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Clinical Rehabilitation
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The Frontal Lobe Score: part I: construction of a mental status of frontal systems

Thierry M Ettlin

Rheinfelden Rehabilitation Centre, Switzerland

Udo Kischka

Rivermead Rehabilitation Centre, Oxford, UK

Michael Beckson

Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute, Los Angeles, USA

Manuela Gaggiotti

Department of Neurology, University of Basel, Switzerland

Udo Rauchfleisch

Department of Psychiatry, University of Basel, Switzerland

D Frank Benson

Department of Neurology, UCLA, Los Angeles, USA

Objective: To develop a bedside mental status examination to assess the behavioural effects of damage to the frontal lobes.

Design: A prospective clinical comparison of patients with cerebral lesions of different locations.

Subjects: A total of 118 subjects were examined: 27 patients with cerebral lesions confined to the frontal lobes, 25 patients with cerebral lesions without involvement of the frontal lobes, 18 patients with mixed frontal/nonfrontal lesions, and 48 normal control subjects.

Measures: Twenty-three mental status tests, clinical examinations and rating scales that had been reported as indicative of frontal lobe function were brought together. By statistical analysis, 12 tests and a neurobehavioural rating scale were selected. These constitute the Frontal Lobe Score (FLS).

Results: The FLS detected pure frontal lesions with a sensitivity of 77.7%. It discriminated patients with frontal lesions from normal control subjects with a specificity of 100%. Differentiation from patients with nonfrontal lesions was obtained with a specificity of 84%.

Conclusion: The Frontal Lobe Score is a useful screening instrument for the clinical detection of effects of frontal lobe damage.

Clinical Rehabilitation, Vol. 14, No. 3, 260-271 (2000)
DOI: 10.1191/026921500669635136
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