Frontotemporal Dementia (Picks Disease)

Frontotemporal dementia (Pick's disease) is a form of dementia characterised by gradually worsening decline of mental abilities. The disease often affects a person's ability to use and understand spoken and written language. It can also affect personality, social behaviour, reasoning, problem solving, and memory.

Frontotemporal dementia (Pick's disease) makes up about 2–3% of all cases of dementia. This is the third most common cause of dementia, after Alzheimer's disease and diffuse Lewy-body dementia (excluding dementia caused by strokes).

Frontotemporal dementia usually develops between 50 and 70 years of age. The male:female ratio is equal.

The specific cause of frontotemporal dementia is unknown. In a small number of cases, the disease is hereditary, meaning that it runs in the family. However, there is no linkage in most cases.

The symptoms of frontotemporal dementia vary widely from person to person. The symptoms are usually very subtle at first and worsen slowly. The rate of deterioration also varies from person to person.

The earliest symptoms are usually changes in behaviour, mood, or personality. This may manifest as depression, aggressive or antisocial behaviours, lack of inhibition, lack of forward planning and so on. In addition, the patient may lose the ability to communicate normally. They may have trouble finding the right word, may speak less, or may stop speaking altogether. They may lose the ability to understand written, spoken, or signed language. Memory may also be affected at a later stage, however this tends to be relatively less severe compared to the effects on speech and personality.

Tests which may be helpful in aiding the diagnosis include:

Psychology assessmentCT/MRI brain scan: shrinking of the frontal and temporal lobes of the brainPET scan: may show decreased blood flow to the frontal or temporal lobesEEG: this is usually normal.

Frontotemporal dementia runs a progressive course, leading to increasing personal disability. The average time from diagnosis to death is 8 years, however, some patients progress much more slowly.

There is no cure for frontotemporal dementia. Treatment is aimed at improving behaviour and mood problems and relieving other symptoms. For example, a speech therapist may be able to help the person improve his or her ability to communicate. Medication can be helpful in treating depressive symptoms. Selective serotonin reuptake inhibitors (SSRIs) have been trialled in patients with FTD, though there is no strong evidence for their us.

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