Frontal lobe test

Question 1

1. Assess verbal fluency

Answer 1

The Patient is asked to name as many words as possible beginning with either the letters ‘F, A or
S’ in one minute. (Ideally all three ought to be tested). Normal subjects should produce at least 15
words for each letter. Less than 10 items is definitely abnormal.
Alternatively you can use a category (name as many animals as possible in one minute). Typical
categories used to test include animals, fruits, vehicles etc.

Question 2

2. Assessment of abstraction

Answer 2

Proverb interpretation
Ask the patient the meaning of two common proverbs:
Example 1: Too many cooks spoil the broth
Example 2: A stitch in time saves nine.

Similarities
The patient is asked to explain the similarities between things (use things that are routinely used).
Example:
a. Table and chair
b. Apple and orange.
c. Glass and ice

Cognitive Estimation: Ask the patient to make estimates such as
• What is the height of an average English man?
• How many camels are there in England?

Question 3

3. Co-ordinated movements (tests response inhibition and set shifting)

Answer 3

Alternate sequence
An alternative sequence of squares and triangles are shown to the patient and they are asked to
copy it.

Go-no-go test
Ask the patient to place a hand on the table and to raise one finger in response to a single tap,
while holding still in response to two taps. You tap on the under surface of the table to avoid
giving visual cues.

Luria three-step task
A sequence of hand positions is demonstrated which would be placing a fist, then edge of the
palm and then a flat palm onto the palm of the opposite hand and repeating the sequence (fistedge-palm)
It can be demonstrated up to five times.

Question 4

4. Frontal Lobe Release Signs

Answer 4

Glabellar tap: Tap between the patients’ eyebrows, which causes repeated blinking even after
five or more taps, if it is positive.

Primitive reflex: This would include Grasp reflex in which you stroke the patient’s palm while
distracting the patient, watch for involuntary grasping and pouting reflex in which you tap on a
spatula on patient’s lips, resulting in spouting and both reflexes can be subtle.