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.
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