut-off <12.5 allocated satisfactorily those PD patients with cognitive impairment (MMSE<26) and scores <11.5 classified suitably those PD patients with dementia (MMSE<24).
The FAB-E is an accurate tool for evaluating EFs in patients with PD and can provide useful information for distinguishing PD patients with and without cognitive dysfunction at a bedside assessment.
在帕金森病（PD）患者中经常检测到执行功能（EF）缺陷。尽管前额评估量表（FAB）尚未在西班牙进行适应性和验证，但它是一种用于评估 EF 的筛选测试。我们评估了 FAB 的西班牙版本（FAB-E）在 PD 患者中的可靠性和有效性。
我们的研究包括 54 名健康受试者和 67 名 PD 患者。使用 FAB-E、简易精神状态检查（MMSE）、连线测试（TMT）、修订版巴塞罗那测试（RBT）和执行访谈（EXIT-25）对参与者进行认知评估。检查了 FAB-E 的内部一致性、内部和重测信度、同时和判别有效性。为了评估认知功能障碍对 FAB-E 表现的影响，我们还根据 MMSE 的认知状态将 PD 患者分为几组，使用已发表的标准来识别 PD 中的认知缺陷。
FAB-E 显示出良好的内部一致性（α=0.751）。FAB-E 各分量表的组内相关系数（范围为 0.559 至 0.891）和 Spearman 相关系数（范围为 0.494 至 0.864）表明具有良好的可靠性。总分和分量表得分通常具有良好的同时有效性，但 FAB-E 的抓握行为项目和 EXIT-25 的干扰和 Go/no-go 任务除外，这些项目的估计值较低。排除抓握行为分量表后，对照组的 FAB-E 表现优于 PD 患者。PD 患者的认知功能障碍也表明 FAB-E 得分明显较差，除运动和抓握行为分量表外。判别分析确定 14.5 为最佳截断值，可区分健康受试者和 PD 患者。此外，<12.5 的截断值可满意地分配给认知障碍（MMSE<26）的 PD 患者，<11.5 的截断值可适当地分配给痴呆（MMSE<24）的 PD 患者。
FAB-E 是评估 PD 患者 EF 的准确工具，可在床边评估时提供有关区分有无认知功能障碍的 PD 患者的有用信息。
