Assessing the Behavioral Consequences of Multiple Sclerosis: An Application of the Frontal Systems Behavior Scale (FrSBe)

Objective: The current study examines the utility of the Frontal Systems Behavior Scale (FrSBe) to document behavioral changes in people with multiple sclerosis (MS). Background: MS results in widespread central nervous system lesions that have a propensity for affecting frontal and parietal brain regions. As a result, behavioral symptoms may present, including disorders of executive functioning, apathy, and disinhibition. Method: Twenty-six people with MS and 15 healthy controls (HC) underwent neuropsychological testing and completed the Frontal Systems Behavior Scale (FrSBe), and measures of emotional functioning. Results: Behavioral ratings for the MS group prior to illness were equivalent to those of the HC group. After illness however, a clinically and statistically significant increase was noted on two of three FrSBe scales, the apathy scale and the executive dysfunction scale. Relationships were also noted between the FrSBe family and self-report forms after illness and measures of neuropsychological performance, particularly information processing, working memory, and executive control. In contrast, physical disease progression was correlated with family ratings of behavior, but not self-ratings. Conclusions: The FrSBe appears to be a sensitive measure of behavioral change in people with MS. Self-ratings and family ratings of behavioral changes are related to measures of neuropsychological performance. However, physical symptoms of MS are related only to the family ratings of behavior.