Galvin James E, Cohen Iris, Greenfield Keri K, Walker Marcia
Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
J Alzheimers Dis. 2021;83(2):721-739. doi: 10.3233/JAD-210446.
Approximately 90%of persons living with dementia experience behavioral symptoms, including frontal lobe features involving motivation, planning, social behavior, language, personality, mood, swallowing, and gait.
We conducted a two-stage study with a development sample (n = 586) and validation sample (n = 274) to evaluate a brief informant-rated measure of non-cognitive features of frontal lobe dysfunction: the Frontal Behavioral Battery (FBB).
In the development sample, internal consistency, principal factor analysis, and correlations between the FBB and outcomes were evaluated. In the validation sample, we examined (a) FBB scores by diagnosis, (b) known-group validity by demographics, subjective complaints, and dementia staging, and (c) correlation between FBB and MRI volumes. Receiver operator characteristic curves assessed the ability of the FBB to discriminate individuals with frontal lobe features due to a neurodegenerative disease.
The FBB characterized 11 distinct frontal lobe features. Individuals with dementia with Lewy bodies and frontotemporal degeneration had the greatest number of frontal lobe features. Premorbid personality traits of extroversion, agreeableness, and openness were associated with fewer frontal lobe behavioral symptoms, while subjective cognitive complaints were associated with greater symptoms. The FBB provided very good discrimination between individuals with and without cognitive impairment (diagnostic odds ratio: 13.1) and between individuals with and without prominent frontal lobe symptoms (diagnostic odds ratio: 84.8).
The FBB may serve as an effective and efficient method to assess the presence of non-cognitive symptoms associated with frontal lobe dysfunction, but in a brief fashion that could facilitate its use in clinical care and research.
约90%的痴呆症患者会出现行为症状，包括涉及动机、计划、社交行为、语言、人格、情绪、吞咽和步态的额叶特征。
我们进行了一项两阶段研究，使用一个开发样本（n = 586）和一个验证样本（n = 274）来评估一种简短的、由 informant 评定的额叶功能障碍非认知特征测量方法：额叶行为量表（FBB）。
在开发样本中，评估了FBB的内部一致性、主成分分析以及FBB与结果之间的相关性。在验证样本中，我们检查了：（a）按诊断分类的FBB分数；（b）通过人口统计学、主观症状和痴呆分期进行的已知组效度分析；（c）FBB与MRI体积之间的相关性。采用受试者工作特征曲线评估FBB区分因神经退行性疾病而具有额叶特征个体的能力。
FBB刻画了11种不同的额叶特征。路易体痴呆和额颞叶变性患者的额叶特征数量最多。病前外向、宜人和开放的人格特质与较少的额叶行为症状相关，而主观认知症状则与较多症状相关。FBB在有认知障碍和无认知障碍个体之间（诊断比值比：13.1）以及有突出额叶症状和无突出额叶症状个体之间（诊断比值比：84.8）提供了很好的区分。
FBB可作为一种有效且高效的方法来评估与额叶功能障碍相关的非认知症状的存在，而且方式简洁，便于在临床护理和研究中使用。
