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Clinical Rehabilitation, Vol. 14, No. 3, 272-278 (2000)
DOI: 10.1191/026921500676524726

The Frontal Lobe Score: part II: evaluation of its clinical validity

Dirk Wildgruber

Department of Neurology, University of Tübingen, Germany

Udo Kischka

Rivermead Rehabilitation Centre, Oxford, UK

Klaus Faßbender

Department of Neurology, Mannheim Medical School, University of Heidelberg, Germany

Thierry M Ettlin

Rheinfelden Rehabilitation Center, Switzerland

Objective: To evaluate the ability of the Frontal Lobe Score (FLS) to differentiate patients with frontal lobe lesions from those with nonfrontal lesions and normal controls.

Design: In a prospective, blind setup, the sensitivity and specificity of the Frontal Lobe Score was compared with the Wisconsin Card Sorting Test (WCST) and the Stroop Test.

Patients: A sample of 108 subjects (26 patients with cerebral lesions confined to the frontal lobes, 28 patients with cerebral lesions without involvement of the frontal lobes, 31 patients with mixed frontal/nonfrontal lesions, 23 controls without cerebral lesions) was examined.

Measures: Frontal Lobe Score, Wisconsin Card Sorting Test, Stroop Test.

Results: The Frontal Lobe Score detected pure frontal lesions with a sensitivity of 92.3%. It discriminated patients with frontal lesions from normal controls with a specificity of 100%; differentiation from patients with nonfrontal lesions was obtained with a specificity of 75.0%. For the WCST, sensitivity for detection of pure frontal lesions was 65.4%, while specificity was 60.9% compared with normal controls and 53.6% compared with nonfrontal lesions. The Stroop Test showed a sensitivity of 30.8%, a specificity compared with normal controls of 95.7% and compared with nonfrontal lesions of 92.9%.

Conclusion: The Frontal Lobe Score has clinical usefulness for screening of effects of frontal lobe damage superior to that of the WCST and the Stroop Test.


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