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      Persian version of frontal assessment battery: Correlations with formal measures of executive functioning and providing normative data for Persian population

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          Abstract

          Background: Cognitive impairment in patients with Parkinson’s disease (PD) mainly involves executive function (EF). The frontal assessment battery (FAB) is an efficient tool for the assessment of EFs. The aims of this study were to determine the validity and reliability of the psychometric properties of the Persian version of FAB and assess its correlation with formal measures of EFs to provide normative data for the Persian version of FAB in patients with PD.

          Methods: The study recruited 149 healthy participants and 49 patients with idiopathic PD. In PD patients, FAB results were compared to their performance on EF tests. Reliability analysis involved test-retest reliability and internal consistency, whereas validity analysis involved convergent validity approach. FAB scores compared in normal controls and in PD patients matched for age, education, and Mini-Mental State Examination (MMSE) score.

          Results: In PD patients, FAB scores were significantly decreased compared to normal controls, and correlated with Stroop test and Wisconsin Card Sorting Test (WCST). In healthy subjects, FAB scores varied according to the age, education, and MMSE. In the FAB subtest analysis, the performances of PD patients were worse than the healthy participants on similarities, fluency tasks, and Luria’s motor series.

          Conclusion: Persian version of FAB could be used as a reliable scale for the assessment of frontal lobe functions in Iranian patients with PD. Furthermore, normative data provided for the Persian version of this test improve the accuracy and confidence in the clinical application of the FAB.

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          Striatonigrostriatal pathways in primates form an ascending spiral from the shell to the dorsolateral striatum.

          Suzanne N Haber, Julie L Fudge, Nikolaus R. McFarland (2000)
          Clinical manifestations in diseases affecting the dopamine system include deficits in emotional, cognitive, and motor function. Although the parallel organization of specific corticostriatal pathways is well documented, mechanisms by which dopamine might integrate information across different cortical/basal ganglia circuits are less well understood. We analyzed a collection of retrograde and anterograde tracing studies to understand how the striatonigrostriatal (SNS) subcircuit directs information flow between ventromedial (limbic), central (associative), and dorsolateral (motor) striatal regions. When viewed as a whole, the ventromedial striatum projects to a wide range of the dopamine cells and receives a relatively small dopamine input. In contrast, the dorsolateral striatum (DLS) receives input from a broad expanse of dopamine cells and has a confined input to the substantia nigra (SN). The central striatum (CS) receives input from and projects to a relatively wide range of the SN. The SNS projection from each striatal region contains three substantia nigra components: a dorsal group of nigrostriatal projecting cells, a central region containing both nigrostriatal projecting cells and its reciprocal striatonigral terminal fields, and a ventral region that receives a specific striatonigral projection but does not contain its reciprocal nigrostriatal projection. Examination of results from multiple tracing experiments simultaneously demonstrates an interface between different striatal regions via the midbrain dopamine cells that forms an ascending spiral between regions. The shell influences the core, the core influences the central striatum, and the central striatum influences the dorsolateral striatum. This anatomical arrangement creates a hierarchy of information flow and provides an anatomical basis for the limbic/cognitive/motor interface via the ventral midbrain.
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            Non-motor symptoms in Parkinson's disease.

            W Poewe (2008)
            Although still considered a paradigmatic movement disorder, Parkinson's disease (PD) is associated with a broad spectrum of non-motor symptoms. These include disorders of mood and affect with apathy, anhedonia and depression, cognitive dysfunction and hallucinosis, as well as complex behavioural disorders. Sensory dysfunction with hyposmia or pain is almost universal, as are disturbances of sleep-wake cycle regulation. Autonomic dysfunction including orthostatic hypotension, urogenital dysfunction and constipation is also present to some degree in a majority of patients. Whilst overall non-motor symptoms become increasingly prevalent with advancing disease, many of them can also antedate the first occurrence of motor signs - most notably depression, hyposmia or rapid eye movement sleep behaviour disorder (RBD). Although exact clinicopathological correlations for most of these non-motor features are still poorly understood, the occurrence of constipation, RBD or hyposmia prior to the onset of clinically overt motor dysfunction would appear consistent with the ascending hypothesis of PD pathology proposed by Braak and colleagues. Screening these early non-motor features might, therefore, be one approach towards early 'preclinical' diagnosis of PD. This review article provides an overview of the clinical spectrum of non-motor symptoms in PD together with a brief review of treatment options.
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              What features improve the accuracy of clinical diagnosis in Parkinson's disease: a clinicopathologic study.

              A J Hughes, Y Ben-Shlomo, S Daniel … (1992)
              Many authorities have drawn attention to the difficulties in clinically distinguishing Parkinson's disease (PD) from other parkinsonian syndromes. We assessed the clinical features of 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic PD according to their pathologic findings. Seventy-six percent of these cases were confirmed to have PD. By using selected criteria (asymmetrical onset, no atypical features, and no possible etiology for another parkinsonian syndrome) the proportion of true PD cases identified was increased to 93%, but 32% of pathologically confirmed cases were rejected on this basis. These observations suggest that studies based on consultant diagnosis of PD, using standard diagnostic criteria, will include cases other than PD, thus distorting results from clinical trials and epidemiologic studies. The strict use of additional criteria can reduce misdiagnosis but at the cost of excluding genuine PD cases.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Iran J Neurol
                Journal ID (iso-abbrev): Iran J Neurol
                Journal ID (publisher-id): IJNL
                Title: Iranian Journal of Neurology
                Publisher: Tehran University of Medical Sciences (Tehran, Iran )
                ISSN (Print): 2008-384X
                ISSN (Electronic): 2252-0058
                Publication date (Print): 5 January 2016
                Volume: 15
                Issue: 1
                Pages: 16-22
                Affiliations
                [1 ]Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [2 ]School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [3 ]Department of Neurology, School of Medicine AND Loghman Hospital, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Corresponding Author: Farzad Ashrafi farzad.ashrafi@ 123456gmail.com
                Article
                Publisher ID: IJNL-15-16
                PMC ID: 4852066
                PubMed ID: 27141272
                SO-VID: 164ce17f-e8dc-45c6-9b85-5b1c574f5545
                Copyright © Copyright © 2015 Iranian Neurological Association, and Tehran University of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 27 June 2015
                Date accepted : 15 October 2015
                Categories
                Subject: Original Article

                Keywords: frontal lobe,executive function,outcome and process assessment,mental status,persian,iran
                Data availability:
                Keywords: frontal lobe, executive function, outcome and process assessment, mental status, persian, iran

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