Components of frontal assessment battery and clinical features in patients with stroke
DOI:
https://doi.org/10.2340/jrm.v57.43270Keywords:
frontal assessment battery, executive function, principal component analysis, cluster analysis, clinical featureAbstract
Objective: First, to investigate whether the 6 aspects of executive functions assessed by the Frontal Assessment Battery have different components and, if so, to extract those components using principal component analysis. Second, to identify patient groups based on their characteristics using cluster analysis.
Design: A cross-sectional study.
Subjects: Seventy-eight patients with stroke.
Methods: The Frontal Assessment Battery, Mini-Mental State Examination, Trail Making Test, and Stroop Color Word Test were performed within 5 days.
Results: Based on principal component analysis, the Frontal Assessment Battery was classified into cognitive control (subscales 1–3, 5) and behavioural control (subscales 4 and 6). Two clusters that reflect these components (cluster 1, n = 68; cluster 2, n = 10) were identified. The between-group comparison showed that compared with cluster 1, cluster 2 had lower scores on Frontal Assessment Battery subscales 4 and 6, the Frontal Assessment Battery total scores, and other executive functions scores. The Mini-Mental State Examination scores had no significant differences.
Conclusions: The Frontal Assessment Battery can be classified into 2 components, and the impairment of Frontal Assessment Battery subscales 4 and 6 identified a specific group of patients with stroke with severe executive dysfunction.
Downloads
References
Skidmore ER, Eskes G, Brodtmann A. Executive function poststroke: concepts, recovery, and interventions. Stroke 2003; 54: 20–29. DOI: https://doi.org/10.1161/STROKEAHA.122.037946
https://doi.org/10.1161/STROKEAHA.122.037946 DOI: https://doi.org/10.1161/STROKEAHA.122.037946
Lipskaya-Velikovsky L, Zeilig G, Weingarden H, Rozental-Iluz C, Rand D. Executive functioning and daily living of individuals with chronic stroke: measurement and implications. Int J Rehabil Res 2018; 41: 122–127. DOI: https://doi.org/10.1097/MRR.0000000000000272
https://doi.org/10.1097/MRR.0000000000000272 DOI: https://doi.org/10.1097/MRR.0000000000000272
Raimo S, Maggi G, Ilardi CR, Cavallo ND, Torchia V, Pilgrom MA, et al. The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis. Neurol Sci 2024; 45: 2427–2443. DOI: https://doi.org/10.1007/s10072-024-07366-2
https://doi.org/10.1007/s10072-024-07366-2 DOI: https://doi.org/10.1007/s10072-024-07366-2
Sakai K, Hosoi Y, Harada Y, Kato Y. Association between the executive dysfunction and balance function in patients with stroke. Brain Behav 2024; 14: e3542. DOI: https://doi.org/10.1002/brb3.3542
https://doi.org/10.1002/brb3.3542 DOI: https://doi.org/10.1002/brb3.3542
Ghaffari A, Rostami HR, Akbarfahimi M. Predictors of instrumental activities of daily living performance in
patients with stroke. Occup Ther Int 2021; 6675680.
https://doi.org/10.1155/2021/6675680 DOI: https://doi.org/10.1155/2021/6675680
Ownsworth T, Shum D. Relationship between executive functions and productivity outcomes following stroke. Disabil Rehabil 2008; 30: 531–540. DOI: https://doi.org/10.1080/09638280701355694
https://doi.org/10.1080/09638280701355694 DOI: https://doi.org/10.1080/09638280701355694
Sakai K, Hosoi Y, Harada Y. Walking ability associated with executive dysfunction in patients with stroke: a cross-sectional study. Brain Sci 2023; 13: 627. DOI: https://doi.org/10.3390/brainsci13040627
https://doi.org/10.3390/brainsci13040627 DOI: https://doi.org/10.3390/brainsci13040627
Laakso HM, Hietanen M, Melkas S, Sibolt G, Curtze S, Virta M, et al. Executive function subdomains are associated with post-stroke functional outcome and permanent institutionalization. Eur J Neurol 2019; 26: 546–552. DOI: https://doi.org/10.1111/ene.13854
https://doi.org/10.1111/ene.13854 DOI: https://doi.org/10.1111/ene.13854
Sakai K, Hosoi Y, Tanabe J. Intervention and assessment of executive dysfunction in patients with stroke: a scoping review. PLOS One 2024; 19: e0298000. DOI: https://doi.org/10.1371/journal.pone.0298000
https://doi.org/10.1371/journal.pone.0298000 DOI: https://doi.org/10.1371/journal.pone.0298000
Sakai K, Hosoi Y, Harada Y, Morikawa K, Kato Y. Validity and reliability of the Japanese version of the frontal assessment battery in patients with stroke. Neurol Int 2024; 16: 1086–1093. DOI: https://doi.org/10.3390/neurolint16050081
https://doi.org/10.3390/neurolint16050081 DOI: https://doi.org/10.3390/neurolint16050081
Tamez E, Myerson J, Morris L, White DA, Baum C, Connor LT. Assessing executive abilities following acute stroke with the trail making test and digit span. Behav Neurol 2011; 24: 177–185. DOI: https://doi.org/10.1155/2011/139703
https://doi.org/10.3233/BEN-2011-0328
Wilson BA, Alderman N, Burgess PW, Emsli H, Evans JJ. Behavioral assessment of dysexecutive syndrome – manual. Bury St. Edmunds: Thames Valley Test Company; 1996.
Scarpina F, Tagini S. The Stroop color and word test. Front Psychol 2017; 8: 557. DOI: https://doi.org/10.3389/fpsyg.2017.00557
https://doi.org/10.3389/fpsyg.2017.00557 DOI: https://doi.org/10.3389/fpsyg.2017.00557
Köstering L, Schmidt CS, Egger K, Amtage F, Peter J, Klöppel S, et al. Assessment of planning performance in clinical samples: reliability and validity of the Tower of London task (TOL-F). Neuropsychologia 2015; 75: 646–655. DOI: https://doi.org/10.1016/j.neuropsychologia.2015.07.017
https://doi.org/10.1016/j.neuropsychologia.2015.07.017 DOI: https://doi.org/10.1016/j.neuropsychologia.2015.07.017
Friedman NP, Miyake A. Unity and diversity of executive functions: individual differences as a window on cognitive structure. Cortex 2017; 86: 186–204. DOI: https://doi.org/10.1016/j.cortex.2016.04.023
https://doi.org/10.1016/j.cortex.2016.04.023 DOI: https://doi.org/10.1016/j.cortex.2016.04.023
Miyake A, Friedman NP. The nature and organization of individual differences in executive functions: four general conclusions. Curr Dir Psychol Sci 2012; 21: 8–14. DOI: https://doi.org/10.1177/0963721411429458
https://doi.org/10.1177/0963721411429458 DOI: https://doi.org/10.1177/0963721411429458
Wang T-L, Hung Y-H, Yang C-C. Psychometric properties of the Taiwanese (Traditional Chinese) version of the Frontal Assessment Battery: a preliminary study. Appl Neuropsychol 2016; 23: 11–20. DOI: https://doi.org/10.1080/23279095.2014.995792
https://doi.org/10.1080/23279095.2014.995792 DOI: https://doi.org/10.1080/23279095.2014.995792
Perneczky R, Wagenpfeil S, Komossa K, Grimmer T, Diehl J, Kurz A. Mapping scores onto stages: Mini-Mental State Examination and clinical dementia rating. Am J Geriatr Psychiatry 2006; 14: 139–144. DOI: https://doi.org/10.1097/01.JGP.0000192478.82189.a8
https://doi.org/10.1097/01.JGP.0000192478.82189.a8 DOI: https://doi.org/10.1097/01.JGP.0000192478.82189.a8
Granger C. Guide for use of uniform data set for medical rehabilitation. Buffalo, NY: Buffalo General Hospital; 1986.
Schönrock-Adema J, Heijne-Penninga M, Van Hell EA, Cohen-Schotanus J. Necessary steps in factor analysis: enhancing validation studies of educational instruments. The PHEEM applied to clerks as an example. Med Teacher 2009; 31: e226–e232. DOI: https://doi.org/10.1080/01421590802516756
https://doi.org/10.1080/01421590802516756 DOI: https://doi.org/10.1080/01421590802516756
Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside. Neurology 2000; 55: 1621–1626. DOI: https://doi.org/10.1212/WNL.55.11.1621
https://doi.org/10.1212/wnl.55.11.1621 DOI: https://doi.org/10.1212/WNL.55.11.1621
Kopp B, Rösser N, Tabeling S, Stürenburg HJ, de Haan B, Karnath HO, et al. Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients. BMC Neurol 2013; 13: 179. DOI: https://doi.org/10.1186/1471-2377-13-179
https://doi.org/10.1186/1471-2377-13-179 DOI: https://doi.org/10.1186/1471-2377-13-179
Han M, Kim DY, Leigh JH, Kim MW. Value of the frontal assessment battery tool for assessing the frontal lobe function in stroke patients. Ann Rehabil Med 2020; 44: 261–272. DOI: https://doi.org/10.5535/arm.19111
https://doi.org/10.5535/arm.19111 DOI: https://doi.org/10.5535/arm.19111
Petersen SE, Posner MI. The attention system of the human brain: 20 years after. Annu Rev Neurosci 2012; 35: 73–89. DOI: https://doi.org/10.1146/annurev-neuro-062111-150525
https://doi.org/10.1146/annurev-neuro-062111-150525 DOI: https://doi.org/10.1146/annurev-neuro-062111-150525
Schmahmann JD. Ferdinando Rossi Lecture: The cerebellar cognitive affective syndrome: implications and future directions. Cerebellum 2023; 22: 947–953. DOI: https://doi.org/10.1007/s12311-022-01456-7
https://doi.org/10.1007/s12311-022-01456-7 DOI: https://doi.org/10.1007/s12311-022-01456-7
Periáñez JA, Lubrini G, García-Gutiérrez A, Ríos-Lago M. Construct validity of the Stroop color-word test: influence of speed of visual search, verbal fluency, working memory, cognitive flexibility, and conflict monitoring. Arch Clin Neuropsychol 2021; 36: 99–111. DOI: https://doi.org/10.1093/arclin/acaa034
https://doi.org/10.1093/arclin/acaa034 DOI: https://doi.org/10.1093/arclin/acaa034
Yamao A, Nagata T, Shinagawa S, Nukariya K, Ochiai Y, Kasahara H, et al. Differentiation between amnestic-mild cognitive impairment and early-stage Alzheimer’s disease using the Frontal Assessment Battery test. Psychogeriatrics 2011; 11: 235–241. DOI: https://doi.org/10.1111/j.1479-8301.2011.00377.x
https://doi.org/10.1111/j.1479-8301.2011.00377.x DOI: https://doi.org/10.1111/j.1479-8301.2011.00377.x
Lima CF, Meireles LP, Fonseca R, Castro SL, Garrett C. The Frontal Assessment Battery (FAB) in Parkinson’s disease and correlations with formal measures of executive functioning. J Neurol 2008; 255: 1756–1761. DOI: https://doi.org/10.1007/s00415-008-0024-6
https://doi.org/10.1007/s00415-008-0024-6 DOI: https://doi.org/10.1007/s00415-008-0024-6
Chapados C, Petrides M. Impairment only on the fluency subtest of the Frontal Assessment Battery after prefrontal lesions. Brain 2013; 136: 2966–2978. DOI: https://doi.org/10.1093/brain/awt228
https://doi.org/10.1093/brain/awt228 DOI: https://doi.org/10.1093/brain/awt228
Published
How to Cite
License
Copyright (c) 2025 Katsuya Sakai, Yuichiro Hosoi, Yusuke Harada, Yuichi Kato, Takayuki Miyauchi

This work is licensed under a Creative Commons Attribution 4.0 International License.
All digitalized JRM contents is available freely online. The Foundation for Rehabilitation Medicine owns the copyright for all material published until volume 40 (2008), as from volume 41 (2009) authors retain copyright to their work and as from volume 49 (2017) the journal has been published Open Access, under CC-BY-NC licences (unless otherwise specified). The CC-BY-NC licenses allow third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
From 2024, articles are published under the CC-BY licence. This license permits sharing, adapting, and using the material for any purpose, including commercial use, with the condition of providing full attribution to the original publication.