The Symptoms Of Pick’s Disease
- intense restlessness
- impulsiveness, poor judgement
- changes in habits, such as overeating, craving unfamiliar foods, being rude when formerly polite
- repetitive behaviour
- aloofness from others loss of interest in things around them
- rapid mood changes
- difficulty in speaking or understanding what others are saying
- repeating what others say
- loss of ability to read or write
- memory loss
- difficulty moving around
- urinary incontinence
When speaking out his fathers condition David Baddiel said: His neurologist explained the symptoms may include incessant and obscene swearing, sexual dis-inhibition and extreme rudeness.
I said: Sorry, does he have a disease, or have you just met him? Because my father has always been like that.
When he first met my partner Morwenna at my mothers 60th birthday party, years before this diagnosis, he opened the door and said: You couple of c**** are late.
What Is Frontotemporal Dementia
Dementia describes a group of symptoms that can include problems with memory, thinking or language, and changes in mood, emotions and behaviour. It is caused when the brain is damaged by disease.
The word frontotemporal refers to the two sets of lobes in the brain that are damaged in this type of dementia. FTD occurs when disease damages nerve cells in these lobes.
This causes the connections between them and other parts of the brain to break down. The levels of chemical messengers in the brain also get lower over time. These messengers allow nerve cells to send signals to each other and the rest of the body.
As more and more nerve cells are damaged and die, the brain tissue in the frontal and temporal lobes starts to get smaller.
What Is The Follow
After Pick disease has been diagnosed and treatment has begun, the individual requires regular checkups with his or her health care provider.
- These checkups allow the health care provider to see how well treatment is working and to make adjustments as necessary.
- They allow detection of new medical and behavior problems that could benefit from treatment.
- These visits also give the family caregiver an opportunity to discuss problems in the individuals care.
Eventually, the person with Pick disease will become unable to care for himself or herself, or even to make decisions about his or her care.
- It is best for the person to discuss future care arrangements with family members as early as possible, so that his or her wishes can be clarified and documented for the future.
- Your health care provider can advise you about legal arrangements that should be made to ensure that these wishes are observed.
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What Do The Terms Mean
One of the challenges shared by people living with these disorders, families, clinicians, and researchers is what terminology to use. Here, we have used the term frontotemporal disorders to characterize this group of diseases and the abbreviation FTD, which is commonly used to refer to them. Other terms used include frontotemporal lobar degeneration and frontotemporal dementia, but it’s important to note that with some frontotemporal disorders, the primary symptoms are problems with speech or movement, rather than dementia symptoms. Physicians and psychologists diagnose the different forms of FTD based on a persons symptoms as well as the results of brain scans and genetic tests.
What Causes Pick’s Disease
Pick’s disease is thought to be caused by abnormal clustering of tau proteins in the frontal and temporal lobes of the brain. These protein clumps are known as Pick bodies. As they gather in these lobes, brain cells begin to die, causing emotional, behavioral, and cognitive changes in your functioning.
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How Is Frontotemporal Dementia Diagnosed
It is important that someone with suspected FTD is assessed by a neurologist, geriatrician or psychiatrist specialising in dementia to establish the diagnosis. A typical assessment would include a detailed medical history, a physical examination, blood and urine tests, a psychiatric assessment, a neuropsychological assessment and brain imaging.
The presence of changes in the frontal and temporal lobes on MRI scans is critical for an accurate diagnosis. Neuropsychological tests to identify specific problems in areas such as comprehension and problem solving also help establish the diagnosis.
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What Research Is Being Done
The National Institute of Neurological Disorders and Stroke and other institutes of the National Institutes of Health conduct and fund research on FTD. Among several research projects, scientists hope to identify novel genes involved with FTD, perhaps leading to therapeutic approaches where delivery of normal genes would improve or restore brain function. Clinical imaging may help researchers better understand changes in the brains of people with FTD, as well as help diagnose these disorders. Other projects are aimed a better understanding the toxic effects of protein buildup and how it is related to the development of FTD and related dementias.
Information from the National Library of Medicines MedlinePlus
The National Institute of Neurological Disorders and Stroke and other institutes of the National Institutes of Health conduct and fund research on FTD. Among several research projects, scientists hope to identify novel genes involved with FTD, perhaps leading to therapeutic approaches where delivery of normal genes would improve or restore brain function. Clinical imaging may help researchers better understand changes in the brains of people with FTD, as well as help diagnose these disorders. Other projects are aimed a better understanding the toxic effects of protein buildup and how it is related to the development of FTD and related dementias.
Information from the National Library of Medicines MedlinePlus
Alzheimers And Picks Disease: How They Differ
Clinically, Picks disease differs from AD in affecting personality before memory shows deterioration. Changes in personality can include poor social judgment, disinhibition, vulgarity, and restlessness. Some patients steal or show repetitive, compulsive behaviors. Many patients become irritable, agitated, or depressed. Others are more apathetic.
Self-awareness can be very limited. Language is affected early and eating behaviors are sometimes affected. Incontinence typically occurs earlier than in AD. A peculiar occurrence in some individuals is the development of artistic talents during the progression of dementia. Diagnosis is made on a clinical basis, although genetic testing can confirm some specific subtypes. Atrophy of the frontal and temporal lobes may be apparent on MRI.
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What Are The Symptoms Of Frontotemporal Dementia
Frontotemporal dementia affects everyone differently. Its symptoms vary a lot and depend on which areas of the frontal and temporal lobes are damaged and so the type of FTD the person has.
As with most forms of dementia, FTD is progressive. This means its symptoms may be mild at first, but they will get worse over time.
Find out more about FTD symptoms below.
Behavioural variant FTD
Precision Medicine For Frontotemporal Dementia
- 1Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
- 2Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- 3Department of Neurology, Memory and Aging Centre, University of California, San Francisco, San Francisco, CA, United States
- 4Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- 5Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom
- 6College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
- 7Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
- 8Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
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Treatment Management And What To Expect
The rate of progression of symptoms can vary, but eventually the behavioral and cognitive symptoms will become more pronounced. Significant impairment in daily activities of living may require additional support, such as residency in a full-time care facility outside the home.
As with all forms of FTD, there are no treatments for bvFTD, and in most cases its progression cannot be slowed. Behavioral and environmental interventions are currently considered to be the most effective way to manage symptoms. Challenging disruptive behaviors can cause more agitation, while reassuring and distracting tactics are considered to be more helpful.
Pharmacotherapy options are limited and the evidence for using medications developed for other conditions are based mainly on small open label studies or individual case reports. Some individuals with bvFTD may benefit from taking a selective serotonin reuptake inhibitor to address symptoms such as apathy, irritability, and disinhibited behavior. Small, controlled clinical trials provide evidence for improvement with trazodone, an anti-depressant, showing improvement in eating behaviors and depression.
Atypical antipsychotics such as risperidone, olzanzapine, and quetiapine have been used to treat agitation, but they can also bring increased risk from unwanted side effects and are not approved for use in FTD.
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Are There Options For Treatment
Today, there is no cure for FTD. Unfortunately, no current treatments slow or stop the progression of the disease. However, if you or a family member or loved one are affected, there are important steps that you can take to preserve and maximize quality of life. A growing number of interventions not limited to medication can help with managing FTD symptoms.
It is important for you and your care partner to identify a team of experts who can help with coordinating care and with the legal, financial, and emotional challenges brought on by this disease.
What Causes Frontotemporal Dementia
FTD is caused by brain disease, but why some people get the disease is unknown .
People with FTD can have one of a number of different underlying changes in brain cells. These various cellular changes generally can not be observed during life, but only with a brain autopsy to identify the changes under a microscope. Cellular studies of the brain have shown that there are two types of protein which accumulate in brain cells in FTD tau and TDP-43. These protein accumulations damage and kill brain cells in the frontal and/or temporal lobes. As the disease progresses, these regions show shrinkage detectable on MRI scans.
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There Are Two Broad Types Of Frontotemporal Dementia:
- Behavioural variant FTD where damage to the frontal lobes of the brain mainly causes problems with behaviour and personality. These lobes are found behind the forehead and process information that affects how we behave and the control of our emotions. They also help us to plan, solve problems and focus for long enough to finish a task.
- Primary progressive aphasia occurs when damage to the temporal lobes on either side of the head nearest the ears causes language problems. This part of the brain has many roles. A key function of the left temporal lobe is to store the meanings of words and the names of objects. The right temporal lobe helps most people recognise familiar faces and objects.
The first noticeable symptoms for a person with FTD will be changes to their personality and behaviour and/or difficulties with language.
These are very different from the early symptoms of more common types of dementia. For example, in Alzheimers disease, early changes are often problems with day-to-day memory. In the early stages of FTD, many people can still remember recent events.
Causes Of Frontotemporal Dementia
Frontotemporal dementia is caused by clumps of abnormal protein forming inside brain cells. These are thought to damage the cells and stop them working properly.
The proteins mainly build up in the frontal and temporal lobes of the brain at the front and sides. These are important for controlling language, behaviour, and the ability to plan and organise.
It’s not fully understood why this happens, but there’s often a genetic link. Around 1 in 8 people who get frontotemporal dementia will have relatives who were also affected by the condition.
If you have a family history of frontotemporal dementia, you may want to consider talking to your doctor about being referred to a geneticist and possibly having a genetic test to see if you’re at risk.
There’s a lot of research being done to try to improve understanding of the causes of frontotemporal dementia so treatments can be discovered.
If you’re interested in helping with research, you can speak to a doctor or register your interest on Join Dementia Research.
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Who Gets Frontotemporal Dementia
FTD can affect anybody. It typically affects people at a younger age than Alzheimers disease, with symptoms beginning in the 50s or 60s, and sometimes younger.
Almost a third of people with FTD have a family history of dementia. However, only about 10-15% of cases have familial FTD, in which a gene mutation is passed on that causes the disease.
The genetic basis of FTD is not fully understood and is actively being researched.
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What Is A Picks Disease Sufferers Life Expectancy
Picks disease unfortunately cannot be cured but it can be managed, especially if it is caught early on.
The patient can have behaviour modification therapies to reinforce appropriate behaviours, they can also have speech therapy and glasses or hearing aids to help combat sensory issues.
It is a progressive disease and the life expectancy of a sufferer is between two and ten years, due to the general failure of the bodys systems rather than the disease itself.
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What Is The Medical Treatment For Pick Disease
Even though Pick disease is not reversible, treatment can slow the progression of symptoms in some people. Relieving symptoms can improve function significantly. Some of the important treatment strategies in dementia are described here.
Nondrug treatment
Behavior disorders such as agitation and aggression may improve with various interventions. Some interventions focus on helping the individual adjust or control his or her behavior. Others focus on helping caregivers and other family members change the persons behavior. These approaches sometimes work better when combined with drug treatment.
Drug treatment
The symptoms of Pick disease can sometimes be relieved, at least temporarily, by medication. Many different types of medications have been or are being tried in dementia. One group of drugs used in Alzheimer’s disease, the cholinesterase inhibitors, has been tried in Pick disease.
- These drugs increase the levels of acetylcholine, a brain hormone related to memory and attention.
- These drugs are not a cure. They improve speech and language in some people with the disease. In other people, they have no effect.
- Many people with Pick disease cannot take one of these drugs, donepezil , because the drug can worsen symptoms such as agitation and aggression.
Other drugs are being used in people with Pick disease. On the basis of what we know from research about the disease, these drugs may help.
Certain drugs are used to treat specific symptoms or behavior changes.
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Support Groups And Counseling For Pick Disease
If you are a caregiver for a person with Pick disease, you know that the disease tends to be more stressful for the family members than for the affected person. Caring for a person with dementia can be very difficult. It affects every aspect of your life, including family relationships, work, financial status, social life, and physical and mental health.
- You may feel unable to cope with the demands of caring for a dependent, difficult relative.
- Besides the sadness of seeing the effects of your loved ones disease, you may feel frustrated, overwhelmed, resentful, and angry.
- These feelings may, in turn, leave you feeling guilty, ashamed, and anxious.
- Depression is not uncommon but usually gets better with treatment.
Caregivers have different thresholds for tolerating these challenges.
- For many caregivers, just venting or talking about the frustrations of caregiving can be enormously helpful.
- Others need more support but may feel uneasy about asking for the help they need.
- One thing is certain, though: If the caregiver is given no relief, he or she can burn out, develop his or her own mental and physical problems, and become unable to care for the affected person.
Support groups meet in person, on the telephone, or on the Internet. To find a support group that works for you, contact the organizations listed below. You can also ask your health care provider or behavior therapist, or go on the Internet. If you do not have access to the Internet, go to the public library.