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Frontal Behavioral Inventory (FBI)

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Supplemental: Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument
Construct measured: FTD-Type Behavioral and Personality Change
Generic vs. disease specific: Specific with regards to FTD dementia, but generic with regards to the presence of MND
Means of administration: Caregiver interview by research staff, by phone or in person, without patient present
Intended respondent: Caregiver
# of items: 24
# of subscales and names of sub-scales: Two subscales: Negative Behavior and Disinhibition
# of items per sub-scale: 12 each
Background: This original version of the FBI has one or two questions for each item, to clarify the question, and it is conducted as a staff-led interview. It does not distinguish between MND symptoms and behavioral changes due to FTD.
Strengths: Good reliability and validity. Widely used. Not copyrighted.
Weaknesses: Not ALS specific. At least 15 items have overlap with MND symptoms, making it difficult to disentangle MND changes from behavioral changes due to frontotemporal deterioration. It is more time consuming than the FBI-mod, which is a self-administed questionnaire given to caregivers without requiring staff involvement.
Administration time: 15-25 minutes
Psychometric Properties

Feasibility: Easy to use interview that can be completed by phone or in person, by any trained staff person.
Reliability: High interrater reliability (Cohen's kappa of .90) and item consistency (a Cronbach alpha of .89).
Validity: Discriminant function correctly classified 92.7% versus other patients (vascular dementia (VaD), Alzheimer's disease (AD), primary progressive aphasia (PPA), and depressive disorder (DD) patients.) The mean scores of FLD patients were significantly above all other groups.
Sensitivity to Change: The FBI has been shown to be sensitive to changes in behavior and personality in both the frontal variant and PPA variants of FTD (Marczinski et al.)
Relationships to other variables: This measures a behavioral construct distinct from clinical depression, PBA, and neuropsychological function (e.g. executive dysfunction).
Used in: This tool has been used widely in clinical trials and observational studies.


Items are scored according to the extent of the behavioral change: 0 = None/never; 1 = Mild, occasional; 2 = Moderate/often; 3 = Severe, most of the time.

Kertesz, A., Davidson, W., & Fox, H. (1997). Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci, 24(1), 29-36.
Kertesz, A. (1998). The quantification of behavior in frontal lobe dementia. In A. Kertesz & D. G. Munoz (Eds.), Pick's disease and Pick complex (pp. 47-67). New York: Wiley & Sons, Inc.
Kertesz, A., Nadkarni, N., Davidson, W., & Thomas, A. W. (2000). The Frontal Behavioral Inventory in the differential diagnosis of frontotemporal dementia. Journal of the International Neuropsychological Society, 6(4), 460-468.
Kertesz, A., Davidson, W., McCabe, P., & Munoz, D. (2003). Behavioral quantitation is more sensitive than cognitive testing in frontotemporal dementia. Alzheimer Disease & Associated Disorders, 17(4), 223-229.
Marczinski, C. A., Davidson, W., & Kertesz, A. (2004). A longitudinal study of behavior in frontotemporal dementia and primary progressive aphasia. Cogn Behav Neurol, 17(4), 185-190.