Frontotemporal dementia (FTD) is a rarer form of dementia. She was formerly also called Pick’s disease or Pick’s disease. Unlike other forms of dementia, memory is largely preserved here. Instead, FTD patients show conspicuous and antisocial behavior. Only later does the frontotemporal dementia resemble Alzheimer’s dementia. Read more about Frontotemporal Dementia: Causes, Symptoms, Diagnosis and Therapy!
Frontotemporal dementia: description
The term frontotemporal dementia (FTD) is colloquially used for a group of disorders whose main symptoms are changes in personality, social behavior and language skills. The technical term for this group of diseases is actually frontotemporal lobar degeneration (FTLD). The FTD is strictly speaking only a sub-form of the FTLD. In total, there are three such subforms:
- Frontotemporal dementia (FTD)
- Semantic dementia
- Progressive non-fluid aphasia
Also in this article, the term frontotemporal dementia is simplified for the frontotemporal lobar degenerations.
Previously, this syndrome was also called Pick’s disease or Pick’s disease.
Frontotemporal dementia: frequency
Frontotemporal dementia is a rare form of dementia. It accounts for approximately three to nine percent of all dementia. The disease breaks out on average between the ages of 50 and 60; However, the range of the age of onset is very large: it is 20 to 85 years. According to studies, frontotemporal dementia is equally common in men and women.
Frontotemporal dementia: symptoms
Nerve cells in the frontal and temporal lobes of the brain are the cause of frontotemporal dementia. Among other things, the symptoms depend on which part of the cerebrum exactly the nerve cells die off.
Frontotemporal dementia in the narrower sense
In the form of frontotemporal dementia, the personality and the interpersonal behavior of the patient first of all change. The most important symptoms are:
- superficial, careless, unfocused and thoughtless behavior
- Neglect of duties
- decreasing interest in one’s own family and hobbies
- Indifference, listlessness and apathy
- sometimes increasing tactlessness towards others, irritability and aggressiveness
- often violation of social norms
- sometimes weird rituals and repetitive behaviors
- Cravings (especially on sweets) and great preference for certain foods
- Neglect of physical hygiene
- hardly disease insight (that is, the patients consider themselves healthy)
In the further course, the frontotemporal dementia leads to speech disorders (up to complete silence) and memory disorders. But the latter are not as severe as Alzheimer’s for a long time.
Patients find it increasingly difficult to cope with everyday life. It comes to incontinence and sometimes to neurological symptoms such as Parkinson’s disease (gait disorder, movement disorders) and dysphagia.
In the terminal stage, the frontotemporal dementia leads to complete care.
Semantic dementia and progressive non-fluid aphasia
The other two subtypes of the FTLD focus on language and language disorders. However, here too, the personality and behavior of the patient can change.
People who semantic dementia suffer, increasingly forget the meaning of words: The vocabulary decreases, but those affected can still speak fluent and grammatically correct. Later, familiar faces are no longer recognized. Mostly the personality and the behavior of the patient also change.
The progressive non-fluid aphasia is characterized by pronounced word finding disorders. Patients have difficulty talking and often make mistakes in grammar or pronunciation. In contrast, brain functions such as memory, thinking, orientation and functioning in everyday life remain long preserved.
Frontotemporal dementia: causes and risk factors
Frontotemporal dementia is characterized by the destruction of nerve cells in the frontal lobe and in the two temporal lobes. How this happens is not known in most cases. However, in about ten percent of patients, frontotemporal dementia is triggered by changes (mutations) in certain genes. Then several blood relatives can show similar diseases.
Apart from such mutations, there are no known risk factors for frontotemporal dementia.
Frontotemporal dementia: diagnosis
Frontotemporal dementia is not easy to diagnose. If it is initially expressed primarily through changes in personality and behavior, it is often confused with mental disorders such as depression, burn-out syndrome, schizophrenia or mania. At an advanced stage, FTD is barely distinguishable from Alzheimer’s dementia.
The diagnosis is based – as generally suspected dementia – mainly on the collection of medical history (Anamnesis), one physical examination and psychological tests (dementia tests). The doctor can also be described by relatives the changes in the personality and behavior of the patient.
Frontotemporal dementia causes brain tissue in the frontal and temporal lobes to shrink (due to the death of nerve cells). This shrinkage (atrophy) can be achieved by means of Computed tomography (CT) and Magnetic Resonance Imaging (MRI) figuratively.
As a result of cell death, energy consumption (sugar consumption) in forehead or temporal lobes decreases in the course of the disease. This altered metabolic activity can be seen with the Positron emission tomography (PET) prove.
There are no specific laboratory tests that can reliably detect the frontotemporal dementia. However, you can have one Sample of cerebrospinal fluid (CSF) and determine protein such as total tau or beta-amyloid. This CSF diagnosis can sometimes help distinguish frontotemporal dementia from Alzheimer’s disease.
If there are already blood relatives with FTD, can Genetic Testing Bring clarity.
Frontotemporal dementia: treatment
There are no medications that have been proven to help with the symptoms of Frontotemporal Dementia. Some patients benefit from so-called serotonergic antidepressants (such as citalopram, sertraline): these drugs have a boosting effect. If the frontotemporal dementia is associated with severe restlessness and aggressiveness, neuroleptics such as melperone, quetiapine or olanzapine can be tried.
Non-drug treatment of FTD
Non-drug interventions are very important in the treatment of frontotemporal dementia. In individual cases it is decided which measures are the most sensible for a patient. For example, sport can help against increased aggressiveness. If the frontotemporal dementia accompanied by withdrawal and apathy, especially music, dance and art therapy are recommended.
Frontotemporal dementia: course and prognosis
Frontotemporal dementia is not curable so far. After the onset of the first symptoms, an average of eight years pass before the patients die. However, the Frontotemporal dementia also unusually fast (disease duration: two years) or very slowly (15 years).