What is Frontotemporal Dementia?

The atrophying of the temporal and frontal lobes of the brain resulting in a permanent loss of function is known as frontotemporal dementia (FTD). Formerly known as Pick’s disease, this rare condition is a more discriminatory form of Alzheimer's disease. Adversely impacting an individual’s personality, frontotemporal dementia is a progressive disorder that is treated with medication to slow its progression and manage symptoms. Though the condition may affect anyone of middle or advanced age, those with a familial history of Alzheimer's or dementia are considered to be at an increased risk for becoming symptomatic.

The portions of the brain affected by disease onset, namely the temporal and frontal lobes, are considered to be the relay centers for all the elements that define one’s personality. A person's ability to function is primarily based on his or her behaviors, motor skills, and overall personality. Those who are diagnosed with frontotemporal lobar degeneration experience a gradual loss of their neurological and motor skills. The known, profound impact of the disease's progression often necessitates assertive measures regarding the planning of long-term care for the individual.

Early disease onset frequently manifests as progressive personality changes that impact one’s ability to be self-sufficient. Some people who have demonstrated a strong, consistent work history may suddenly become unable to sustain employment. Often, compulsive and inappropriate or aggressive behaviors, pronounced mood changes, or flat affect may impact an individual’s ability to successfully interact with co-workers, friends, and family. Some individuals who were once outgoing may start to exhibit introversion or repetitive behaviors that stifle their ability to maintain social connections.

Eventually, behavioral issues may be more complex as the person's ability to communicate becomes impaired. Many may find speaking or understanding the speech of others to be difficult and lose their ability to communicate verbally, or become mute. The gradual degeneration of one’s language abilities results in an inability to read, write, and understand verbal and written communications. The progression of neurological deficiencies further impacts the individual’s ability to move and control his or her bodily functions. Cognitive deficiencies, presenting initially as periodic memory loss, also worsen with time.

The shrinkage of brain tissue associated with frontotemporal dementia, also known as frontotemporal lobar degeneration, is considered to be triggered by cell mutation. The original moniker, Pick’s disease, was adopted more or less as an umbrella term for frontotemporal dementia. A key discovery based on cell presentation and composition contributed to the formation of an initial subtype of frontotemporal dementia that would keep the name Pick’s disease. The various, subsequent subtypes of frontotemporal dementia discovered were entirely classified on the types of brain cells affected. Despite its subtype classifications, the signs and symptoms associated with frontotemporal lobar degeneration disease remain consistent across the board of its cell-based classifications; though the severity of symptom presentations may vary dramatically from one individual to another.

When frontotemporal dementia is suspected, physicians will generally order a battery of imaging tests and blood work to confirm a diagnosis. Seeking markers indicative of atrophied or degenerative tissue, a computerized tomography (CT) scan or magnetic resonance imaging (MRI) of the brain may be performed. Blood work is employed to assess organ function and hormone and chemical levels to rule out other conditions. In some cases, neurological testing may also be utilized which involves evaluating one’s cognitive abilities, namely memory and information processing.

If individuals with this type of dementia have been diagnosed with an underlying or chronic condition, such as heart disease or clinical depression, treatment for the pre-existing condition is essential. In some cases, the existence of a secondary condition may contribute to disease progression or symptom severity. Treatment for frontotemporal dementia often involves the administration of medication to slow the disease's progression. Antipsychotic and antidepressant medications may be utilized to counteract the behavioral manifestations of frontotemporal lobar degeneration and stabilize the individual’s mood, but their use does carry significant risk for certain individuals. There is no cure for frontotemporal lobar degeneration.