Sensitivity, specificity and predictive value of the BADS to anterior executive dysfunction

Abstract

In this study we investigated the validity of the BADS subtests to adequately discriminate anterior lesions (AL) from posterior lesions (PL). Therefore, we compared the performances of 30 AL patients, 22 PL patients and 29 healthy controls (HC) on the BADS subtests. Seven standard executive test variables were also examined. Our multiple comparisons showed that the BADS Zoo Map–Part 1 was not indicative for AL, whereas Rule Shifting, Action Programme, Key Search, Zoo Map–total score, and BADS–total score were found to be sensitive to AL. More importantly, the Modified Six Element Test (MSET), and the Zoo Map–Part 2 were highly specific for AL. In both BADS subtests AL patients performed significantly worse than either the PL or the HC groups, whereas no significant differences on the same variables were found between PL and HC individuals. Further logistic regression analysis revealed that the BADSMSET was the best predictor for distinguishing AL from PL patients, correctly classifying 78.8% of the patients. These results suggest that the BADSMSET is an accurate screening tool for the detection of anterior pathology. Poor performance on this BADS subtest is a significant indicator of executive dysfunctioning after anterior brain damage.

Keywords:

• Neuropsychological assessment
• Executive functioning
• Ecological validity
• Brain injury
• Frontal lobes.

The authors thank all the participants and their therapists as well as the healthcare institutions that participated in this study: Rehabilitation Centre “Anagennisi” (Nea Redestos, Thessaloniki, Greece) and Saint Lukas Clinic (Panorama, Thessaloniki, Greece).