Frontal assessment battery: A tool for screening minimal hepatic encephalopathy?

Table 1 Frontal assessment battery

Frontal assessment battery

(1) Similarities

In what way are they alike?

(a) A banana and an orange

(b) A table and a chair

(c) A tulip, a rose, and a daisy

3 correct: 3

2 correct: 2

1 correct: 1

None correct: 0

(2) Lexical fluency

Say as many words as you can begin with the letter "S", except for proper nouns

(3) Motor series

Fist, palm, edge (first together, then alone)

6 correct consecutive series alone: 3

At least 3 correct consecutive series alone: 2

3 correct consecutive series with the examiner: 1

Cannot perform 3 correct consecutive series even with the examiner: 0

(4) Conflicting instructions

Tap twice when I tap once

Tap once when I tap twice

No errors: 3

1-2 errors: 2

More than 2 errors: 1

Patient imitates the taps of the examiner at least 4 consecutive times: 0

(5) Go/No Go

Tap once when I tap once

Do not tap when I tap twice

No errors: 3

1-2 errors: 2

More than 2 errors: 1

Patient imitates the taps of the examiner at least 4 consecutive times: 0

(6) Behavior

Do not touch my hands

The patient’s hands should be on his/her knees with the palm up. Without saying anything, the examiner brings his/her own hands close to the patient’s. If the patient touches the examiner’s hands, the examiner says: Now, do not touch my hands. Then, a new attempt begins

Patient does not touch the examiners hands: 3

Patient hesitates and asks what he/she has to do: 2

Patient touches the examiner’s hands without hesitation: 1

Patient touches the examiner’s hands even after he/she was told not to do so: 0

Table 2 Characterization of the cirrhotic and non-cirrhotic patients n (%)

Variables	Cirrhotic (n = 87)	Non-cirrhotic (n = 40)	P-value
Gender			0.814
Male	68 (78)	32 (80)
Female	19 (22)	8 (20)
Age range			0.001
50 yr or older	69 (79)	20 (50)
Under 50 yr	18 (21)	20 (50)
Formal schooling			0.577
None	5 (6)	3 (7.5)
1 to 3 yr	15 (17)	3 (7.5)
4 to 7 yr	33 (38)	18 (45)
8 to 11 yr	28 (32)	12 (30)
12 or more years	6 (7)	4 (10)

Table 3 Comparison of causes of cirrhosis and the underlying diseases of non-cirrhotic patients n (%)

Variables	Cirrhotic (n = 87)	Non-cirrhotic (n = 40)	P-value
Alcoholism			0.434
Yes	57 (65.5)	29 (72.5)
No	30 (34.5)	11 (27.5)
Hepatitis B surface antigen			0.864
Positive	14 (16)	7 (17.5)
Negative	72 (84)	33 (82.5)
Anti-hepatitis C virus antibodies			0.316
Positive	22 (25.6)	7 (17.5)
Negative	64 (74)	33 (82.5)
Non-alcoholic steatohepatitis/diabetes			0.007
Yes	22 (25)	2 (5)
No	65 (75)	38 (95)