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The Frontal
Assessment Battery (FAB) The Frontal Assessment Battery (FAB) is a concise neuropsychological tool designed to evaluate executive functioning, particularly those functions mediated by the frontal lobes of the brain. This quick and easy-to-administer test, typically taking about 10 minutes, has become an essential instrument in routine clinical use for assessing cognitive impairments associated with various neurological and psychiatric conditions.
The FAB consists of six subtests, each targeting specific aspects of frontal lobe function. These subtests provide valuable insights into a patient's conceptualization abilities, mental flexibility, motor programming, sensitivity to interference, inhibitory control, and environmental autonomy.
by Nandha kumaran Key Indications for FAB Administration 1 Neurological Conditions 2 Traumatic Brain Injury FAB is commonly used to evaluate frontal lobe impairment in The test is useful in assessing cognitive deficits following brain various neurological conditions, including dementia (particularly injuries, especially those affecting the frontal lobes. frontotemporal dementia), Parkinson's disease, and stroke.
FAB helps assess executive dysfunctions in conditions like It can be used to evaluate cognitive changes in elderly individuals, schizophrenia, bipolar disorder, and major depressive disorder with differentiating between normal aging and pathological cognitive cognitive impairments. decline. Similarities (Conceptualization) Procedure Normal Response Frontal Lobe Dysfunction
The examiner asks the patient to A typical response would be Patients may give concrete answers explain how two items (e.g., "a identifying a higher-order category, (e.g., "They are both round") or fail banana and an orange") are similar. such as "They are fruits." to find meaningful connections, This tests the patient's ability to indicating impaired conceptual identify higher-order categories. thinking. Lexical Fluency (Mental Flexibility) 1 Procedure The patient is asked to generate as many words as possible beginning with a specific letter (e.g., "S") within 60 seconds.
2 Normal Response A typical patient generates a reasonable number of words (typically more than 9).
3 Frontal Lobe Dysfunction
Patients may produce very few words, repeat words, or exhibit perseveration (repeating the same word or idea), indicating impaired mental flexibility. Motor Series (Programmed Activity) Demonstration The examiner demonstrates a sequence of hand movements (e.g., fist- palm-edge).
Imitation The patient is asked to imitate the sequence repeatedly.
Evaluation The examiner assesses the patient's ability to reproduce and maintain the sequence.
Patients with frontal lobe dysfunction often struggle to complete or maintain the sequence, showing motor perseveration or difficulty in planning movements. Conflicting Instructions (Inhibitory Control) Procedure The examiner asks the patient to tap the table once when the examiner taps twice and vice versa, inhibiting the automatic tendency to mimic the examiner's action.
Normal Response The patient correctly follows the conflicting instructions, demonstrating good inhibitory control.
Frontal Lobe Dysfunction
The patient tends to copy the examiner's taps automatically, showing impaired inhibition and difficulty following conflicting instructions. Go-No-Go (Inhibitory Control) 1 Instruction The patient is asked to tap once when the examiner taps once but refrain from tapping when the examiner taps twice.
2 Execution The examiner performs a series of single and double taps, observing the patient's responses.
3 Evaluation The examiner assesses the patient's ability to inhibit responses to double taps.
Patients with frontal lobe dysfunction often tap after two taps, failing to inhibit the response and indicating poor impulse control. Prehension Behavior (Environmental Dependency) Procedure Normal Response Frontal Lobe Dysfunction
The examiner places their hand in The patient resists the urge to grasp The patient involuntarily grasps the front of the patient and asks them the examiner's hand, demonstrating examiner's hand, indicating not to grasp it. The examiner then good volitional control. environmental dependency and loss slowly moves their hand toward the of volitional control. patient's hand. Scoring and Interpretation Score Interpretation
0 Severe impairment
1-2 Partial impairment
3 Normal performance
Each subtest is scored between 0 and 3, with a total possible score of 18. A total score below 12 suggests significant frontal lobe dysfunction, often seen in disorders such as Frontotemporal Dementia (FTD), Parkinson's Disease with Cognitive Impairment, Progressive Supranuclear Palsy, and Corticobasal Degeneration.
Patients with lower scores generally exhibit problems with mental flexibility, inhibitory control, and conceptual thinking, which are key functions of the frontal lobes. Clinical Significance and Applications
Assessment Results from the FAB can The FAB is widely used in As a brief 10-minute test, The FAB provides quick guide treatment strategies research studies exploring the FAB serves as an insights into executive and rehabilitation efforts for cognitive impairments in efficient screening tool in functions, aiding in the patients with frontal lobe various neurological and clinical settings where time diagnosis and monitoring dysfunction. psychiatric disorders. is limited. of various neurological conditions.
The Frontal Assessment Battery has become an invaluable tool in both clinical practice and research, offering a standardized approach to assessing frontal lobe functions across various patient populations.
(Routledge Handbooks in Philosophy) Christopher Erhard (Editor), Tobias Keiling (Editor) - The Routledge Handbook of Phenomenology of Agency-Routledge (2020)
(Routledge Handbooks in Philosophy) Christopher Erhard (Editor), Tobias Keiling (Editor) - The Routledge Handbook of Phenomenology of Agency-Routledge (2020)
