Abstract
BackgroundDeficits 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.Materials and methodsOur 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.ResultsThe 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).ConclusionThe 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.
Highlights
Parkinson’s disease (PD) is a progressive, disabling, neurodegenerative disorder which is traditionally considered as a motor system disorder characterized by shaking, rigidity, bradykinesia and postural instability
The Frontal Assessment Battery (FAB)-E is an accurate tool for evaluating executive functions (EFs) in patients with PD and can provide useful information for distinguishing PD patients with and without cognitive dysfunction at a bedside assessment
In line with previous studies examining the accuracy of the FAB as a valid tool for the assessment of executive functioning in PD patients[10,11,12,13,14,15,16], our results support the good performance of the Spanish version of the FAB provided by an extensive set of adequate measures of the psychometric capacity of the test
Summary
Parkinson’s disease (PD) is a progressive, disabling, neurodegenerative disorder which is traditionally considered as a motor system disorder characterized by shaking, rigidity, bradykinesia and postural instability. PD does not necessarily imply dementia and patients can maintain their abilities to normally perform their daily activities, in the early stages of the disease, due to frontal lobe and basal ganglia circuitry dysfunctions, cognitive deficits can be observed in patients, predominantly affecting visual-spatial functions, memory and executive functions (EFs)[2]. They often present difficulties for tasks that require planning, problem-solving, cognitive flexibility, generating strategies, sequencing and abstract verbal reasoning that lead to a negative impact on daily activities [2,3]. We evaluated the reliability and validity of the Spanish version of the FAB (FAB-E) in PD patients
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